Skin Cancer: Half Of People Surviving Advanced Melanoma
Health and science correspondent, BBC News
More than half of patients can now survive a deadly skin cancer that was considered untreatable just a decade ago, say UK doctors.
Ten years ago only one-in-20 patients would live for five years after being diagnosed with late-stage melanoma. Most would die in months.
But drugs to harness the body’s immune system mean 52% now live for at least five years, a clinical trial shows.
Doctors said it was an extraordinary and rapid transformation in care.
Living With A Melanoma Diagnosis
Melanoma is not just skin cancer. Its real. Its cancer. And left untreated, will kill you.
I was diagnosed with skin cancer July 16, 2012. When I spotted an odd looking mole just below my right ribcage, my heart sunk. I knew about the dangers of melanoma, but I still was not ready to hear the words, Im sorry, but its cancer. Its melanoma.
It wasnt until a friend was diagnosed with melanoma that I even considered wearing sunscreen. I grew up in the era when baby oil and iodine were used as tanning lotions. Then, in 1999, I started frequenting tanning salons. I tanned at the salon two to three times per week. I guess one could say I was an addict. I continued to go after that golden tan. I would spend every moment I could either laying out in the sun or in a tanning bed. In my mind, I felt and looked better with a tan. Little did I know at the time I was setting the stage for a melanoma diagnosis.
Why do I do this? That answer is easy. Even though I am only one person with only one voice, my story is worth telling. If I can reach just one person and help prevent a deadly skin cancer, my effort is worthwhile.
So, if you havent done so yet, please make that appointment for a full-body check. It just might save your life.
Sandra Klein works at Mayo Clinic Health System in Red Wing.
Topics in this Post
When Should I Call My Doctor
You should have a skin examination by a doctor if you have any of the following:
- A personal history of skin cancer or atypical moles .
- A family history of skin cancer.
- A history of intense sun exposure as a young person and painful or blistering sunburns.
- New or numerous large moles.
- A mole that changes in size, color or shape.
- Any mole that itches, bleeds or is tender.
A note from Cleveland Clinic
Receiving a diagnosis of melanoma can be scary. Watch your skin and moles for any changes and seeing your doctor regularly for skin examinations, especially if youre fair-skinned, will give you the best chances for catching melanoma early when its most treatable.
Last reviewed by a Cleveland Clinic medical professional on 06/21/2021.
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Recognizing The Signs And Symptoms
The most noticeable sign of melanoma is the appearance of a new mole or a change in an existing mole or birthmark. People should be aware of any pigmented areas on the skin that appear abnormal in color, shape, size, or texture.
People with stage 4 melanoma may also have ulcerated skin, which is skin with tiny breaks on the surface. These ulcerations can bleed.
Another sign is swollen or hard lymph nodes, which a doctor can confirm by carrying out a physical examination. Other tests include blood tests and imaging scans to confirm the presence of cancer and check how much it has spread.
You May Have A Genetic Mutation
Its very likely that your melanoma tumor will have a DNA mutation. These mutations turn off tumor-suppressor genes, allowing cancers to grow out of control, according to the American Cancer Society. Discovering which mutation you have through genetic profiling can help your doctor determine the best course of treatment. Research has shown that about 50% of melanomas contain the BRAF mutation, while others may contain MEK mutations or the less common C-KIT mutation. Most people will only have only one of these mutations.
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Risk Factors For Metastatic Melanomas
You cannot get metastatic melanoma without first having melanoma, though the primary melanoma may be so small its undetectable. Major risk factors for melanomas include:
- Light skin, light-colored hair or light-colored eyes
- Skin prone to burning easily
- Multiple blistering sunburns as a child
- Family history of melanoma
- Frequent exposure to sun or ultraviolet radiation
- Certain genetic mutations
- Exposure to environmental factors, such as radiation or vinyl chloride
Other factors have been connected with increased metastasis. In a 2018 study in the Anais Brasileiros de Dermatologia and a 2019 study in the Journal of the National Cancer Institute, the following factors were associated with higher levels of metastasis:
- Male gender
- Primary tumor thickness of more than 4 mm
- Nodular melanoma, which is a specific subtype that a care team would identify
- Ulceration of the primary tumor
Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful. It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.
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Treating Stage 3 Melanoma
If the melanoma has spread to nearby lymph nodes , further surgery may be needed to remove them.
Stage 3 melanoma may be diagnosed by a sentinel node biopsy, or you or a member of your treatment team may have felt a lump in your lymph nodes.
The diagnosis of melanoma is usually confirmed using a needle biopsy .
Removing the affected lymph nodes is done under general anaesthetic.
The procedure, called a lymph node dissection, can disrupt the lymphatic system, leading to a build-up of fluids in your limbs. This is known as lymphoedema.
Cancer Research UK has more information about surgery to remove lymph nodes.
The Challenges Of Living With Cancer
Living with metastatic cancer is challenging. The challenges are different for everyone, but they can include:
Feeling upset that the cancer came back. You might feel hopeless, angry, sad, or like no one understands what you are going through, even family.
Worrying that treatment will not help and the cancer will get worse.
Dealing with tests, doctors appointments, and decisions.
Talking with family and friends about the cancer.
Needing help with daily activities if you feel exhausted or have side effects from treatment.
Finding emotional and spiritual support.
Coping with the cost of more treatment. Even if you have insurance, it might not cover everything.
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Reduce Your Risk Of Infection
You may find that you get more infections because you have myeloma. You can speak to your doctor about vaccinations that may help, such as the flu vaccination.
Some people with myeloma have medicines to boost their immune system or prevent infection. You can talk to your doctor about whether this is right for you.
What Does Your Family Want To Know
When making your decision about details, of course, it can be important to think about those who love you and may help care for you. Many family members want complete information about how long a loved one may live after being diagnosed with stage 4 colon cancer.
Other family members may find this information very upsetting. They may not want to hear it.
Make sure your healthcare provider knows who in your family wants complete information and who does not.
Your healthcare provider can even make a note in your chart describing your goals for information sharing about your cancer treatment. This way, everyone on the healthcare team will be on the same page during appointments.
Being diagnosed with stage 4 colon cancer can make you feel out of control. Knowing your options regarding information sharing about your cancer, your treatment decisions, and end of life care decisions will help you move forward at a difficult time.
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Women Share What Its Like To Live With Skin Cancer
Getting a skin cancer diagnosis can be surprising and life-changing. While severity can run the gamut from an easy-to-remove speck of basal cell carcinoma to a late stage melanoma, you’re never the same after hearing the C word.
Skin cancer can be sneaky and easy to miss. “It could be similar in color to your skin, and they’re slow-growing many times,” George W. Monks, M.D., a dermatologist at the Tulsa Dermatology Clinic in Tulsa, Oklahoma, tells SELF. “It kind of creeps up on people and many times they’re shocked they have a skin cancer.” That’s why it’s so important to see a dermatologist regularly, and especially if you notice any new or changing skin spots.
SELF spoke with five different women about what it’s like to have skin cancer. Some are still battling the disease today, while others haven’t had a recurrence in years. Each proves how differently skin cancer can affect people’s lives, and reminds us why we all need to follow the safe sun advice that can oftentimes be easier to ignore.
My dermatologist started discovering basal cells when I was around 14. They started popping up frequently. Every time I went back for an acne treatment, I ended up having more frozen off. I started seeing a dermatologist every three to six monthsI can probably count only five or six times since then that Ive gone and not had anything taken off. In my 20s I didnt wear hats or swim shirts, I didnt care. I still spent days at the lake and let myself get burned.
What Affects Survival
Your outlook depends on the stage of the cancer when it was diagnosed. This means how deeply it has grown into the skin and whether it has spread.
Survival is better for women than it is for men. We don’t know exactly why this is. It may be because women are more likely to see a doctor about their melanoma at an earlier stage.
Age can affect outlook and younger people have a better prognosis than older people.
Your outlook may also be affected by where the melanoma is in the body.
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What Is Liver Cancer
Liver cancer, also known as hepatic cancer, is a type of cancer that starts in the liver. The different types of liver cancer are:
- Primary liver cancer: This cancer starts in the liver. Primary liver cancer is of many different types:
- Hepatocellular carcinoma
- Angiosarcoma and hemangiosarcoma
- Secondary liver cancer : Cancer that originates in the liver and spreads to other parts.
- Benign liver tumors: Noncancerous tumors may grow large enough to cause problems, but they do not grow into nearby tissues.
Stress Can Be Caused Both By Daily Responsibilities And Routine Events As Well As By More Unusual Events Such As A Trauma Or Illness In Oneself Or A Close Family Member When People Feel That They Are Unable To Manage Or Control Changes Caused By Cancer Or Normal Life Activities They Are In Distress Distress Has Become Increasingly Recognized As A Factor That Can Reduce The Quality Of Life Of Cancer Patients
Ernest H. Rosenbaum, M.D. Isadora R. Rosenbaum, M.A.
As medical professionals, we have always been fascinated by the power of the will to live. Like all creatures in the animal world, human beings have a fierce instinct for survival. The will to live is a force within all of us to fight for survival when our lives are threatened by a disease such as cancer. Yet this force is stronger in some people than in others.
Many physicians have seen how two patients of similar ages and with the same diagnosis, degree of illness, and treatment program experience vastly different results.
Sometimes the biology of a cancer will dictate the course of events regardless of the patients attitude and fighting spirit. These events are often beyond our control. But patients with positive attitudes are better able to cope with disease-related problems and may respond better to therapy. Many physicians have seen how two patients of similar ages and with the same diagnosis, degree of illness, and treatment program experience vastly different results. One of the few apparent differences is that one patient is pessimistic and the other optimistic.
We have known for over 2,000 years from the writings of Plato and Galen that there is a direct correlation between the mind, the body, and ones health. The cure of many diseases is unknown to physicians, Plato concluded, because they are ignorant of the whole. For the part can never be well unless the whole is well.
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It Usually Starts With Suspicious Spot
Maybe you noticed a mole that stood out from the rest . Its edges were irregular, maybe it was asymmetrical in shape, unevenly pigmented, noticeably large , or rapidly changing . These are the spots that concern dermatologists. If you had one, your doc did a biopsy on your own ugly duckling. During this in-office procedure, your doctor either shaved off a layer of your mole, punched it out with a hole-punch-like tool, or removed it with surgical excision, along with a margin of healthy skin to check for wandering cancer cells.
How Should Caregivers Talk To Children About A Family Member’s Advanced Cancer
Children deserve to be told the truth about a family members prognosis so they can be prepared if their loved one dies. Its important to answer all of their questions gently and honestly so they dont imagine things that are worse than reality. They need to be reassured that they will be taken care of no matter what happens.
Caregivers need to be prepared to answer tough questions. To do this, they should know what their own feelings and thoughts are about the situation. They need to be able to show children how to hope for the best while preparing for and accepting that their loved one may die.
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Survival Rates By Disease Extent
Instead of classifying the disease by stage, scientists with the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program took a simpler approach, estimating survival based on the extent of the disease in the body.
Under the SEER classification system, lung cancer is classified in one of three ways:
- Localized: Cancer confined to the lungs
- Regional: Cancer that has spread to nearby lymph nodes or structures
- Distant: Cancer that has spread to distant organs
Stage 1 lung cancer falls under the localized classification. According to SEER data from 2010 to 2016, stage 1 NSCLC has a five-year survival rate of 59%.
The downside to the SEER classification system is that allows for a significant overlap in definitions. For example, stage 1 NSCLC falls into the same “localized” category as stage 2a NSCLC given that neither involves lymph nodes. Even so, the five-year survival rate for stage 2a lung cancer in only 60% compared to 96% for stage 1a lung cancer.
Factors That Can Influence Survival Times
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
As the earliest stage of disease, stage 1 lung cancer generally has the most promising outlook. Current statistics suggest that anywhere from 70% to 92% of people with stage 1 non-small cell lung cancer can expect to live at least five years following their diagnosis. Many patients live for far longer given newer and more effective therapies.
There are variables that can increase or decrease life expectancy in any stage of lung cancer. Understanding what they areand changing any that are modifiablecan increase your chances of remission and help ensure your longest, healthiest life.
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When Is The Right Time To Use Hospice Care
Many people believe that hospice care is only appropriate in the last days or weeks of life. Yet Medicare states that it can be used as much as 6 months before death is anticipated. And those who have lost loved ones say that they wish they had called in hospice care sooner.
Research has shown that patients and families who use hospice services report a higher quality of life than those who dont. Hospice care offers many helpful services, including medical care, counseling, and respite care. People usually qualify for hospice when their doctor signs a statement saying that patients with their type and stage of disease, on average, arent likely to survive beyond 6 months. More information about hospice can be found below in the Related Resources section of this fact sheet.