BIO1010 9AM

Melanoma: A Serious
Killer
Sam Watson

According to the National Cancer Institute melanoma is a malignant tumor of

melanocytes, which are the cells that make the pigment melanin and are derived from the neural
crest. Merriam Webster dictionary describes it in more concise terms as a benign or malignant
skin tumor containing dark pigment. Data from the National Cancer Institute states that
melanoma most commonly arises in the skin but can be found in other parts of the body as well.
It represents less than five percent of skin cancers but results in the most deaths. Elderly men are
at highest risk; however, melanoma is the most common cancer in young adults aged 25 to 29.
Melanoma is also the second most common cancer in those aged 15 to 29. Although it can occur
anywhere on the body, in women it occurs more commonly on the extremities, and in men it
occurs most commonly on the trunk or head and neck. The most common place for melanoma to
be found is on moles.
The reason that I chose to do further research about melanoma cancer is because my
mother passed away due to a malignant mole behind her ear at the young age of 49. Some of the
biggest risk factors of getting melanoma include; exposure to UV rays and family history. Family
history is the risk factor that worries me the most due to the fact that it is something that is less
preventable. Personally I believe that the more knowledgeable you are regarding a subject, the
more prepared you are to take preventable measures and decrease risk. I wanted to do this
research to help me better understand what the risk factors are, and how to prevent them. I also
wanted to know what was being done to treat and possibly cure melanoma.
It is well known that the most common way to get skin cancer is due to the ultra violet
rays that the sun gives off. Melanoma is the most serious type of skin cancer, and is becoming
more and more common. Between 10 and 20 per cent of cases are ultimately fatal (Weller,
2015). Intriguingly, melanoma is more commonly found in people that work inside rather than
outdoors, and in people that dont have a sun tan than the ones with a sun tan. Episodic sun
exposure and sunburn are probably a greater risk factor than continual exposure (Weller, 2015).
This does not mean however, that everyone should go out and enjoy continual sun exposure,
seeing as it still will likely cause skin cancer. The skin cancer will still be cancer just not
melanoma skin cancer, which as stated before you have a one in five chance that it could be fatal.
Artificial tanning beds are even more dangerous than the harmful rays of the sun. Many
people believe that going to the tanning beds to get a base tan is alright, since they are less
likely to get a sun burn when they go out in the sun. While there is some truth to this statement,
the majority of researchers suggest staying away from the tanning beds all together. Those who
are under the age of 18 are even more strongly advised to stay away from them. But whatever
the reason or the season, minors should not be allowed to lie in tanning beds. These devices are
skin cancer factories, and people younger than 18 have the highest risk (Editors, 2015). With
this information as a base, it is absurd to continue to allow minors to use tanning beds. If you are
at the highest risk when you are under the age of 18, why should they even have a chance of
obtaining skin cancer, or worse melanoma. This should be something similar to tobacco, where
once the person is no longer a minor, they can have the choice to endanger their health, if they so
choose. This should not be something that should be a choice of someone who struggles to see
the future past next week. The quest for a tan contributes to frequent visits, but the behavior is
also addictive. Basking under the bulbs releases opioid endorphins that increase relaxation and
boost positive feelings that make patrons seek out the exposure again (Editors, 2015). The
addictive nature should also be a bright red flag of the dangers of over exposure to the ultraviolet
rays. While they may fell an increase in relaxation, their skin cells do not fell the same. UV rays
damage cellular DNA, which increases the chances those cells will become malignant (which is

known as melanoma). Radiation from indoor tanning devices is often more intense than the sun's
natural rays (Editors, 2015). It is easy to see the dangers caused by ultraviolet rays, and most are
aware of these dangers, but how many people are truly aware of the significance of the risk?
The number of skin cancer cases linked to tanning beds every year is two times the number of
lung cancer cases associated with smoking (Editors, 2015). The evidence of the danger
continues to grow. In 2014 a systematic review and meta-analysis of 88 studies concluded that
the beds lead to over 10,000 new cases of melanoma every year in the U.S., Australia and Europe
and as many as 450,000 cases of other skin cancers (Editors, 2015). While many countries have
banned tanning beds altogether, only 10 U.S. states have placed a ban for minors to use them.
This is a step in the right direction, but no minor should be allowed to use them, with or without
parental approval. The tanning habit is dangerous for anyone but especially risky for young users
because the earlier UV damage begins, the more time it has to add up and get worse. People
who begin tanning before the age of 35 have a melanoma risk that is at least 60 percent greater
than those who start after that age. Melanoma is the second most common cancer among women
in their 20s, and its incidence in those young women continues to rise, even as the rates of most
other cancers have stabilized (Editors, 2015).
The biggest question of all then becomes, what is being done to prevent/cure the most
aggressive and deadly form of skin cancer? One thing that is being done is a drug called
checkpoint inhibitors that can extend the life of the infected patient by stopping cancer cells from
disarming the immune system. Unfortunately these checkpoint inhibitors arent the only way for
cancer to trick the immune system, so only around 20 percent of patients will benefit from these.
However, combinations of checkpoint inhibitors work even better, and should raise the
proportion of people who benefit. When melanoma patients, for example, took nivolumab plus a
drug called ipilimumab, the disease went into remission for nearly a year, compared with 3 and 7
months for ipilimumab or nivolumab alone (Upfront 2015). However, drug combinations
have worse side effects. Still it is a good movement in the right direction to prolong the lives of
those affected by these incurable cancers. There are more experiments being done in the
United Kingdom to help prolong life with cancer. One particular woman was diagnosed with
melanoma and given about six months to live. Through a charity dedicated to the study of
melanoma she was given experimental treatment. Over several weeks, she received three
intravenous infusions. After the second, the lumps she had felt in her throat and breast had
vanished. She was thrilled and is still alive almost three years after her initial diagnosis
(Coghlan 2016). This is a great turn around, from six months to three plus years. Many, who
have taken part in similar experiments, are still living decades after their diagnosis. Lung and
melanoma used to be death sentences before checkpoint inhibitors, now it is just the beginning of
whats to come.
Other researchers believe they have discovered a mechanism, by which tumors
eventually evade effective combination treatments for melanoma, providing clues that could lead
to longer-lasting therapies for the deadliest of skin cancers (Berkrot 2015). There are targeted
therapies that are designed to turn off specific molecular pathways associated with tumor growth.
The approach can have dramatic effects, until tumor cells develop resistance (Berkrot 2015).
Dr. Roger Lo of the UCLA Jonsson Comprehensive Cancer Center said of this resistance: "The
resistance is basically a matter of time, but if we figure out the strategies by which the resistance
happens we can propose new ways to suppress these mechanisms. If we can understand better
what type of (genetic) mutations occur in melanoma ... we can design better and better drugs to
suppress these. Either new drugs, better combinations of drugs or better regimens of drugs.

These, along with the other advances, are a good sign that the most deadly form of skin cancer
could one day no longer be considered as such.

Literature Cited
Berkrot, B. (2015). Clues Found on How Melanoma Resists Treatments. Scientific American,
312(1),6.
Coghlan, A. (2016). CLOSING IN ON CANCER. New Scientist, 229(3063), 34.
Editors. Ban the Tan. (2015). Scientific American, 312(4), 10.
Upfront. (2015). New Scientist, 226(3024), 6.
Weller, R. (2015). The prodigal sun. New Scientist, 226(3025), 26.