Skin Cancer

The Sanibel-Captiva Rotary has some of the smartest people I know as members. James Cardle Ph.D., J.D. Registered Patent Attorney is one of them with all kinds of prestigious academic achievements noted in his biography. As a Registered Patent Attorney his areas of expertise include the mechanical arts; medical devises; fluid mechanics; physical & chemical processes; semiconductors; thermal management of electrical devices; software; solar and alternative energy and more. That being well noted, unfortunately that didn’t really help much with the most important fight in his life, his diagnoses of stage four-melanoma skin cancer.

James Cardle, Melanoma 6-17-2013 8-12-02 PM 760x891

James really spoke to us as a warning, that no one is immune from a diagnosis like his. In James’s case he really only thought it was a skin irritation that had returned; might be just a little eczema or psoriasis. He was at the dermatologist for a checkup and the PA did a biopsy…just checking. Melanoma is sneaky. He had the biopsy, then a PET Scan…diagnosis Stage 3 Melanoma. Just wanted another opinion on treatment went to Mayo Clinic for this.

Warning here, know your body, check out anything suspicious, and get to the doctor for a skin biopsy.

What to look out for…a skin bump or irritation that might cause some concern. Use the ABCDEs observation method: A-Asymmetric, B-Brown or Black, C-Colors (plural), D-Diameter-bigger than a pencil eraser, E-Existing growths that changes or that ugly duckling thing that might just need watching.

Another warning from James, people of any skin color can get skin cancer. I bet most of us didn’t realize that Bob Marley died of Melanoma.

James was lucky enough to seek treatment at the University of Texas Health Science Center and Mayo Clinic. At Mayo his Melanoma was classified as Stage 4 and treatments started immediately with some of the newer treatment protocols for this type of cancer. Mayo Clinic-“The treatment of widespread melanomas has changed in recent years as newer forms of immunotherapy (known as immune checkpoint inhibitors) and targeted drugs have been shown to be more effective than chemotherapy.”

Now for me comes the tricky part…disclaimer here…I am definitely not a medical person, so to explain the treatments being used for stage 4 melanoma is extremely difficult; James even used a disclaimer at the beginning of his power-point presentation.

Bear with me here…The current treatment is-Cytokines used to provoke an immune response-Granulocyte Macrophage Colony Stimulation Factor (GM-CSF), Interleukin (IL-2) Interferon (IF-a). On one of James’s slides he presents this information…Discovery of Down Regulation of T-Cells…Tumor cells produce antigens (An antigen is any substance that causes your immune system to produce antibodies against it), Dendritic cells in the immune system recognize the antigens, Dendritic cells present the antigens to cytotoxic T lymphocytes (CTL’s), CTLs then should destroy the cancer cells, however, the Dendritic cells also present an inhibitor to the CTLs that down regulates the CTLs aborting the attack on the Tumor-the Tumor survives. Recognition of this mechanism allows for new-targeted therapies.

This treatment has been successful for some but there also have been side effects. New investigational treatments are being tried to find the right combination of drugs that provide a more effective and less harmful way to treat Stage 4 melanoma. This is not a one size fits all treatment. There are treatments that now use a combination of drugs.…Ipilimumab, Pembrolizumab, Nivolumab, Pidilizumah, and in clinical trials MEDI-4736, BMS-936559, and MPDL3280A. Combinations might be Ipilimumab(CTLA-4 block) with Nivolumab (PD-1Block), Ipilimumab with GM-CSF and various other combinations. Each drug used to produce an intended effect and produce antibodies…relieve the immune checkpoint, stimulate T cells, or inhibit T regs.

Melanoma is the deadliest form of skin cancer. Although it comprises less than 5% of skin cancer cases, melanoma accounts for the great majority of skin cancer-related deaths.

James’s take-away…it all starts with self-examination…know your skin & body; if you notice anything get different get checked immediately. Metastatic melanoma is no longer an absolute death sentence-progress is being made. He is living prove.