A Brief History of Melanoma

skin cancer preventionI thought melanoma was a recent invention, but not so. The first recorded descriptions of the dark tumor (melas oma) are found in the writing of Hippocrates in the 5th century B.C. The earliest physical evidence comes from the skeletons of Pre-Columbian mummies estimated to be at least 2,400 years old.

Physicians learned that melanomas often originated in moles but knew little about how cancers grow and spread. The only treatment in the early days was to cut or burn off the mole and hope for the best.

In the last decade, researchers have discovered the relationship between cancer cells and the immune system. This opened the door to new treatment options for melanoma.

Scientists also discovered “driver mutations,” changes that occur in tumors and fuel the growth and spread of cancer cells. These mutations, which occur in more than half of all melanoma patients, can now be targeted with agents that either turn off or block their activity.

In the past, the only treatment after surgery (adjuvant therapy) that improved survival was interferon, an agent that boosts the overall immune response.

The immunotherapy ipilimumab has been used as a treatment for metastatic melanoma since 2011. It unblocks or takes the brakes off the immune system by targeting the CTLA-4 component that helps turn off the immune system.

Current targeted therapies can inhibit the BRAF gene. Since there are multiple variations of the BRAF mutation, doctors continue to seek more precise and individualized treatments for these mutations. Another targeted therapy is one that inhibits MEK, a protein involved in cancer growth. KIT is another gene that sometimes mutates in certain types of melanoma.

Bottom line: Cancer treatment is rapidly advancing in its success and survival rates. With so much improvement in this decade, who knows what the next decade will reveal?

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