100-Year-Old WWII Veteran Says, ‘You’ve Got to Do What You’ve Got to Do,’ After Beating Skin Cancer Twice With the Help of His Own Reengineered Immune System Through Immunotherapy

His response to the diagnosis was as steady as his wartime resolve: “You’ve got to do what you’ve got to do,” he told Fox Chicago. “If you worry about it, you’re giving yourself double problems.”

Before turning to immunotherapy, Hirsh had already been treated with radiation and surgery.

Hirsch’s immunotherapy regimen involved receiving treatment every three weeks, and after eight months of treatment, Hirsch says he is in remission.

RELATED: Some Melanoma Survivors See Long-Term Side Effects After Immunotherapy Treatment, According to New Study

Immunotherapy Offers Hope for Some Skin Cancer Patients

SurvivorNet spoke with the pioneer in immunotherapy research, Dr. James (Jim) Allison at MD Anderson Cancer Center, who was awarded a Nobel Prize for the development of the science called checkpoint inhibitors.

“Immunotherapy is rather unique in that for the first time, we’re getting truly curative therapies in many kinds of disease– not just in melanoma but in lung cancer, kidney cancer, bladder cancer, Hodgkin’s lymphoma, Merkel cell cancer, head and neck cancer,” Dr. Allison tells SurvivorNet.

While we do not know the exact type of “aggressive skin cancer” Hirsh was diagnosed with, several types can be treated with immunotherapy. According to the American Cancer Society, basal cell (a common form of skin cancer that’s highly treatable) and squamous cell (another common type of skin cancer) can be treated with immunotherapy.

ACS says, immunotherapy treatments such as “Cemiplimab (Libyayo), pembrolizumab (Keytruda), or cosibelimab (Unloxcyt) can be used to treat people with advanced squamous cell carcinoma that cannot be cured with surgery or radiation therapy.”

Cemiplimab can also be used to help treat basal cell carcinoma.

Basal cell carcinoma (BCC) is the most common form of skin cancer, with an estimated 3.6 million cases diagnosed each year in the U.S., according to the Skin Cancer Foundation.

According to the Centers for Disease Control and Prevention, squamous cell carcinomas are “thin, flat cells that form the top layer of the epidermis.” This skin cancer type isn’t life-threatening and grows slowly, according to the American Academy of Dermatology Association.

Melanoma starts in the same cells that give your skin, hair, and eyes their color—the cells in melanoma change, allowing them to spread to other organs.

WATCH: Am I at High Risk for Melanoma?

Medical oncologist, Dr. Anna Pavlick, explains who is most at risk.

“Patients at risk are patients who are fair-skinned, with blond hair and blue eyes, patients who may have a family history of melanoma, or patients who have what we call dysplastic nevus syndrome, who are just covered in thousands and thousands of moles,” Dr. Pavlick said.

WATCH: Immunotherapy for Melanoma Can Work, but Side Effects are a Risk

While it was initially developed for stage 4 melanoma patients, immunotherapy might also be used earlier in the course of the disease. There’s also an immunotherapy cream, Imiquimod (Aldara), used for melanoma in situ (stage 0).

FDA-Approved Immunotherapy for Melanoma

There are several FDA-approved immunotherapies for melanoma. Each is approved for certain instances of melanoma.

• Tebentafusp-tebn (Kimmtrak)
• Aldesleukin (Proleukin)
• Atezolizumab (Tecentriq)
• Dostarlimab (Jemperli)
• Interferon alfa-2b (Intron A)
• Ipilimumab (Yervoy)
• Nivolumab (Opdivo)
• Peginterferon alfa-2b (Sylatron/PEG-Intron)
• Pembrolizumab (Keytruda)
• Talimogene laherparepvec (Imlygic)
• Imiquimod (Aldara)

The goal is to steadily reduce the risk of recurrence in all patients. It’s not a one-size-fits-all approach. Some people may not be candidates for this therapy, and side effects vary from person to person.

How Immunotherapy Works

Checkpoint inhibitors, like pembrolizumab, help the immune system do its job by removing the “invisibility cloak” that cancer cells use to hide. Normally, a protein called PD-1 acts like a brake on T cells, keeping them from attacking healthy cells. But cancer takes advantage of that brake to avoid being targeted. Pembrolizumab blocks PD-1, releasing the brake and letting T cells go after cancer cells more aggressively—just like they’re meant to.

“We have known for a while now that immunotherapy is a very important weapon in the fight against melanoma,”  Dr. Janice Mehnert, associate director of clinical research at NYU Langone’s Perlmutter Cancer Center, explains to SurvivorNet.

“This study sought to investigate whether giving the anti-PD-1 antibody pembrolizumab to melanoma patients with bulky stage IIIB through stage IV disease may be superior to the standard of care approach, which is surgery followed by immunotherapy.”

The implications are significant. Instead of waiting until after surgery to deploy immunotherapy, researchers are exploring whether earlier intervention with pembrolizumab could improve outcomes for patients with more aggressive disease.

Used across multiple cancer types, immunotherapy has already revolutionized treatment paradigms. In melanoma, it’s not just a promising option—it’s a game-changer.

WATCH: Tell Your Doctor About Immunotherapy Side Effects

Immunotherapy for melanoma is not without risks. The severity of the side effects depends on whether you’re being treated with one medicine or a combination of two medicines, says Dr. Pavlick.

You have about a 10 to 15 percent chance of developing side effects such as a severe rash or severe diarrhea from a single-agent immunotherapy drug. If you have metastatic disease, you may be offered two medicines, which increases the risk of developing side effects to about 50 percent.

According to Dr. Pavlick, “Of that 50% who get side effects, at least 10% are going to have severe side effects where we may need to stop their medicine.”

Common Immunotherapy side effects include:

• Fatigue
• Nausea or stomach discomfort
• Joint pain
• Diarrhea or constipation
• Cough
• Rash
• Loss of appetite
• Changes in blood cell counts
• Fever

Spotting Skin Cancer

You should check your body for unusual spots or moles at least once a month. Any new spots or changes in size or color demand your attention.

Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. Though these marks are unlikely to be cancerous, you’ll want to keep an eye on them and inform your doctor about any changes you notice.

WATCH: When checking for melanoma, remember your ABCDEs

Melanoma is most likely to develop on sun-exposed skin, such as the face, neck, arms, and legs. Surprisingly, it might also develop in places that have never been exposed to the sun, such as the palms of your hands or soles of your feet, your eyes or mouth, or under your nails.

SurvivorNet experts describe melanoma symptoms as:

• A sore that doesn’t heal
• Color that spreads from the border of a spot to the skin around it
• Redness or swelling that goes beyond the area of a mole.
• Itchiness, tenderness, or pain
• A change in the way the surface of a mole looks.
• Scaliness, oozing, or blood

Tips to Protect Your Skin from Skin Cancer

As many of us enjoy spending lots of time in the sun during the spring and summer, we must remember that the sun can harm us. For most people, there are simple ways to significantly reduce their risk of developing skin cancer.

Dermatologist Dr. Dendy Engelman offers five ways to protect your skin from cancer. Most of her recommendations are simple to follow and could save your life.

WATCH: How to protect your skin from skin cancer.

Her simple tips include:

• Avoid the sun during peak hours, from 10 a.m. to 2 p.m. If you are outside during those hours, protect yourself from harmful sun rays.
• Cover your skin and eyes. A wide-brim hat and sunglasses will protect your face, the top of your head, your ears, and the delicate skin around your eyes.
• Wear an SPF of 30 or higher. Dr. Engelman also recommends reapplying every few hours or after excessive sweating or swimming.
• Get an annual skin check. You can check your skin for anything that looks out of the ordinary, but you should still get a yearly check to ensure you don’t miss anything. If you notice anything unusual between checks, schedule an appointment to talk to your doctor.
• Avoid tanning beds.

If you feel like you’re just too pale, Dr. Engelman recommends a sunless tanner. “There’s absolutely no benefit to going to a tanning bed,” Dr. Engelman said.

WATCH: Melanoma treatment options

People with Darker Skin Complexions Also Face Skin Cancer Risks

A rare form of melanoma called acral lentiginous melanoma (ALM) impacted Bob Marley. According to research published in the medical journal Neoplasia, acral melanoma “arises on the non-hair-bearing skin of the nail bed, palms of the hand and soles of the feet” and is not linked to sun ultraviolet (UV) light like other skin cancers.

This rare subtype of melanoma is more common among people of Black, Hispanic/Latin, and Asian descent. The Centers for Disease Control and Prevention (CDC) says, “Non-Hispanic Black people are often diagnosed with melanoma at later stages, and the predominant histologic types of melanomas that occur in non-Hispanic Black people have poorer survival rates than the most common types among non-Hispanic white people.

Questions to Ask Your Doctor

If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests the following to help you on your cancer journey.

• What type of skin cancer do I have?
• What treatment options exist for my specific cancer?
• Will insurance cover this treatment?
• Would treatment through a clinical trial make sense to me?
• What resources exist to help
  

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  Kavontae Smalls is a writer and reporter for SurvivorNet. Read More