How Does Skin Cancer Become More Than Skin Cancer?

skin-cancer-melanoma-president-jimmy-carter

Most melanomas are cancers of the skin that can arise within a mole that may have been present for many years. Melanomas can also show up as a new spot on the skin. In both cases, most melanomas are “ugly ducklings” — they don’t look like the other moles and spots on the skin.

The good news: When they’re diagnosed early, most melanomas are still confined to the skin and can be treated successfully with surgery. More advanced melanomas can spread to the lymph nodes and even to organs, such as the lungs, liver, brain, and bone.

“Melanoma can spread to the brain by way of the bloodstream,” says Tawnya Bowles, MD, surgical oncologist at Intermountain Medical Center. “As a skin melanoma grows, the cancerous cells gain access to channels that lead to lymph nodes, which are small infection-fighting organs found throughout our bodies, and to the bloodstream. Once melanoma cells have entered the bloodstream, they can travel to the brain or to other organs.”

According to information released about Carter’s case, his doctors weren’t able to trace the melanoma found in his brain and liver to melanoma that originated on his skin. While unusual, this can happen when a person’s immune system attacks the melanoma on the skin and causes it to disappear. Also, rarely, melanoma can arise in the organs without first appearing as a skin melanoma.

Melanoma’s spread to the brain can be difficult to control. Surgical resection or radiation treatments can help.  Patients can also receive chemotherapy to help kill any other melanoma cells that may be present throughout the body. 

Newer melanoma treatments called immunotherapies work by activating one’s own immune system against melanoma cells. These immunotherapies are more effective than traditional chemotherapy for melanoma and are associated with fewer side-effects.

According to numerous reports, Carter will be receiving a new immunotherapy recently approved by the Food and Drug Administration called pembrolizumab (brand name Keytruda).

Early diagnosis and treatment of melanoma, before it’s spread from the skin, is key.

Dr. Bowles recommends people follow the ABCDEs of skin checks.  If any spot on the skin shows Asymmetry (one side doesn’t look like the other), irregular Borders, Color change (especially black), increasing Diameter bigger than a pencil eraser, or is Evolving (changing) over time, it needs to be checked by your doctor. 

Additionally, most melanomas are caused by sun exposure. Using SPF 30 sunscreen regularly and protecting your skin from the sun can prevent many melanomas, thus reducing your risk of skin cancer.