The Ottumwa Courier

February 25, 2014

Fighting a war on melanoma

Courier staff writer

---- — OTTUMWA — Farmers 50 years of age and older are the most common people in Iowa to have melanoma skin cancer. It is more frequent in this age of men, surpassing colon, prostate and lung cancer.

The University of Iowa Carver College of Medicine is trying to change those statistics.

At a UI Mini Medical School workshop held Monday at Indian Hills Community College, the topic was saving your skin and the advances in melanoma research and treatment.

Melanoma is the most deadly form of skin cancer. Someone dies from melanoma every hour of every day. In addition, it is one of the fastest-growing cancers in the United States and worldwide.

The mini clinic's presenters were quick to explain that there are no easy answers and no definitive solutions for melanoma.

"There's no rhyme or reason to melanoma," Dr. Kris DeMali, an associate professor at Carver College of Medicine, told the eager listeners. "You don't try to predict who, where or how fast it will metastasize. You have to try to understand how to treat it."

While older Iowans often have the most sun-damaged skin after years of outdoor exposure, Dr. Mohammed Milhem, clinical associate professor and the Iowa melanoma specialist, says he is seeing more young people in his office with melanoma — and the cause this time is simple.

"I'm seeing more teen girls who have been using tanning beds," he said. "They're 16 to 18 years old and they're in my office. No tanning beds. There's too much direct UV light."

But he stressed that staying inside all day every day isn't the answer, either.

"Some sun is actually not bad, but in moderation," he explained, adding that the Vitamin D from sunshine is essential to the body. "You can be in the sun as long as you want and use sunscreen, but just don't burn."

While melanoma can develop on anyone — no matter their age, gender or race — caucasians are especially vulnerable to the disease.

All of this information makes the research and treatment of melanoma increasingly important. In the lab, DeMali says, researchers are working on finding out what drives the cancer cells to divide, and in the case of melanoma, divide so rapidly.

"The drugs we're developing are working very poorly. They're stopping the signals being sent to the melanoma cells to metastasize, but then other signals pop up, telling it to grow. We're doing research to learn what those new signals are and how to stop them," DeMali said.

Research in the lab, clinical trials and more information about how different treatments can be combined for more effective results are all part of the school's plan for moving forward in stopping melanoma.

One of the most fascinating parts of the evening was a time-lapse computer-generated model of melanoma cells in a petrie dish. Photos were taken every 10 minutes, and Milhelm said after three weeks, it showed how much more knowledge is still out there to discover.

"It's alive. It's inside us growing," he said as the shapes enlarged, grew together and took over the screen. "It's making blood vessels and trying to establish itself. It's creating this mass all by itself."

Melanoma knows no bounds. It can work its way from the skin through the blood vessels to any part of the body — an eye, the brain, heart, even the big toe. And unfortunately, it is also the only cancer than can be spread from a pregnant woman to her baby.

This type of information is the reason the University of Iowa began these mini clinics around the state. The Mini Medical School program is designed to provide an insight into the world of medicine by spotlighting researchers and clinicians from the university. The clinics are broken down into community education programs and STEM education programs for kids.

— Follow reporter Laura Carrell on Twitter @CourierLauraC

The ABCDEs of melanoma A - Asymmetry (A line drawn through the middle will not create matching halves.) B - Border (The edges will frequently be uneven, often containing scalloped or notched edges.) C - Color (Different shades of brown or black are often the first sign of a malignant melanoma.) D - Diameter (Common moles are usually less than 6 millimeters, the size of a pencil eraser.) E - Evolving lesions (Any lump or mole that changes or grows should be a concern.)