Merkel cell carcinoma (MCC) is rare, but it’s becoming less rare. Compared to melanoma, MCC is much more likely to be fatal, so it’s important for people to be aware of it. Because melanoma incidence has been increasing over the last few decades, researchers suspected that MCC incidence was increasing as well. After examining data from the National Cancer Institute’s SEER-18 registry, they found that it was increasing even more than they had anticipated.
From 2000-2013, the number of reported MCC cases increased 95 percent, compared to 57 percent for melanoma and 15 percent for other cancerous tumours. Based on current population trends, Dr. Nghiem and his team predict that MCC incidence will grow from nearly 2,500 cases in 2013 to more than 3,200 in 2025.
Psoriasis is a chronic inflammatory disease that causes skin cells to multiply faster than normal resulting in raised, red patches covered by silvery scales. It occurs most commonly on the scalp, knees, and elbows but can appear anywhere on the body including the face, genitals, nails, and other places. In moderate to severe cases, it carries an increased risk of heart attack, stroke, and premature death, a finding established by Gelfand in a 2006 landmark study. The National Psoriasis Foundation estimates psoriasis affects about 7.5 million Americans.
Ustekinumab, sold under the name Stelara, is approved by the U.S. Food and Drug Administration to treat psoriasis, psoriatic arthritis, and Crohn’s Disease. Researchers wanted to know if the benefits of the drug go beyond clearing the skin.
“The type of inflammation we see in psoriasis is similar to what we see in atherosclerosis — a type of heart disease that involves the build-up of fats, cholesterol, and inflammatory cells in the artery walls,” Gelfand said. “Since ustekinumab blocks the specific pathways involved in both skin and cardiovascular inflammation, we wanted to test whether it can improve aortic vascular inflammation.”
The more times metastasised melanoma has mutated and the patient’s immune system has been activated against a tumour — the better the chances of survival after immunotherapy. This is what emerges from a research collaboration between Lund University in Sweden and Herlev university hospital in Denmark. The findings are now published in the scientific journal Nature Communications.
In simple terms, the treatment entails first removing the patient’s own T cells from a tumour. T cells are the part of the immune system that recognises tumour cells. The patient’s cells are then cultured in the lab and subsequently injected back into the patient.
“The aim is for them to seek out and fight a tumour and the circulating tumour cells,” explains Göran Jönsson, a researcher at Lund University. He is collaborating with Herlev university hospital in Copenhagen, which is one of few hospitals in Europe currently conducting clinical trials of this form of immunotherapy.
Although the treatment outcomes are promising, only just below half of the patients respond to this immunotherapy.
“Between 10 and 20 percent of those affected by advanced melanoma can be cured with a single treatment of adoptive T cell therapy. On the other hand, the treatment is very intensive and has many side effects. It is therefore important to be able to predict which patients stand to benefit from the treatment so that we give it to the right ones,” say, Inge Marie Svane and Marco Donia, physicians at Herlev university hospital and researchers at the University of Copenhagen.
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The technology employs machine-learning software to analyze images of skin lesions and provide doctors with objective data on telltale biomarkers of melanoma, which is deadly if detected too late, but highly treatable if caught early.
The AI system — trained using tens of thousands of skin images and their corresponding eumelanin and hemoglobin levels — could initially reduce the number of unnecessary biopsies, a significant health-care cost. It gives doctors objective information on lesion characteristics to help them rule out melanoma before taking more invasive action.
The technology could be available to doctors as early as next year.
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The researchers report that, between 2000 and 2010, squamous cell carcinoma (also called cutaneous squamous cell carcinoma) diagnoses increased 263 percent, and basal cell carcinomas increased 145 percent. They compared the 2000-2010 period to two other segments of time: 1976-1984 and 1985-1992.
Women 30-49 experienced the greatest increase in basal cell carcinoma diagnoses; whereas, women 40-59 and 70-79 experienced the greatest increase in squamous cell carcinomas.
Men had an increase in squamous cell carcinomas between the first and second time period studied (1976-1984 and 1985-1992), but experienced a slight decline in the 2000-2010 period. However, for basal cell carcinomas, men over 29 showed similar increases in diagnoses in the 2000-2010 period than the two earlier periods.