What You Need to Know About Melanoma
May 03, 2021 Nicole Levine
"Melanoma is on the rise for a lot of reasons. We have more time in the sun. Better understanding among physicians and dermatologists on screening for the disease. It's lifestyle-driven—and there are also other factors we're still learning about."
Not all melanomas are related to sun exposure
Melanoma can happen anywhere on the body, even places such as the soles of the feet or the palms of the hands that don't usually get sun exposure. Not all melanomas look alike—they might not be darkly pigmented.
Kaelyn Garvine, 43, was diagnosed with melanoma when she went to see a dermatologist about what she thought was a wart on her foot.
"If something doesn't look right and it doesn't react the way you expect it to right away, get it checked out by someone who is an expert," she says. "I tried to take care of mine on my own for two years. That was a year and 11 months too long."
Internet searches aren't always your friend, she adds. She found plenty of pictures of warts that looked like the lesion on her foot before she decided it was time to see her dermatologist.
Just one serious sunburn can increase risk
According to the Skin Cancer Foundation, a single, serious blistering sunburn in childhood or adolescence can double the risk of developing melanoma later in life. Other studies point to risk doubling on average if they have had more than five sunburns.
An ounce of prevention, in the form of a few ounces of regularly applied sunscreen, goes a long way to mitigate risk, Dr. Hamid says.
The revolution in treating solid tumors with immunotherapies started with melanoma
Immunotherapy is the harnessing of one's own immune system to fight a disease or infection—like cancer.
"This new class of therapies revolutionized the way that we treat cancer," Dr. Hamid says.
One of the key classes of drugs for immunotherapies are called checkpoint inhibitors. They were first used for melanoma, but now are approved for many malignancies including kidney, lung, bladder, and head and neck cancers. They're also being studied to treat many more malignancies.
"Checkpoints" are proteins in the body that protect healthy cells from the immune system by attaching to immune cells and signaling that they should not attack. Cancer uses these same checkpoint proteins as a cloaking device to trick the body into mistaking tumor cells for healthy tissue, therefore evading destruction.
Checkpoint inhibitors block these proteins so they cannot be used to fool T cells—the "fighters" of the immune system—making the cancer cells ripe for attack by the immune system.
"We're proud of the role we've played in investigating these therapies through our clinical trials program, presenting the data and bringing them to the clinic for patient care," Dr. Hamid says. "It's had a massive impact on the lives of our patients and patients everywhere."
From 6 months to 60 months
How big of an effect have these new therapies had? Median survival for melanoma jumped from an average of 6 to 8 months to 60 months since their introduction a decade or so ago. Yervoy, the first immunotherapy drug for melanoma, will celebrate the 10th anniversary of its FDA approval this year.
The annual diagnoses of melanoma increased 619% from 1950 to 2000, according to the National Cancer Institute. The incidence has continued to climb over the last two decades.
"Melanoma is on the rise for a lot of reasons," he says. "We have more time in the sun. Better understanding among physicians and dermatologists on screening for the disease. It's lifestyle-driven—and there are also other factors we're still learning about."