Were you one of those kids whose mom used to encourage you to sit in the sun because you “needed color,” or “were too pale?” As a teen, did you slather yourself with baby oil, or Coppertone #2 or Hawaiian Tropic (it smelled great) in an effort to get that Southern California “beach girl” or surfer dude bronze?
How naive we were. Melanoma, the deadliest form of skin cancer, wasn’t anything we thought about – or probably even knew about. But it’s been on the rise for the past three decades – coinciding with the time my generation hits middle age. There hasn’t been a new drug to treat this disease in over a decade.
That’s why the news this week about a study published in the New England Journal of Medicine received so much media coverage. The data was also presented simultaneously at at the annual meeting of the American Society of Clinical Oncology (ASCO). In clinical studies, a new drug called ipilimumab (ipi, for short) was shown to be highly effective against some kinds of advanced melanoma. Patients who took this drug lived an average of three and a half months longer than patients who had other treatments.
The drug apparently causes the immune system to attack the cancer in 20-30 percent of patients. Unfortunately, the doctors can’t tell which patients will benefit, but still, there is more hope for many skin cancer sufferers than there was just a week or two ago. Metastatic melanoma patients only live an average of 6-9 months after the cancer reaches this stage, so three months is a big deal for them. Some patients lived up to several years longer – and a few even went into remission. Although there are some serious side effects, like rashes and colitis, those effects are reversible.
Bristol-Myers Squibb is encouraging the FDA to fast track the drug to market by the end of the year, which may help save or prolong many lives. Normally FDA approval for a new drug can take years, but in this case, there are so few treatments for this disease, the pharma company, doctors, and patients, are hoping for a much speedier process.
My mom was one of those lucky people (so I thought) that tanned a deep golden brown. Me? I usually went from red/burn to peeling, to finally a café au lait tone. We were the generation that was encouraged to tan. Remember the ads?
By the end of the summer the contrast between where the bikini was, and wasn’t, was pretty stark. Well, not only are my bikini days over, but so are my days of being a sun worshipper. I’ll never know if my mom would have been a melanoma victim, since she succumbed to breast cancer more than a decade ago instead. I now hope I’m not going to be a statistic either.
I won’t lock myself in the house – I enjoy being outdoors. But I always put on at least an SPF 30 sunblock– higher if I’m at the beach, and make sure it protects against both UVA and UVB rays. I cringe now when I see my teenage son, or other teens, lay out and bake in the sun, with little care for “what might happen 20 or 30 years down the road.”
Maybe by the time he hits middle age, the promise that this drug holds – “this randomized, controlled trial showed that there was a significant improvement in overall survival among patients with metastatic melanoma” (NEJM, http://www.nejm.org June 5, 2010 (10.1056/NEJMoa1003466) for not only melanoma but for other types of cancer, will make this an unnecessary worry.
In the meantime, I’m going to follow the scientific evidence. I will also strongly urge my teen to protect his skin (OK you try getting a teen to listen to his mom); one sunburn these days is one too many.