Australasia’s first Familial Melanoma Clinic based at Princess Alexandra Hospital is reducing the risks for families of known melanoma patients thanks to the introduction of a genetic counsellor.

Targeting those at a higher risk of developing melanoma, the one-stop-clinic is the first of its kind to offer a sequential, holistic approach to management and prevention.

Introduced in October 2021 under the shade of COVID-19, Clinical Researcher Dr Aideen McInerney-Leo said the clinic offers total body Vectra 3D imaging, dermascopic imaging of suspicious lesions and genetic testing under the one roof overseen by a dermatologist and genetic counsellor.

“Members of the population diagnosed with a melanoma before the age of 40, who have previously had multiple melanomas - or have had three of more family members with melanoma, are at increased risk. They are who we are targeting with this clinic,” said Dr Aideen McInerney-Leo.

Funding through a Metro South Health SERTA grant has secured a genetic counsellor whose role is to screen patients, review their results and create an appropriate management plan.

“The counsellor’s role calls patients and family members ahead of appointments to take a detailed personal and family history so that the clinic can more specifically address the individual genetic risks for that person.

“We know from the literature that people who have mutations in specific genes should be screened more often so any melanoma which occurs is picked up early. This leads to a much better prognosis for the patient,” she said.

This precision medicine approach offers complete understanding of the risks to each patient as well as potential risks to their family.

“The research shows us that when you offer genetic testing to people for melanoma, they have little to no psychological distress as a result of the testing process and it actually improves their sun protective behaviour and their screening behaviour so it’s a win-win.”

Often referred to as ‘Australia’s cancer’, the survival rates for melanoma are improving.

“There are two exciting aspects to this clinic. Firstly, all patients have 3D Total body imaging. Doing 3D total body imaging across visits means we can detect lesions which have changed since the last visit. We can also highlight new lesions. This increases our chances of detecting suspicious lesions early, and improving patient outcomes,” Dr McInerney-Leo said.

“The second is the fact that we can care for families. A person who has had a melanoma is usually offered surveillance on a regular basis. However, the extent to which their relatives are screened can vary.”

In this clinic, if a person with melanoma is found to carry a change in a melanoma gene, we can offer testing and 3D Total Body Imaging to their first-degree relatives. If any of them test positive, we can offer testing to their first-degree relatives etc.”

“Everyone in the cancer world talks about five-year survival but I think we should raise our eyes to the horizon given how fantastic the five-year survival rate is for melanoma at this stage, and start thinking about the ten-year survival rate.”

The complete risk assessment model offered through the Familial Melanoma Clinic is proactively addressing this, ensuring those at risk are properly managed to ensure any developing cancer is picked up early.

“Melanoma is so common in Australia that the threshold to get people referred to a genetics clinic for testing is incredibly high so making sure people have ready access to it makes a huge difference for prospective patients and their families.”

REFERRAL:

• People diagnosed before the age of 40 are at increased risk. People who have had multiple melanomas themselves are at increased risk, and people who have had three or more first or second-degree relatives with melanoma should ask to be referred to PAH high risk skin cancer clinic.