Dados do Resumo

Título

Familial Melanoma Clinic - 14 years' experience

Descrição da inciativa

The Familial Melanoma Outpatient Clinic (FMOclinic) was conceived based on the expertise acquired from the GenoMel Project (2007) (melanoma genetics), an international, multicenter study, of which A.C.Camargo was the coordinating institution and I was the research nurse coordinator. During the project, we identified and included in the study around 65 families (and their first- and second-degree relatives) who met the clinical criteria for Familial Melanoma Syndrome. With the end of the study, we had to think of a way to maintain the care of these families and others that would come, in a structured and efficient way. So, we started talking to the Social Service about making a kind of specific agreement feasible so that the cancer-free family members of the so-called index cases (those who are affected by the disease) could also benefit from annual follow-up; since, in the context of hereditary cancer predisposition syndrome, one of the differentials is to also follow up family members. We therefore decided that the first-degree relatives of the index cases without cancer could have an annual visit to the FMO clinic, have any suspicious lesions removed and receive the necessary treatment. The main objective of this form of follow-up is primary and secondary prevention; in other words, screening, surveillance and guidance for the high-risk population and early diagnosis, which makes all the difference to the patient's prognosis. The FMOclinic was set up in 2010 and today we have more than 500 families registered, many of them with their families also being monitored. The consultations include a detailed personal and family anamnesis, a complete dermatological examination (total body mapping and dermoscopy of melanocytic lesions), as well as an analysis of risk phenotypes. There are many benefits, such as: new melanomas diagnosed at an early stage (with smaller thicknesses than the first melanoma), surveillance and personalized follow-up, with well-defined partnerships with oncogenetics and molecular diagnostics. There have been 10 articles published over these 14 years of the FMOclinic, always with the support and recognition of the head of the Skin Cancer Department, and the rich contribution of some professionals who are no longer in the group. The FMOclinic continues to take place every Thursday at the Skin Cancer Department, under the coordination of myself and Dr. Bianca Costa Soares de Sá. About two years ago, Dr. Joyce Gouvea Freire (dermatologist) joined us.

Impacto e resultados

The impact of awareness among the high-risk population for melanoma development is very important. In addition, there is a real and practical impact, which is the early diagnosis of new primary melanomas in this population, which might not have been possible without a rigorous surveillance program like the one we have; not to mention the opportunities that have arisen from relatives without cancer being diagnosed during visits to the FMOclinic. In addition, there is continuous learning, since discoveries regarding hereditary cancer predisposition syndromes are so dynamic and require continued study and development. We have also made a significant scientific contribution, with 10 articles over the years and the potential for others.