Melanoma is a type of skin cancer that develops from the melanocytes, the pigmenting cells that give skin its color. Since 1973, the incidence of melanoma in the U.S. has more than doubled. According to the American Cancer Society, about 53,600 new cases will be diagnosed this year. The cancer can occur anywhere on the body, but is most commonly seen on the backs of men and the legs of women. Melanoma is less common than other types of skin cancer (accounting for only about four percent of all cases). But the condition is more deadly – being responsible for more than 79 percent of skin cancer deaths. That's because melanomas often invade underlying tissue and can quickly spread throughout the body. Even a spot the size of a small freckle can be very deep and deadly. This year, about 7,400 Americans are expected to die from melanoma.
The most important risk factor for melanoma is excessive exposure to the sun. Just a single, blistering sunburn during childhood or adolescence can greatly increase the risk for melanoma later in life. The dangerous element in sunlight is ultraviolet radiation. (Tanning lamps and booths also provide exposure to ultraviolet light and should be avoided). People with fair skin and light colored hair, who freckle or burn easily, are at highest risk for developing melanoma.
The standard treatment for melanoma is surgery. Doctors remove the cancer and a small margin of healthy tissue. Depending upon the size and depth of the melanoma, patients may require a skin or tissue graft. Patients may also receive chemotherapy (treatment with anticancer drugs) and or high dose interferon-alfa (INTRON® A). Some side effects of chemotherapy can include hair loss, nausea, vomiting, fatigue, weakness, and loss of appetite. The most common side effects of interferon treatment may cause flu-like symptoms, such as fever, headache, fatigue, appetite loss, nausea, and vomiting.
Several vaccines are under development for melanoma. One of them is CANVAXIN™ (CancerVax®, Corp.). The vaccine is made from three different cell lines of melanoma and Bacillus Calmette-Guerin (BCG, an inactivated strain of the bacteria that causes tuberculosis). The BCG stimulates the immune system to recognize the melanoma cells. Hopefully, the body will respond to the vaccine by increasing the production of immune cells and antibodies that will fight the cancer. In phase 2 clinical trials patients getting the vaccine had a median survival time of 58 months versus 28 months for those getting a placebo.
Currently, CANVAXIN is in phase 3 clinical trials for patients with advanced melanoma that has spread to the lymph nodes or other parts of the body. Once accepted into the trial, participants are randomly assigned to receive the vaccine or a placebo. Patients receive a series of about eight injections every other week for eight weeks, and then monthly for the rest of the year. BCG is administered only at the first and second visit. Injections are given every two months in the second year of the study and every three months in years three through five. Side effects of the vaccine can include skin pain, itching, or ulceration at the site of the injection, fever, fatigue, chills, muscle aches, joint pain, nausea, diarrhea, headache, and dizziness.
Important note: CancerVax has temporarily halted enrollment of new patients into the trial. The company will begin accepting patients again when production issues are resolved with the FDA. In the meantime, patients who are already enrolled or who met eligibility criteria as of April 25, 2002 will still be able to continue to receive the vaccine or placebo.
For information about the vaccine or the clinical trial, visit the manufacturer's website at www.cancervax.com . (NOTE: CancerVax has temporarily halted enrollment of new patients into the trial. New patients can be accepted when production issues are resolved with the FDA. Watch the company's website for updates.)
For information about other melanoma clinical trials, contact the National Cancer Institute at (800) 4-CANCER, or visit their website at www.nci.nih.gov .
For information about melanoma: American Academy of Dermatology, www.aad.org