Mirror, Mirror on the Wall

You’d rather forget about those moles, but you shouldn’t

Most of us carry remnants of a sun-filled life, and it’s common to have a number of moles or blemishes that come from changes in our skin’s pigment. We also carry the birthmarks and beauty marks we inherited. And while many of us wish these bumps, raises and darkened patches would vanish, we shouldn’t ignore them.

They could be sending us an important message.

Yes, it’s easier to hide one’s skin during the winter months; but don’t ignore it. Examine your skin monthly; look at your moles — check color, size and shape. Look for any between toes or under arms and other hidden places.

That odd-shaped freckle tucked inside the crook of your baby toe might just be a budding melanoma — the most serious form of skin cancer — or a precursor to this deadly disease.

“It’s important to be aware of one’s own skin. If anything is suspicious, have it evaluated by a doctor,” says Craig Slingluff, M.D., a melanoma expert and director of the Human Immune Therapy Center at UVA. Researchers at the center are exploring ways to fight cancer, including melanoma and ovarian cancer, by boosting a person’s immune system.

What to Look Out For

There are three types of skin cancer: basal cell and squamous cell, both highly curable and accounting for the majority of skin cancers detected.

Melanoma is the most serious form of skin cancer, made up of abnormal skin pigment cells called melanocytes. As it grows deeper into the skin’s layers, melanoma can spread to other organs, becoming difficult to control.

While most commonly found on the skin, melanoma also occurs in such hidden places as the nail bed (underneath the nail), mucosal tissue (tissue lining the nose, mouth, female genitals, anus, urinary tract and esophagus), scalp and eye (eyelid or pigmented coating of the eyeball).

The American Cancer Society estimates that this year there will be 62,480 new cases of melanoma in the United States and about 8,420 people are expected to die of the disease.

Still, current research indicates that early diagnosis, before it has invaded the deeper layers of the skin, increases survival. That’s why regular skin checks are critical. Skin checks may save your life or the life of someone you love.

Are You at Risk?

Your risk increases if you:

• Are fair skinned
• Have a history of intense sun exposure, especially in childhood
• Have more than 100 moles or large, irregular or unusual moles;
• Have close blood relatives — parents, siblings, children — with melanoma.

About 10 percent of patients with melanoma have a close family member with this cancer. More recently, research has shown that tanning bed exposure can also lead to melanoma.

An interesting breakthrough in understanding melanoma, pioneered by Slingluff and a team of UVA scientists, is that those with a weakened immune system are at increased risk of developing the cancer.

“The immune system is full of checks and balances. And we’re trying to better understand how it works,” says Slingluff.

Why Seek Melanoma Treatment at UVA?

“It’s what we do,” says Slingluff. “We have a very strong team of physicians and clinicians and we work closely to help patients get the best care.”

Melanoma Vaccine

More than a decade ago, Slingluff and fellow scientists discovered a cancer vaccine for patients with advanced melanoma. Designed to target an immune response by stimulating T cells to kill cancer cells, early trials proved promising.

“For patients with advanced melanoma who are not candidates for standard therapies (surgery, radiation, biological therapy or chemotherapy), our clinical trials offer an option,” Slingluff says. “Today we are interested in newer targeted therapy agents and immune modulators.”

Since their initial discovery, Slingluff and his team believe that defeating melanoma may mean combining an immune-boosting vaccine with targeted therapeutic agents or other vaccines.

“There’s no denying the challenges we still face as we strive to find ways to harness the human immune system to destroy cancer,” Slingluff says. “But there’s also no denying the tremendous progress we have made and will continue to make.”

Know the ABCDs of Moles

Melanomas vary greatly in appearance but here are some things to look for:
Asymmetry: Irregular shape; one half does not match the other
Border: Ragged, notched, blurred, or irregular in outline; the pigment may spread into the surrounding skin.
Color: Uneven color. Shades of black, brown, and tan may be present; areas of white, grey, red, pink, or blue may also be seen.
Diameter: Increasing size; melanomas are usually larger than the eraser of a pencil.
Source: National Cancer Institute