Melanoma Cancer: New Research Shows Gut Health Can Improve Treatment Success
May is National Melanoma (Skin Cancer) Awareness Month. So we wanted to shed some light on the basic information of melanoma to help with early detection. There is also some new research coming out showing how to improve immunotherapy treatments through gut microbiome modulation that we would love to share with you.
So first things first…
What is Melanoma Cancer?
Melanoma is a type of tumor that affects your melanocytes and not all melanomas are cancerous. Melanocytes are the cells that pigment your skin. They are affected by UV rays from the sun or tanning beds to give you a sunkissed glow. However, the UV rays can also mutate your melanocytes causing cancers to grow. This isn’t the only way that melanoma can happen but it is one of the most commonly known causes.
Melanoma is one of the more rare skin cancers, but it is the most serious. The diagnosis has grown in frequency and is now the 5th most common cancer in men and the 6th most common in women. Cases have increased by 270% between the years 1973 and 2002.
Melanoma is an interesting disease since it affects the sexes differently based on their age. Women are more likely to get it until the age of 40 where they are less at risk. Men on the other hand start to increase their risk around 40 and become 3 times more likely to end up with melanoma by 75.
There are several different types of melanoma. The most common forms are:
- Superficial Spreading Melanoma (SSM)
- Nodular Melanoma (NMM)
- Lentigo Maligna Melanoma (LMM)
- Acral Lentiginous Melanoma (ALM)
- Desmoplastic Melanoma (DM)
Early detection, like with all cancers, is one of the most important parts of a successful recovery from any form of melanoma.
How is Melanoma Diagnosed?
Since melanoma is in the more superficial part of our skin it is a little easier to detect early on. This makes testing less invasive compared to other forms of cancer.
Early detection begins with self-examination. Become aware of your skin and the different spots you see. If there are any that look abnormal or are changing, it’s best to get them checked out by your physician.
For your self-detection checklist remember to check for ABCDE:
- Asymmetry
- Border irregularity
- Color changes or an uneven appearance
- Diameter (greater than 6mm)
- Evolving
Any spots on your skin that fit these criteria are good to show your doctor to avoid further complications.
Melanomas won’t always be easily visible to the human eye and some will be in places you can’t physically check. Seeing your doctor regularly can help in these instances as they’ll know what to look out for. Since melanoma can be genetic if you have a family history make sure to bring this up to your physician.
Once the initial evaluation happens a specialist will conduct other tests if they believe you may have melanoma. These tests can include dermoscopy, total body photographic images, reflectance confocal microscopy (RCM).
What are Treatment Options for Melanoma?
Treatment options will differ based on the type and severity of melanoma being treated. Some of the different options will include:
- Surgery
- Radiation
- Medication
Surgery
For easily accessible tumors, surgery will be used. In the early stages of melanoma, surgery may be the only type of treatment needed. Part of the surgery will be the removal of tumors. The other portion will be lymphatic mapping and/or lymph node dissection if the lymphatic system has been affected by cancer.
If the cancer is further along or has started spreading, then other treatments will be needed to ensure all of the cancer is removed.
Radiation
Radiation therapy is often used in an area that has already had surgery to remove the cancerous area. Radiation shouldn’t be used for long periods of time as it can cause damage to healthy tissues. But it is very effective in preventing cancer from coming back. People often experience side effects and a lower quality of life while on radiation therapy so doctors do try to limit its use if possible.
Medication (Systemic Therapies)
There are three main categories of medication treatments for melanoma:
- Immunotherapy
- Targeted therapy
- Chemotherapy
Each of these therapies can be used individually or in combination with another. Physicians should speak with their patients about what they believe the best course of action would be. Each has its pros and cons and they should be noted prior to administration.
Immunotherapy
Immunotherapies focus on boosting the body’s immune cells to help them fight and better target the cancer cells. Some of the different types of immunotherapies are:
- PD-1 and PD-L1 Inhibitors — this therapy allows T cells to function better because they are no longer being blocked from finding the melanoma cells by PD-1 and the PD-L1 protein
- CTLA-4 Inhibitors — this therapy works by targeting a molecule called cytotoxic T-lymphocyte-associated molecule-4 (CTLA-4) and interrupting its effects on immune cells. CTLA-4 inhibitors work well alongside chemotherapy and/or PD-1 inhibitors
- Interleukin-2 (IL-2, Proleukin) — this therapy activates T cells but often has more side effects
- Virus Therapy — T-VEC is a laboratory designed herpes virus that is used to make an immune-stimulating hormone
These therapies have been found to be more effective in patients with optimal gut microbiome balances (read below to learn more about these studies).
Targeted Therapy
Targeted therapy focuses on attacking the cancer-specific genes, proteins, and tissues without negatively affecting the healthy tissues around it. This treatment focuses on stopping the growth and spread of cancer. Some of the options for targeted therapy are:
- BRAF Inhibitors
- MEK Inhibitors
- KIT Inhibitors
- Tumor-agnostic Treatment
Chemotherapy
Chemotherapy doesn’t have to be used as often with melanoma since the other options are usually very effective on their own. Chemotherapy is a last resort option since the side effects reduce the patient’s quality of life so significantly.
Whatever therapy is chosen, the patient and doctor should both weigh the pros and cons and be comfortable with the choice that is right for the individual’s specific case.
New Research Shows Gut Optimization Can Improve Responsiveness to Immunotherapy in Melanoma Patients
Our immune system is highly affected by our gut health. It is where our nutrients from our foods are extracted and recirculated throughout our bodies to improve our health. So doctors are now focusing on how to optimize our health through the delicate balance that is our gut microbiome.
Cancer is no exception to the extent of how our gut microbes improve our health outcomes.
Several studies have been done and show that there are specific bacteria that affect how effective cancer treatments (specifically immunotherapies). Here are some of the important findings:
- Patients who had higher levels of Bifidobacterium longum, Collinsella aerofaciens, and Enterococcus faecium in their stool samples responded better to PD-1 therapy along with better tumor control.
- Patients undergoing PD-1 immunotherapy who had a higher alpha diversity of the Ruminococcaceae family had more successful responses to their treatments
- Germ-free mice were given a fecal microbiota transplant (FMT) from non-responders receiving PD-1 therapy. The FMT samples were notably low in the bacteria Akkermansia muciniphila. Oral administration of this bacteria helped the mice to have better responses to treatment.
- Patients who weren’t responding to PD-1 treatment were given a FMT from patients who experienced success with PD-1 therapies. A noticeable difference in their gut bacteria was seen in the nonresponsive patients. Along with a better bacterial count, the tumor microenvironment was changed and finally responded to the PD-1 therapy after the FMT was done.
All of these studies show us how important a balanced microbiome is in the success of our immune system and treatments for melanoma patients. The FMT treatments allowed for the patient’s bodies to overcome the initial resistance to therapy allowing it to be successful and help rid them of their cancer.
While this research is in its novel stages, it’s paving the way for critical findings in our fight against cancers of all kinds.
Maintaining a healthy gut is proving a very important key. Supplements such as Atrantil play an important role as a prebiotic and nourish the microbiome.
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- https://iv.iiarjournals.org/content/28/6/1005.long
- https://www.cancer.net/cancer-types/melanoma/types-treatment
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529202/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707353/
- https://pubmed.ncbi.nlm.nih.gov/29097493/
- https://pubmed.ncbi.nlm.nih.gov/29097494/
- https://science.sciencemag.org/content/371/6529/595