Understanding Melanoma
- A 32-year-old mom was diagnosed with late-stage melanoma just four years after she had a cancerous lump removed from behind her ear. Now, she’s raising awareness to help encourage others to get checked when something seems off, as her symptoms of stage 4 melanoma were initially dismissed as “just a virus” following a vacation.
- Cooper is working to manage the disease through radiotherapy and immunotherapy cancer treatments while maintaining strength and optimism throughout her cancer fight.
- Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change, allowing them to spread to other organs.
- 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. You’ll want to watch them and tell your doctor about any changes you notice.
Four years prior to her advanced skin cancer diagnosis, Cooper had a small cancerous spot behind her ear surgically removed. However, the cancer returned and spread to other areas of her body, including her bones and other organs.
“Cooper is currently undergoing an intensive treatment plan to manage her pain and, we hope, to slow the progression of the cancer. The next few months are critical. Her doctors have made it clear: how the cancer responds during this time will be key to what comes next.”
Expert Melanoma Resources
- Blood Test Could Predict the Best Type of Treatment for Metastatic Melanoma
- Atypical Moles Don’t Necessarily Mean You Have Melanoma
- Examining Your Skin for Melanoma: Remember ABCDE
- Am I at High Risk for Melanoma?
- How is Melanoma Treated After Surgery? The Landscape of Therapies Explained
- Melanoma Relapse Treatment: Advances on the Horizon
- The Biopsy Helps Identify Staging and Treatment for Melanoma
- Immunotherapy for Melanoma Can Work, but Side Effects are a Risk
The GoFundMe was established to help cover Cooper’s medical and living expenses and create a comfortable “healing space” at her home.
“Katie’s doctors recently said: ‘Promise us you’ll fight – fight for your life and for your little girl. ‘And that’s exactly what she’s doing — but she needs our help. With your support, we can give Katie the best possible chance to continue her fight with strength and dignity,” the page concluded.
“We want to give her peace of mind so she can focus on what matters most: her daughter, her health, and the love of her family.”
According to Manchester Evening News, Cooper spoke with SWNS in a recent interview and explained how when she received her late-stage melanoma diagnosis, her cancer had spread throughout her body to her lungs, ovaries, abdominal wall, spin, and liver.
Cooper, who is working to manage the disease through radiotherapy and immunotherapy, recounted her cancer journey to SWNS, “It’s terrifying. We had no idea, and we just thought I was unwell. It blindsided us.
“Finding out subsequently that it was in my other organs as well, I knew it would be quite difficult from here on out.”
Now, Cooper hopes her story will inspire others to better “advocate for themselves” and seek medical advice when needed.
“You know your body best. If you feel like something is not right, then you are within your rights to go and ask, and don’t be afraid to keep pushing to get those answers,” she said.
Cooper’s friend, who created her GoFundMe page, also told SWNS that if her treatment plan works, she’ll have a “60% chance [of living] 10 years” with the disease.
Understanding Melanoma
Melanoma occurs in the same cells that give your skin, hair, and eyes their color. In this type of cancer, the cells change, allowing them to spread to other organs.
Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma.
You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:
- The palms of your hands or soles of your feet
- On your eyes or mouth
- Under your nails
The top way to protect yourself is by staying out of the sun, especially during peak hours, and avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma.
Experts, such as Dr. Anna Pavlick, an oncologist at NYU’s Perlmutter Cancer Center, say tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided completely.
RELATED: How Do I Know My Skin Cancer is Gone?
Dr. Pavlick says that people who are covered with moles stand a higher risk of developing skin cancer, especially people with dysplastic nevus syndrome or “atypical” moles.
Atypical moles are unusual-looking and irregularly shaped when seen under a microscope. Although usually benign, a high number of atypical moles does signal an increased risk for melanoma, according to the Skin Cancer Foundation, which says people with 10 or more atypical moles have a 12 times higher risk of developing melanoma.
Warning Signs of Skin Cancer – Remember ABDCE
The most important thing to look out for when it comes to finding melanoma is a sudden, new spot on your skin or a spot that is quickly changing in size, shape, or color.
Dr. Cecelia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends implementing the ABCDE rule to determine if a mole requires further examination.
The ABCDE rule:
- A: Asymmetry of the mole, or when one half of the mole doesn’t match the other
- B: Border irregularity or Bleeding
- C: Color change, either lightening or darkening of a mole
- D: Diameter greater than 6mm or enlarging moles
- E: Evolving size, shape, or color.
WATCH: Dr. Cecila Larocca on the ABCDEs of checking moles for signs of skin cancer
Melanoma that moves into the body, away from the skin, becomes an entirely different treatment journey for patients.
Treatment options for melanoma that have spread include targeted therapy and immunotherapy, which give people a better chance of living a long and healthy life than ever before. If you’re diagnosed with melanoma, there’s a good chance surgery will be the treatment your doctor recommends.
Cancer removal usually leads to a cure in the early stages of the disease. After surgery, the removed tissue and lymph nodes are examined to measure the melanoma and determine if it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma.
When no cancer cells are left around the removed area, your cancer is less likely to return.
Melanoma Treatment Options
Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.
If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery but which kind you’ll have.
WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma
For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer until all the cancer is gone.
In general, stage I melanoma surgery consists of a dermatologist’s simple, in-office removal of the cancerous cells. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.
The removal of stage II and III melanomas is performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes and possibly to other organs. Where the cancer is will dictate your treatment.
After surgery, the removed tissue and lymph nodes are sent to a specialist called a pathologist, who measures the melanoma and determines whether it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.
Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.
Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is a recurrent disease.
Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022. The combination of two immunotherapies is called Opdualag.
For those with the BRAF mutation, targeted drugs that shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:
- Zelboraf (vemurafenib) and Cotellic (cobimetinib)
- Braftovi (encorafenib) and Mektovi (binimetinib)
- Tafinlar (dabrafenib) and Mekinist (trametinib)
- Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.
“Every patient is different, and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe” for treating stage IV melanoma.
There Is No “Cookie Cutter Recipe” for Treating Stage Four Melanoma
Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”
So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.
Questions to Ask Your Doctor
If you are diagnosed with skin cancer, SurvivorNet suggests some of the following questions to address with your care team:
- What type of skin cancer do I have?
- What treatment options exist for my type of melanoma?
- Will insurance cover this treatment?
- Would treatment through a clinical trial make sense for me?
- What resources exist to help manage my anxiety because of this diagnosis?
Leading Experts Urge Us to Be Proactive
“If I had any advice for you following a cancer diagnosis, it would be to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview, “because finding a doctor who is up to date on information is important.”
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances, the specific course of treatment is not clear-cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
RELATED: Be Pushy, Be Your Own Advocate, Says Leading Expert
The bottom line is that being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can so that you know that you did your best to take control of your health.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
