Skin Cancer and Melanoma Awareness Month: innovations in treating advanced melanoma
More people are diagnosed with skin cancer each year than with all other cancers combined, making it the most common type of cancer in the United States and worldwide. One in five Americans will develop skin cancer by the age of 70.1 Fortunately, it is also one of the most preventable forms of cancer. Raising awareness can help save lives, and that’s why, each year, the month of May is dedicated to promoting prevention and diagnosis of and screening and treatment for skin cancer—particularly its most deadly type: melanoma.
In this article, we’ll take a deeper look at melanoma: what it is, how it’s diagnosed, the latest treatment breakthroughs, the importance of treatment response monitoring for advanced melanoma patients, and how to get involved so that, together, we can end melanoma.
Melanoma 101 and the importance of prevention and screening
All three of the primary skin cancer types—basal cell carcinoma, squamous cell carcinoma, and malignant melanoma—are mainly caused by ultraviolet (UV) radiation from the sun and tanning devices. No one is immune: all ethnicities and skin tones are at risk for developing skin cancer.
Melanoma comprises less than 5% of all skin cancer, with 207,390 cases projected to be diagnosed in the US in 2021.1 It is curable when caught early, but it is also the most dangerous skin cancer because it’s much more likely to invade nearby tissues and spread to the other parts of the body.2 Although melanoma is more common in men than women and among individuals of fair complexion, anyone can get melanoma.3
What is melanoma?
Melanoma, also known as malignant melanoma and cutaneous melanoma, develops when melanocytes—the pigment-producing cells that give each person a unique skin color—become damaged and start growing out of control. While most melanomas start on sun-exposed skin as a result of DNA damage from UV radiation, they can also develop in other areas of the body where melanocytes are present, including the eyes, palms, soles, or under fingernails.4,5
According to the American Cancer Society, the average five-year relative survival rate for melanoma is 93%, but it varies greatly based on the melanoma stage or how serious a case it is:6
|Stage||Five-year survival rate*|
|Localized: There is no sign that the cancer has spread beyond the skin where it started.||99%|
|Regional: The cancer has spread (metastasized) beyond the skin where it started to nearby structures or lymph nodes.||66%|
|Distant: The cancer has spread (metastasized) to distant parts of the body, such as the lungs, liver, or skin on other parts of the body.||27%|
|All stages combined||93%|
* Note: these numbers are based on people diagnosed with melanoma between 2010 and 2016. As treatments have improved over time, current melanoma survival rates may be better.
How is melanoma diagnosed?
The most important warning signs of melanoma are any new spots on the skin, spots that are changing in size, shape, or color, or sores that do not heal. That’s why many doctors recommend doing a monthly full-body self-exam and paying particular attention to the areas where melanoma is most likely to occur: torso, head, and neck for men, and lower legs and torso for women. If you notice any concerning changes, it’s time to have your skin checked by a doctor.
The doctor will do a physical exam, ask questions about your symptoms and risk factors, and assess any suspicious spots on your skin using the “ABCDE” criteria:7
- Asymmetry – Is one half of the mole or skin mark different from the other?
- Border – Are the edges irregular, ragged, notched, or blurred?
- Color – Are there different colors or shades in the mole or skin mark?
- Diameter – Is the spot larger than six millimeters across (about a quarter-inch—the size of a pencil eraser)?
- Evolving – Has the spot changed in size, shape, or color over time?
If the doctor suspects that the spot might be melanoma, he or she will order a skin biopsy, during which a part of the suspicious area will be removed and sent to a lab for a close examination. In the case that melanoma has spread to the lymph nodes or other organs, your doctor will order additional biopsies, imaging tests (such as a CT scan or an MRI), and blood tests.
Why melanoma prevention and early screening are essential
The good news is that melanoma is largely preventable by simply protecting oneself from damaging UV exposure. Unprotected skin can be damaged by the sun’s UV rays in as little as 15 minutes, and you still need protection even if it’s cool and cloudy.8 As you’re heading outdoors this summer, remember that the sun’s rays are the strongest between 10 am and 2 pm. Stay safe by bringing some sun-protective clothing, a hat, sunglasses that block UV rays, and, of course, SPF 15+ sunscreen with both UVA and UVB (broad-spectrum) protection.
Also, keep in mind that identifying melanoma as early as possible makes a big difference, because localized melanoma is the easiest type to remove during surgery and the type that is most likely to be cured. Don’t wait to contact your doctor—even localized melanoma surgery is sometimes challenging, and if the melanoma spreads beyond the skin, you will need to undergo additional cancer treatment.
New tools for advanced and metastatic melanoma
If a biopsy shows that the melanoma has affected the lymph nodes or other organs, the melanoma is considered to be advanced or metastatic. In this case, treatment may include more intensive surgery, chemotherapy, targeted therapy, radiation, immunotherapy, and clinical trials.
In recent years, FDA approval of new drugs that target specific mutations and immunotherapy treatments called immune checkpoint inhibitors (ICIs), which take advantage of a person’s own immune system to help kill cancer cells, have led to significant leaps forward in advanced melanoma treatment and to substantial declines in melanoma deaths.9
It’s imperative that clinicians are able to prescribe these innovative therapies based on the intricacies of each person’s unique tumor mutations. Comprehensive genomic profiling (CGP) can identify a person’s specific mutations, determine the best course of treatment, and showcase any relevant clinical trials to the patient. Learn more about Altera, a groundbreaking comprehensive genomic profiling (CGP) test for advanced melanoma patients.
Advanced melanoma treatment response monitoring using ctDNA
Despite this tremendous progress in melanoma treatment and the many metastatic melanoma patients who are experiencing remission, ICIs don’t work for everyone.10 If you’re managing your cancer using ICI treatment, it is critically important for your doctor to monitor treatment response so that they can understand how to best guide your therapy.
The latest research from Natera’s INSPIRE trial shows that Signatera, a personalized circulating tumor DNA (ctDNA) blood test, can help accurately identify whether your ICI treatment is working. This study validated Signatera’s ability to effectively evaluate tumor response to immunotherapy across 25 different types of cancer, including melanoma. Read more about the results of the INSPIRE trial and how Signatera can help you to avoid unnecessary treatment.
Learn more and get involved to end melanoma together
If you’d like to deepen your understanding of melanoma prevention, screening, diagnosis, and therapy, there are plenty of comprehensive resources available online. Natera’s partners, including Melanoma Research Alliance, Melanoma Research Foundation, and AIM at Melanoma, offer additional research, information on clinical trials and the latest advancements in treatment, and a place to connect with the community. We’ve also included a few leading-edge sources of melanoma information in the Additional Resources section below.And if you’re interested in taking the next step and getting involved to help end melanoma together, check out these upcoming fundraising events (this year, they may be held virtually or in-person, depending on COVID-19 guidelines):
- Steps Against Melanoma, an annual series of walks sponsored by AIM at Melanoma to support people living with skin cancer, share stories to spread awareness, and promote treatment and early screenings
- Miles for Melanoma, an annual series of walks held by the Melanoma Research Foundation in various cities across the US in an effort to raise money for melanoma prevention and treatment research
- Skin cancer facts and statistics. Skin Cancer Foundation. March 11, 2019. Updated January 13, 2021. Accessed April 22, 2021. https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/
- How is immunotherapy for melanoma changing the outlook for patients? Cancer Research Institute. Updated April 2020. Accessed April 22, 2021. https://www.cancerresearch.org/immunotherapy/cancer-types/melanoma
- Melanoma and Skin Cancer Awareness Month. American Association for Cancer Research. December 6, 2019. Accessed April 22, 2021. https://www.aacr.org/patients-caregivers/awareness-months/melanoma-and-skin-cancer-awareness-month/
- What is melanoma skin cancer? American Cancer Society. Updated August 14, 2019. Accessed April 22, 2021. https://www.cancer.org/cancer/melanoma-skin-cancer/about/what-is-melanoma.html
- About melanoma. Melanoma Research Alliance. Accessed April 22, 2021. https://www.curemelanoma.org/about-melanoma/
- Survival rates for melanoma skin cancer. American Cancer Society. Updated January 29, 2021. Accessed April 26, 2021. https://www.cancer.org/cancer/melanoma-skin-cancer/detection-diagnosis-staging/survival-rates-for-melanoma-skin-cancer-by-stage.html
- Signs and symptoms of melanoma skin cancer. American Cancer Society. Updated August 14, 2019. Accessed April 26, 2021. https://www.cancer.org/cancer/melanoma-skin-cancer/detection-diagnosis-staging/signs-and-symptoms.html
- Skin cancer awareness. Centers for Disease Control and Prevention. April 13, 2021. Accessed April 26, 2021. https://www.cdc.gov/cancer/dcpc/resources/features/skincancer/index.htm
- Deaths from metastatic melanoma drop substantially in the United States. National Cancer Institute. April 21, 2020. Accessed April 26, 2021. https://www.cancer.gov/news-events/cancer-currents-blog/2020/metastatic-melanoma-deaths-drop
- Expanding the tool box: new melanoma treatment approaches being explored. Melanoma Research Alliance. July 29, 2020. Accessed April 26, 2021. https://www.curemelanoma.org/blog/article/expanding-the-tool-box-new-melanoma-treatment-approaches-being-explored