“I always knew I wanted to be a doctor and specialize in oncology,” says, Dr. Anna Pavlick of the NYU Cancer Institute. “Growing up in a small town in New Jersey, I’d read the Weekly Reader, which would have articles on cancer, explaining what cancer cells looked like, and why they were bad. I knew then that any doctor working on a cure for cancer would have to be smart and dedicated and I knew I was up to being just that.”

Pavlick attended undergraduate school at Fairfield University, with a double major in pre-med biology and nursing. It was for her the best of both worlds: pre-med biology would give her a solid grounding for medical school and nursing would give her “hands-on patient experience.” This was followed by a Master’s degree in anatomy at Fairleigh Dickinson University, and then medical school at the University of Medicine and Dentistry of New Jersey. Her initial focus was internal medicine followed by a three-year fellowship at Memorial Sloan-Kettering Center where she trained in hematology and oncology. Since March of 1999, Anna has been at the NYU Cancer Center caring for patients with melanoma, the most serious form of skin cancer. May is National Melanoma/Skin Cancer Awareness Month.

Unfortunately, melanoma is on the rise: Anna sees about 75 patients a week (ranging in age from 16 to 97) who have been diagnosed as “high risk” meaning they’ve had melanoma tumors that are deep (larger than one millimeter) or they’ve had a melanoma tumor in their lymph node(s). Approximately 50 percent of this group will develop metastatic melanoma. The survival rates once a melanoma has metastasized (spread to other parts of the body such as the liver, lungs or brain) are grim and typically range from six months to six years with an average of two years. Anna is seeing younger and younger patients: For women between the ages of 25 and 35, melanoma is the leading cause of death.

Who Is at Risk

People most at risk include: 1) those who’ve had excessive sun exposure through sun bathing and such outdoor sports as golf; 2) individuals who burn frequently, and, who are typically blue-eyed, fair-skinned, and freckled. However, Pavlick cautions, “I am seeing an increase in skin cancer in all populations, including African-Americans, who often get melanomas on their palms and the soles of their feet.” Less than 10 percent of melanomas are genetically pre-disposed, but there is a correlation between pancreatic cancer and melanomas. “They both come from the same genetic family.”

Melanoma Prevention

Prevention is key and as Pavlick notes, “There is much that individuals can do to both prevent melanoma from developing in the first place, and to detect it early, when it can be very treatable. As she advocates, “Practice sun protection. Wear wide-brimmed hats and use sun screen.” Melanomas can occur in many parts of the body, including the eye. Known as ocular melanoma, these melanomas are found in the retina part of the eye. Wearing sun glasses are an important protection for the eyes. Clothing manufacturers have also developed “sun-protective clothing” with sun screen imbedded in the fabric. You mention tanning salons and Anna has a prepared sermon: “Tanning salons are particularly harmful to young girls who often frequent them because unlike other things they don’t need parental consent and it’s the thing to do before their big prom nights. They have the attitude: ‘I look healthy when I’m tan.’” Dr. Pavlick relates because she “too was a Jersey sun girl.”

Early Detection Is Critical

While melanoma becomes deadly when it’s metastasized, early detection is critical. It’s important to see a dermatologist for full-body examinations at least yearly and for individuals at risk even more frequently, every three to six months. Self-examination is also key and Pavlick points out the “ABCDE” rule for moles and melanoma: Asymmetry, Border Irregularity, Color, Diameter, and Evolving.

Asymmetry – Does half of a mole look different from the other?

Border Irregularity –Is the edge of the mole ragged, or blurred?

Color – Does the mole have a variety of colors and hues within the same lesion?

Diameter – What is the size of the mole? Melanomas are usually greater than 6 millimeters.

Evolving – An evolving lesion is one that is changing in terms of the five S’s: size, shape, symptoms (itching or tenderness), surface bleeding, or shades of color.

Pavlick says with regard to moles and melanoma, “You can have a pre-existing mole or a brand new one that becomes melanoma. Freckles don’t become melanomas.”

Treatment

“Because my patients are high risk I don’t tell them their cancer is curable, but I do try to give them hope: healing doesn’t always mean curing.” Unfortunately, melanoma is not readily treatable with chemotherapy. “Standard chemotherapy treatments, while not useless, are not home runs either.”

But Anna is on a mission and her mission is to see vast improvements in the current therapies available to treat melanoma. She spends two days a week, doing clinical research focusing on identifying risk factors and markers of melanoma progression and, the development of therapies that will be effective in the treatment of melanoma.

She describes NYU’s program as “cutting-edge.” It takes a multi-disciplinary approach to the care of its patients. The surgical, medical and radiation oncologists work closely with radiologists, dermatologists, pathologists and support staff to provide melanoma patients with personalized, coordinated care. NYU has recently applied for a SPORE (Specialized Program of Research Excellence) grant, which, if given would designate NYU’s program, a “Melanoma Excellence Center.” Excellence denotes dedication. Pavlick has it: As she puts it, “If you’re a melanoma patient of mine, you’re my patient until I retire.”

This feature is dedicated to all melanoma patients and to the memory of Dr. Jill Kaplan.

For more information on melanoma go to: http://ci.med.nyu.edu/

Woman Around Town’s Six Questions

Favorite Place to Dine: Trattoria dell’ Arte, 900 Seventh Avenue, across from Carnegie Hall.
Favorite Place to Shop: Mostly online, but I love the Nordstrom’s at the Garden State Plaza in Paramus, New Jersey.
Favorite New York Sight: The Empire State Building with the change of colors to reflect the changing holidays.
Favorite New York Moment: Christmas in New York with the lights and tree at Rockefeller Center.
What You Love About New York: If you make it here, you can make it anywhere. I love the excitement.
What You Hate About New York: The traffic.