By Louise M. Perkins, Ph.D.
Chief Science Officer
President Jimmy Carter revealed to the world his diagnosis with melanoma with both the grace and bravery that we may all aspire to in the face of such news. His melanoma presentation was a bit unusual and naturally confusing. He was initially diagnosed with a tumor in his liver and then on closer exploration it was found to have spread to the brain. Once the tumor in his liver was removed and analyzed, his doctors could tell that it was a melanoma. Understanding what type of cancer he has is important, as it is helping to direct his treatment. It is fairly typical for melanoma to progress to the brain, as has been reported in President Carter’s case.
So, how can a cancer that usually starts in the skin suddenly pop up in someone’s brain and liver? Well, first of all, this is really rare. Some estimates say only 2% to 6% of melanomas are identified without ever finding the original (primary) tumor. Where do these odd melanomas come from?
Let’s back up a second. Melanomas are pigment-producing cells called melanocytes that have become cancerous.
Melanocytes are not only present on what we think of as skin, but also found in mucosal surfaces like the inside of the nose or mouth, under nails, as well as in eyes and ears – and even some organs.
So, in the case of President Carter, there are a couple possibilities:
- He may have had a skin melanoma that had a couple bad cells that split off and hid while his immune system effectively dealt with the primary tumor and he was none the worse. For whatever reason the stray cells then got out of control, leading to his current disease.
- Alternatively, something similar may have happened with the melanoma being relatively benign at a rare site in his body, but a few “bad guy” cells broke away and seeded in the brain and liver and then grew more aggressively.
We may never know.
The good news is that Mr. Carter is able to take advantage of the benefits of research that has led to sweeping advances in melanoma. Beginning in 2011, care for patients with advanced melanoma changed profoundly and the FDA has approved eight new treatments since then. Of relevance to President Carter’s specific treatment plan, MRA has funded research on melanoma brain metastases as well as on the combination of anti-PD-1 treatment and radiation therapy, similar to what has been offered him by his doctors.
MRA’s critical and timely infusion of funding has contributed to the sweeping changes in melanoma care with a significant part of our portfolio invested in research on just the types of treatments that will hopefully help President Carter and tens of thousands of other cancer patients in the future. My thoughts and prayers are with him and the many others engaged in their fight against melanoma.
You can learn more about our investments and hope you will consider making a donation to continue to support melanoma research.