Catch Cancer Before Its Too Late TM

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Catch Cancer Before Its Too Late TM

• A New Fishing Technique For an Old and Fearsome
  Adversary

Jose M. Acostamadiedo, MD Instructor of Internal
Medicine Wake Forest University School of
Medicine Medical Advisor,World Billfish SeriesTM
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(No Transcript)
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Introduction

• MEDLINE Search From 1966 to 2001
• NO data addressing the incidence of melanoma and
  non-melanoma skin cancer in recreational sport
  fishing industry
• Recreational anglers
• Professional charter captains
• Professional mates

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Exposure Pattern to Ultraviolet Radiation

• Chronic exposure and a high total cumulative dose
• Captains and mates
• Periodic bursts of large amounts of sun exposure
  leading to severe sunburn.
• Office workers (anglers)
• Recent trends also show that melanoma is more
  common amongst the higher socioeconomic strata
  (anglers) except gt70 years of age)
• Case fatality gt amongst the lower socioeconomic
  groups (captains and mates).

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Background and Rationale

• To date no study evaluating the incidence of skin
  cancer in the recreational sport fishing
  population has been performed.

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Demographic Profile

• Average age of 44 years,
• Have been fishing for an average 25 years and
• Fish at least 84 days per year, their
• Average annual income is 245,000
• Average net worth is 1,300,000
• 75 are college educated
• 83 of them own boats.

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The Fishing Grounds
Pirates Cove Billfish Tournament
Ducks Unlimited The Big Rock
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The Migration

• Predator and
• Prey
• Like in the ocean everyone benefits from
  everything.

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The Release
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So What Are We Fishing forMarlin or Melanoma?
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 Malignant Melanoma

• Significant public health problem
• Incidence is rising faster than that of any other
  cancer in the US. At current rates,
• 1 in 74 Americans will develop melanoma during
  their lifetime.
• Management of melanoma is a complex issue
  requiring a multidisciplinary approach.

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Attacking Melanoma

• Many strategies are coming of age but still the
  most effective method of protection against the
  development of malignant melanoma is

• Minimization of ultraviolet exposure from
  sunlight.

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Most Avoidable Risk Factor for Malignant Melanoma

• Sun exposure
• Responsible for more than half of all melanomas
  worldwide

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Sunburns have been consistently associated with
melanoma. Exposure early in life appears to be
the most important determinant of later risk.
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The Target Population

• Over 90 of the participants in these events do
  not live in these coastal communities, and
  frequently take this time as part of their yearly
  vacation.
• Many travel from different parts of the country
  to participate in such tournaments but the
  majority comes mainly from inland in each state.

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Economic Impact

• The income of these local communities is directly
  related to the attendance to the tournaments.
• (Captains and Mates) almost invariably live in
  the coastal communities.
• When fishing season is over they usually find
  other activities or travel south following the
  billfish migration to the southern Caribbean and
  Mexico.
• The income mostly depends on the influx of this
  higher socioeconomic group (Anglers) during the
  months of April thorough September

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Screening Schedule

• North Carolina all free skin cancer screenings
  are offered from May through July, (AAD website
  screening schedule)
• Only one of these in the Cape Fear area is in a
  true coastal community that will facilitate the
  access to those who make their livelihood at sea
• So even during the off-season these captains and
  mates seldom become accessible targets of land
  based skin cancer screening programs.

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So Why Did I Think This Was Going to Be
Successful?
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Smarty Marlin Told Me
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This Smarty Marlin
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Are Screenings Effective?

• Data from participants in the AADs skin cancer
  programs from 1992 to 1994 revealed
• Almost 40 of these individuals reported that
  without the free AAD program they would not have
  otherwise had a physician examine their skin.

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Because of the aforementioned

• Demographic
• Socioeconomic and biological characteristics
• High Profile Offshore Fishing Tournaments are the
  perfect setting for this program
• They work like a FAD (Fisherman Attraction
  Device)
• They Congregate these two Very High-Risk
  populations
• Excellent Screening Scenario
• Subjects can be effectively and cost efficiently
  targeted.

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How to Stop Advanced Melanoma

• Early detection and treatment are critical and
  result in improved patient survival rates.
• Only through increased public awareness and
  education in all areas relating to the
• Prevention
• Detection
• Treatment of malignant melanoma
• Decreasing trend in the incidence and
  mortality from this cancer in the future.

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The Fishing Last Year Was Better?As the Old Timer
Saidjust a Fishing Tale???

• NOT THIS TIME, THE FISHING IS BETTER NOW I
  wish it was the same for Billfish!
• In the 1930s the lifetime risk of an American
  developing invasive melanoma was 1 in 1,500.
• Approximately 8000 persons died from melanoma in
  the year 2000.

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How Is the Fishing Going to Be This Year? Well

• In 2001, an estimated 51,400 new cases of
  melanoma are expected in the U.S.
• This year, 7,800 people will die from melanoma
  5,000 men and 2,800 women.
• Currently that risk is 1 in 74.

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So Who Are You Going to Call?

• Since 1985, the American academy of dermatology
  has sponsored free annual national melanoma/skin
  cancer prevention campaigns.
• In its 17 years, more than 1.2 million people
  have been screened through the AADs program, and
  approximately 116,000 suspicious lesions,
  including 15,150 suspected melanomas, have been
  detected.

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So Who Are You Going to Call?

• If every American were completely examined
  yearly for malignant melanoma, death from this
  disease would be a rare event.
• However the cost benefit and feasibility of mass
  population screenings for skin cancer are a
  significant concern.

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More Cost Effective Strategies and More Realistic
Ones Include Screening of Those at Highest Risk.
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Catch Cancer Before Its Too Late TM

• Concentrate our screening effort to this
  high-risk group of people and
• Decrease the mortality of malignant melanoma
  through early detection,

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Catch Cancer Before Its Too Late TM

• Decrease the incidence of melanoma by raising the
  awareness and education of this high-risk group
  of individuals.

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Catch Cancer Before Its Too Late TM

• Result
• Better quality of life for the beneficiaries of
  the program and their relatives
• By preventing the morbidity and mortality caused
  by melanoma.

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The WBS and Catch Cancer

• World Billfish series ?(WBS) (which sanctions the
  largest Billfish tournament circuit in the world
  equivalent to PGA, major league baseball.

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In Australia, They Teach

• Slip - on a shirt
• Slap - on a hat
• Slop - on some sunscreen
• Wrap - around sunglasses

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Slip Slap Slop

• We believe that this program might have as much
  success as the "slip, slap and slop and sun smart
  program" developed by the Australians, which has
  diminished the mortality of melanoma over the
  last 50 years.

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The By Catch by No Means a Small Fish

• There will be 600,000 to 800,000 skin cancers
  this year in the united states
• One in six people will get skin cancer during
  their life
• Many skin cancers present as nonhealing lesions
• Early diagnosis and treatment results in best
  chance of cure

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Actinic (Solar) Keratoses
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Basal Cell Carcinoma
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Basal Cell Carcinoma

• The most common type of cancer
• Caused by lifetime sun exposure

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Squamous Cell Carcinoma
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Melanoma
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ABCDs of Melanoma

• Asymmetry
• Border Irregularity
• Color variation
• Diameter

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Superficial Spreading Melanoma

• Irregular edge, variation in color, variation in
  topography, and a lesion that is more than 6 mm
  in diameter
• Superficial spreading melanomas and some unusual
  nevi vary in these criteria only in degree

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Nodular Melanoma

• Isolated nodule without typical pigment spread
• Poor prognosis

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Lentigo Maligna Melanoma

• Most occur on the face
• Usually start as a noninvasive process
• Any thickening suggests the evolution to invasive
  melanoma

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Nail Bed Melanoma

• Variant of acral-lentiginous melanoma
• Manifested by streaks of pigmentation on the nail
  as well as pigmentation emerging from under and
  around the nail

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Melanoma Prognosis 5 Year Survival
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Smarty Recommends Sunscreens, Lets Go to the
Website

• http//www.catchcancer.org/

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Marketing and Promotion
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Was It Good?
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Events That Hosted the Catch Cancer Before Its
Too Late TM Program in 2001

• The Big Rock Blue Marlin Tournament, June 9-16,
  Morehead city, NC
• 13th Annual Ducks Unlimited Band the Billfish
  Tournament, Aug. 2-4, Morehead city, NC
• Pirates Cove 18th Annual Billfish tournament,
  Aug. 13-17, Manteo, NC

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Catch Cancerbefore Its Too LateTM 2001 Results
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Catch Cancerbefore Its Too LateTM 2001 Results
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PCBT Aug 15,2001
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What we love!
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Future Marketing Plans

• Exposure through WBS web site, magazines and
  media kits
• www.catchcancer.org        
• Exposure through periodic press releases
• Beach 105 FM radio address The Other Side of
  Fishing
• WBC Grand Championship ESPN-2 and local media
  film coverage of WBS events.
•  

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AcknowledgmentsWe All Know Who Goes FirstGod

• Bayard Powell, MD
• Earl Gross, MD Crystal Coast Dermatology
• Thomas King, MD ECU
• Joseph Jorizzo,MD
• Phillip Williford, MD
• Scott, David, Bobby and the Crew of the Hammer
  Time
• ACS Volunteers
• Mary Mathias
• Lynn Basset
• Sarah Hodges
• Carey Chen Cayman Arts
• Guy Harvey Guy Harvey Inc.
• Professional Offshore Anglers Inc.

• Teresa Acostamadiedo
• Robert Cooper, MD
• Julia Cruz, MD
• Sherry Spainhour
• Tyler Haney Web Manager WFUSM
• Gerard Aulong Blue Marlin of Ghana
• Phillip Gregory ACS
• Dawn Bergmire-Sweat ACS
• Robin Forti-Anderson
• Julia Brakhage
• Heather Maxwell Pirates Cove
• Jack Lamb Ducks Unlimited
• Crystal Watters The Big Rock
• Marty Brill Capt. Martys Baits