The body has a built-in defense: the immune system, which consists of white blood cells, lymph system tissues and organs that work together to identify and destroy infections and abnormal cells. However, cancer cells use genetic changes to hide their abnormality or interfere with the immune system's ability to detect and destroy them. Immunotherapy helps the immune system overcome these defenses.

"We're working with what the body naturally does but has not done perfectly, as it has allowed cancer to develop. We're trying to reinforce the body's natural defenses," says Svetomir Markovic, M.D., Ph.D., a Mayo Clinic Comprehensive Cancer Center medical oncologist who researches immunotherapy for melanoma and non-Hodgkin lymphoma.

"Immunotherapy leverages the patient's immune system to fight cancer. It activates and pushes it to find the tumors and kill them," says Haidong Dong, M.D., Ph.D., a Mayo Clinic Comprehensive Cancer Center cancer immunologist. "You can use different tools — T cells, vaccines, targeted drugs — but they all use the patient's immune cells to fight their tumors."

Dr. Markovic and Dr. Dong discuss the history of cancer immunotherapy at Mayo Clinic, how it works, its benefits and risks, and its future:

The roots of cancer immunotherapy at Mayo Clinic

In the late '90s, Dr. Dong and his colleagues at Mayo Clinic discovered that a protein called PD-L1 regulates the immune system's response to cancer cells and other threats. PD-L1 acts as a check or brake by binding to another protein in T cells called PD-1. This discovery led them to develop an antibody that blocks PD-L1's function.

"Using the antibody to block PD-L1 restores the immune system's ability to kill the tumor," says Dr. Dong, the Iris and Winston Clement Professor of Research. "This breakthrough laid the foundation for immunotherapy drugs that target the PD-L1 pathway."

In 2002, Dr. Dong and his team reported their findings, paving the way for the development of new immunotherapy drugs called immune checkpoint inhibitors. In 2014, the Food and Drug Administration approved pembrolizumab as the first immune checkpoint inhibitor to treat melanoma. Today, pembrolizumab is approved to treat 18 types of cancer.

How does cancer immunotherapy work?

Cancer immunotherapy drugs don't directly target cancer cells. Instead, they enhance the body's immune cells, improving their ability to recognize and destroy cancer cells.

"Immunotherapy helps the immune system see where the tumor is in the body. The immune system can see a single cancer cell. That's powerful," says Dr. Dong.

"Immunotherapy helps the immune system see where the tumor is in the body. The immune system can see a single cancer cell. That's powerful."Dr. Haidong Dong

"It's almost like cancer therapy by proxy," says Dr. Markovic, the Charles F. Mathy Professor of Melanoma Research. "We're engaging the body to do its job in ways that make it uniquely effective."

Some of the most common immunotherapies used in cancer treatment include:

Immune checkpoint inhibitors

Immune checkpoint inhibitors are immunotherapy drugs that block checkpoint proteins, such as PD-L1, on cancer cells from binding to their partner proteins on immune cells (T cells). This allows the immune system to destroy cancer cells. Pembrolizumab is one example of an immune checkpoint inhibitor. Eleven immune checkpoint inhibitors have now been approved to treat cancer.

Most of these drugs are used for advanced cancer or cancer that has spread (metastasized). However, some immune checkpoint inhibitors are now being used in earlier stages of cancer to prevent its spread and recurrence. Clinical trials are also investigating combinations of these drugs with other treatments and new immune checkpoint inhibitors.

Learn about immune checkpoint inhibitors and related research at Mayo Clinic:

• Immune checkpoint inhibitors: Immunotherapy for people with triple-negative breast cancer
• From molecule to melanoma: A foundation of research brings new cancer immunotherapies to patients

Oncolytic viruses

Oncolytic viruses use naturally occurring or lab-made viruses to infect cancer cells, causing them to rupture. This stimulates the immune system to attack the remaining cancer cells.

Most oncolytic virus treatments for cancer are still in clinical trials. A weakened form of herpes simplex virus type 1 given by injection is approved to treat melanoma on the skin or in lymph glands.

Learn about oncolytic virus research at Mayo Clinic:

• Novel oncolytic immunotherapy shows promise for patients with bladder cancer
• Unleashing viruses aimed at killing cancer
• Mayo Clinic researchers load CAR-T cells with oncolytic virus to treat solid cancer tumors

Personalized cancer vaccines

Personalized cancer vaccines train the immune system to recognize a specific cancer-related protein from a person's tumor. As the immune system learns to recognize the protein, it can fight it. This treatment is still being studied in clinical trials.

Learn about personalized cancer vaccine research at Mayo Clinic:

• Mayo Clinic Minute: How personalized vaccines target cancer tumors
• Vaccines: The next frontier of lung cancer treatment and prevention
• Tomorrow's Cure: How personalized vaccines combat cancer
• Mayo Clinic researchers design personalized vaccines to fight cancer
• Harnessing the immune system to fight ovarian cancer

Cellular therapies

Cellular therapies involve collecting cells from blood and modifying them to attack cancer cells. These include chimeric antigen receptor (CAR)-T cell therapy and tumor-infiltrating lymphocyte (TIL) therapy.

• CAR-T cell therapy: For this therapy, white blood cells called T cells are removed from a person's blood and genetically modified to produce chimeric antigen receptors. CARs allow T cells to recognize markers on the surface of cancer cells, activating the T cells to kill them. The modified CAR-T cells are then infused into the patient's body to identify and destroy their cancer. The FDA has approved CAR-T cell therapy to treat several types of blood cancer, and clinical trials are exploring its use for solid tumor cancers.
• TIL therapy: This therapy involves surgically removing a person's cancerous tumor, extracting immune cells (lymphocytes) from it, and enriching them. During this process, the patient receives chemotherapy to prepare to receive the enriched immune cells, which are later infused into their body to target any remaining cancer. "The first treatment the patient receives warms up the immune system — improves it to a degree ­— but not enough to kill the tumor. TIL therapy gives the immune cells more power to finish the job," says Dr. Dong. In 2024, the FDA approved the first TIL therapy, lifileucel, for people with melanoma that has spread or cannot be removed by surgery.

Learn about cellular therapy research at Mayo Clinic:

• What is CAR-T cell therapy?
• Understanding CAR-T cell therapy for cancer: Mayo Clinic expert explains how it works
• Unleashing CAR-T cell therapy to destroy solid tumors in thyroid cancer
• Using molecular scissors to improve CAR-T cell therapy
• Preparing to biomanufacture a new CAR-T cell therapy for B-cell cancers

Cytokines

Cytokines are proteins made by white blood cells that signal the immune system to either activate or slow down. Cytokines used as immunotherapy drugs include interleukins and interferons:

• Interleukins: These act as chemical signals between white blood cells. Aldesleukin is a lab-made interleukin (IL-2) that increases the growth and activity of certain white blood cells. It is used to treat melanoma and kidney cancer that has spread throughout the body.
• Interferons: These help the body resist viruses and cancer cells. Interferon alfa-2b is a type of interferon (IFN-alpha) used to treat hairy cell leukemia, melanoma, follicular lymphoma and AIDS-related Kaposi sarcoma.

Bispecific antibodies

When the immune system detects cancer cells or other abnormal cells, it produces immune cells called antibodies to attack them. Bispecific antibodies are lab-made antibodies that can bind to both cancer and immune cells simultaneously, bringing them close together to enhance the immune system’s ability to destroy cancer cells.

The FDA has approved seven immunotherapy drugs that use bispecific antibodies to treat cancer.

Learn about bispecific antibody research at Mayo Clinic: "New research discovers a new combination of therapy for people with a type of leukemia, leading them to live longer."

What are the benefits and risks of immunotherapy?

Immunotherapy is effective against many types of cancer because it uses the immune system to recognize and attack cancer cells. "We don't yet know which immunotherapy best suits all malignancies. As we learn the biology of all this, as our intervention tools become more sophisticated, the number of cancers we can treat increases," says Dr. Markovic.

"We don't yet know which immunotherapy best suits all malignancies. As we learn the biology of all this, as our intervention tools become more sophisticated, the number of cancers we can treat increases."Dr. svetomir Markovic

Immunotherapy can also produce long-lasting responses to treatment by training the immune system to recognize cancer and respond quickly if it returns.

However, immunotherapy can cause side effects. "That’s the price we pay," says Dr. Markovic. "When turned on, the immune system attacks the cancer but may also attack noncancerous tissue, producing side effects similar to autoimmune disease symptoms. They mimic allergic reactions."

Side effects vary based on the type of immunotherapy. Some can be serious, but most can be managed, treated and resolved. Common side effects include redness, itching or blistering of the skin, flu-like symptoms, diarrhea, swelling and weight gain.

Mayo Clinic scientists and colleagues worldwide are researching how to reduce immunotherapy's side effects and increase its benefits. "As we get better with cancer immunotherapy, our treatments become more effective, less toxic and help more people," says Dr. Markovic.

The future of cancer immunotherapy

Scientists are researching ways to improve immunotherapy outcomes and reduce its limitations. Dr. Dong says research is exploring these key areas:

• Understanding why the responses vary from person to person.
• Combining immunotherapy with other treatments, such as chemotherapy, radiation therapy, or targeted drug therapy, to produce the best outcomes.
• Reducing side effects.
• Identifying biomarkers to help predict which people will respond to immunotherapy.

Dr. Dong says this research could improve the effectiveness of immunotherapy and patients’ quality of life. It will also help care teams make more informed treatment decisions and may decrease the financial burden of cancer treatment.

"Immunotherapy has fundamentally changed cancer medicine with the possibility of a cure for cancers that have been considered completely incurable," says Dr. Markovic. "It was once unheard of for patients with metastatic, advanced melanoma to be cured of their disease. Today, a person with this diagnosis has a one in three chance of being cured. That’s a dramatic improvement in outcomes."

Learn more

Drs. Dong and Markovic encourage you to ask your care team specific questions about your treatment. Other trusted sources of information about immunotherapy include:

• American Cancer Society
• Cancer Research Institute
• National Cancer Institute
• National Comprehensive Cancer Network

Find a clinical trial at Mayo Clinic.

Join a support group on Mayo Clinic Connect, an online community moderated by Mayo Clinic for patients and caregivers.

This article first published on the Mayo Clinic Comprehensive Cancer Center blog.

The post What is cancer immunotherapy? appeared first on Mayo Clinic News Network.

When people think of a pharmacist, they usually think of someone dispensing medication. Pharmacists do fill prescriptions, but there's another type of pharmacist who plays a vital role in clinical research. The research pharmacist is skilled in making the clinical trial part of drug development possible.

Indeed, research pharmacists are part of multidisciplinary teams that investigate new pharmaceuticals and drugs developed for patient care.

There are two types of research pharmacists at Mayo Clinic. One facilitates clinical trials involving medications through protocol review and support of the medication management process. The other designs and conducts research as a principal investigator, or research to address other questions in the fields of pharmacy or medicine.

"There is a lot of skill and training required to be able to correctly develop and prepare experimental therapeutics," says Svetomir Markovic, M.D., Ph.D., an oncologist and principal investigator of the Melanoma Research Lab at Mayo Clinic. "These are medications that we administer to a patient in a vein or inject in a tumor or the brain. The research pharmacists make sure that the drugs are made correctly, that they go to the right person in the correct dosage."

A pharmacist's role is multifaceted, but to be a trusted medication expert, pharmacists must complete a comprehensive and rigorous Doctor of Pharmacy (Pharm.D.) curriculum. After completion of Pharm.D. coursework, pharmacists can pursue additional elective postgraduate residency training to focus on specialty designations.

Mayo Clinic offers one- and two-year postgraduate residency programs. Research is a requirement of these programs.

"The residents complete a research project as part of the programs. I think that's where many times pharmacists decide whether research is for them or not," says Elizabeth Ventresca, Pharm.D., director of pharmacy services at Mayo Clinic.

Bringing new treatment options to patients with melanoma

Kristi Franta, Pharm.D., joined Mayo Clinic after her residency in 2013 as a central pharmacist; a year later, she moved to the position of clinical hematology/oncology pharmacist.

For Franta, the path to research pharmacist revealed itself over time. Her previous roles exposed her to clinical trials that allowed her to work alongside the research support pharmacy team while caring for patients. In her current role, Franta supports a wide range of adult oncology and pediatric hematology/oncology clinical trials.

Franta is part of a team conducting several studies working with Dr. Markovic and Anastasios Dimou, M.D., an oncologist at Mayo Clinic in Rochester. One of the clinical trials is evaluating the use of an investigational device for metastatic melanoma.

A phase 1 clinical trial, also called an early-phase clinical trial, might be the first time an experimental cancer drug or intervention is used with people. It tests the safety, side effects, best dose and timing of a new treatment. It also may test the best way to administer a new treatment — such as by mouth, infusion into a vein, or injection — and observe how the treatment affects the body.

"These melanoma studies are exciting to me because they have the potential for patients to be able to receive chemotherapy in a more convenient way and hopefully with less of the toxicities commonly associated with them," says Franta.

Franta enjoys being involved in studies from an early phase, such as protocol writing through activation, dispensing drugs to patients and publication of results. "My work provides a great deal of satisfaction knowing I’m contributing to potentially bringing another treatment option to patients who may have limited or no other options."

Working on personalized cancer vaccines

Vanessa Toncray, Pharm.D., is a research pharmacist who works on clinical trials. She joined Mayo Clinic in 2018 as a pharmacist in clinical practice. Before joining Mayo Clinic, Toncray worked as a pharmacist and in quality and patient safety.

As a research pharmacist, Toncray says there is no such thing as a typical day. But the one thing she knows for sure when it comes to her job is that communication is key.

"Something that most people don’t know about my job is the level of communication that is required. We are in constant communication with both internal team members and external contacts to determine timelines, obstacles and to problem-solve," Toncray says.

Toncray is part of a team of researchers working on a trial of a personalized vaccine for patients with advanced cancerous tumors.

"The research pharmacist provides expertise and invaluable insight from development and implementation of research protocols, which are critical to ensuring patient safety first and the quality of the study," says Yanyan Lou, M.D., Ph.D., an oncologist at Mayo Clinic in Florida.

Research pharmacists engaged in clinical trials also are guided by the Food and Drug Administration (FDA) rules for investigational drugs.

"There is a whole set of FDA regulations that these pharmacists must navigate as they’re working through different studies to determine the right path forward," says Ventresca.

Working on clinical trials aligns with what Toncray likes most about her job, which is being able to facilitate the treatment for patients who potentially have exhausted other options. "Having a small part in the advancement of science, as it relates to therapeutic options, is exciting," says Toncray.

A career pivot to research pharmacist

Christopher Grilli, Pharm.D., is a clinical pharmacy specialist and researcher at Mayo Clinic in pharmacogenomics, the study of how genes affect the body's response to medication, an emerging field within patient care.

Grilli joined Mayo Clinic in 2015 as a pharmacy department manager, a position he held for six years before moving to his current role as a pharmacist researcher. Before joining Mayo Clinic, he was a manager at a large retail pharmacy.

He says research was never on his radar as a career trajectory. Rather, it was his "extreme dislike" of not knowing the answer to a problem when he needed it most. "Pursuing scientific truth through data and asking lots of questions, coupled with a strong commitment to finding answers, is how I ended up at this place in my career," Grilli says.

Grilli is principal investigator of a study using whole exome sequencing data, which enables the analysis of all protein coding sequences in the human genome. This technology supports the investigation of cancer-related genetic abnormalities in the exonic regions, which carry information for a genetic code.

For Grilli, the process of scientific discovery has always been exciting.

"Identifying new ways to treat and, in some cases, cure disease for the sickest and hardest-to-treat patients is such a gratifying way to spend my time," says Grilli. "As an added bonus, working with some of the best and most skilled minds in Mayo research makes the process of discovery and translation enormously rewarding."

Like all scientists, curiosity is a shared trait among clinical trial research pharmacists.

"These folks are always thinking, surely there's something better, a medication with less side effects and toxicities to the patient that will deliver better outcomes," says Ventresca. "I think curiosity on the part of a research pharmacist is really a key characteristic."

Postgraduate clinical and translational science research training is supported by the Mayo Clinic Center for Clinical and Translational Science, which is funded by Clinical and Translational Science Award grant UL1 TR000135 from the National Center for Advancing Translational Sciences.

The post Science Saturday: Pharmacists play key role in clinical research appeared first on Mayo Clinic News Network.

Dawn Botsford was sitting in a chair at the hair salon in 2011 when her hairdresser commented on a spot on the top of her head.

It was bug season in North Dakota, so Dawn didn’t think much of it. "When I told my hairdresser that, she said, ‘I really think you need to get it checked out.' She saved my life," Dawn recalls.

Dawn met with a local dermatologist to have the spot examined. A few hours after her biopsy, Dawn's dermatologist told her she had melanoma, a form of skin cancer.

Dawn's dermatologist wanted her to see a local oncologist as soon as possible, but there were no appointments available.

"With that kind of news, I got worried," Dawn says.

Dawn visited her local physician for another trusted opinion. His comment was even more unsettling: "This looks pretty serious."

He then picked up the phone and called Mayo Clinic to make a referral.

No. 1, and six hours away

After receiving news of availability and discussing it with her husband, John, and their son, Tom, Dawn made an appointment at Mayo Clinic in Rochester. Dawn and John made the trip to Mayo Clinic and met with Eric Moore, M.D., the next day.

Dr. Moore scheduled surgery for Dawn two days later.

"We're fortunate to have the No. 1 medical system in the world a six-hour drive away," Tom says. "We never really questioned that we were going to go to Mayo."

They really wanted to give me hope that this diagnosis was not fatal.

Dawn Botsford

In October 2011, after several appointments and the initial surgery to remove the spot, doctors confirmed that Dawn's melanoma was late-stage.

"The physicians at Mayo Clinic were all so kind and caring," Dawn says. "They really wanted to give me hope that this diagnosis was not fatal."

A month after surgery, Dawn developed an infection in the incision on the top of her head. She happened to be in Minneapolis with family, and they decided to head to Mayo Clinic in Rochester's emergency department, about 75 miles away. When they arrived, Dawn was amazed to see a doctor waiting for her who had read her chart and was up to speed on what was going on.

"That is remarkable patient care," she says.

Finding hope in a clinical trial

In early 2013, doctors performed a precautionary lung X-ray and found that melanoma had spread to Dawn's lungs.

Her oncologist, Robert McWilliams, M.D., suggested she enroll in a clinical trial with an immunotherapy drug, conducted by Svetomir Markovic, M.D., Ph.D., a medical oncologist and hematologist who specializes in the care of patients with advanced melanoma.

"Dr. Markovic said a clinical trial was her only option, and that the survival rate at the time was 2%," Tom says. "I still remember sitting in our home office, my dad and I Googling this stuff, looking for papers on outcomes and survival rates. That's what we found — 2%."

Dawn decided to take part in the study.

"It was always equally as important to her that she was participating in a clinical trial, not knowing if it would help her, but knowing that the results would eventually help others," John says.

Best bet: surgery

By the end of 2013, Dr. McWilliams and thoracic surgeon Stephen Cassivi, M.D., decided that surgery on both lungs was now Dawn's best bet.

The entire team of researchers, providers and staff who saved my life and always gave me hope is something the clinic can be very proud of.

Dawn Botsford

"I got back to the hospital, and in my room on the whiteboard there was a sign that said, 'Welcome back, Dawn!' I just felt like everybody took such good care of me," Dawn says. "They didn't know it, but they were challenging me, too. I had to get my lungs working again."

In July 2015, another spot was found on Dawn's right lung. She then had three stereotactic radiation treatments, a noninvasive radiosurgery technique. After her treatments, Dawn came back to Mayo Clinic every six months for routine testing.

10 years later

After numerous PET scans and appointments, and with the strong support of family and friends, Dawn officially completed her time with the oncology program at Mayo Clinic in July 2020 — 10 years after the first spotting of melanoma and five years since the last recurrence.

Following completion of her treatments, Dawn and her family decided to support Mayo Clinic through philanthropy. Mayo Clinic recognizes the Botsford Family Foundation as a Major Benefactor for the family's generosity.

"I can't say enough about the people and the facilities at Mayo Clinic," Dawn says. "The entire team of researchers, providers and staff who saved my life and always gave me hope is something the clinic can be very proud of."

For John and Tom, Mayo Clinic means even more.

"Not only did Dr. Markovic and the team at Mayo Clinic save my mom, but they allowed her to get to know her grandkids," Tom says. "That's something you can never put a price on."

This story originally appeared in Mayo Clinic Magazine.

The post Dawn’s Journey: Overcoming a near-zero survival rate appeared first on Mayo Clinic News Network.

This column spotlights the people you think about when you think about Mayo Clinic. They've answered questions, serious and silly, so you can know them better.

You see them at bedsides. Behind desks. You may spot them walking down a hall or sprinting across a lobby, making every effort to look like they're walking. You see them talking quietly with a patient and family, or sitting down with you at a meeting. They personify life at Mayo. They may be friends, teammates or someone you know only by sight. But you're glad they're here. And it's reassuring to know that the health of our patients, our colleagues and the institution itself rests in their capable, friendly, earnest, caring and compassionate hands.

Join us in celebrating them, and let us know if you'd like to see one of your colleagues featured here. Yes, they'll probably be embarrassed and they may even protest, but let's celebrate them just the same.

After finishing medical school in Philadelphia, Svetomir Markovic, M.D., Ph.D., and his wife, Patricia Best, M.D., came to Mayo Clinic "for the beautiful weather," he says, before confessing the real reason the couple landed in Rochester. "Everything we had heard about Mayo Clinic seemed to suggest that this was the sort of place that we would want to be," Dr. Markovic says. "And, fortunately, much of what we hoped turned out to be true."

Favorite part about working here: The warm feeling of community surrounding our shared sense of what we are all here to do: Take care of people. I see this every day.

One of my favorite things about Mayo Clinic: All the wonderful people that I get to work with every single day. Our daily struggles notwithstanding, the folks around this place are top-notch.

The single most important thing I did at work yesterday (or expect to do tomorrow): Help someone fight cancer.

A book I would recommend or one I want to read: I just finished a biography of Leonardo da Vinci. It was inspiring. Next on my list is to reread is "Little Women" with my teenage daughter.

Mayo Clinic has taught me: We are not alone, no matter what the struggle.

Most treasured or best advice from a colleague at Mayo: "The best things in life are indeed free."

Most memorable Mayo moment: I will never forget a moment that I witnessed in passing, just outside the room of a patient on one of our inpatient hematology services. A young teenage girl walked out of a hospital room after saying her final goodbye to her father, who was dying from cancer. He was not my patient, and I did not know the family. I did know the doctors who took care of him and who were doing everything possible to save him. This image will be with me for as long as I live. It reminds me of what I need to do every day when I come to work. I simply cannot allow for this to keep happening.

If I could choose the "on hold" music for Mayo Clinic: The theme song from "Chariots of Fire."

Favorite space on campus this month: Three days in two weeks in the same exam room on Gonda 10, I told patients that their metastatic melanoma was gone, and the treatment worked. Pretty cool room.

People who inspire me: All those who allow me to be part of their lives in their struggle against cancer — these are my heroes.

The most fun I've had at work this year: Every time I tell a patient that they no longer need my help and need to start worrying about their cholesterol instead. (I'm a cardiologist by marriage.)

What is something about the practice of medicine that has surprised you: What a profoundly human experience medicine really is. Beyond all the science, the data, the academia, this profession of ours has always been, and always will be, about kindness and care for those who suffer.

Team Dr. Charlie or Team Dr. Will? Or Team Mother Alfred or Team Dr. W.W.? Why? I'm not sure I would measure up to play on these teams. I'd be more than happy to be the water boy for any of them.

What I hope patients remember about their visit to Mayo Clinic: They cared about me.

The post In a Word: Dr. Svetomir Markovic on what drives him to fight for his patients every day appeared first on Mayo Clinic News Network.

By 65, Caucasian men are reportedly twice as likely as women to get melanoma. And not only are they more likely to develop melanoma, but also they often have a more aggressive form of the disease, according to a report from Blue Cross Blue Shield Association.

"Melanoma is often believed to be 'just another skin cancer,'” says Dr. Svetomir Markovic, an oncologist at Mayo Clinic not involved with the report. "Unfortunately, this is not true."

Melanoma, the most serious type of skin cancer, develops in the cells (melanocytes) that produce melanin — the pigment that gives your skin its color. Melanoma also can form in your eyes and, rarely, in internal organs, such as your intestines.

According to a 2016 report in Nature, "Differences in the expression of a particular gene could explain why men with skin cancer tend to have a lower survival rate than women."  The Skin Cancer Foundation agrees, noting that, "Genetics may play a larger role in mortality among men than previously thought."

There could be other reasons contributing the gender difference. "We don’t have a clear explanation for this difference, but what likely plays a significant role is that men are far less engaged in health care than women," says Dr. Markovic. This mean that they sometimes don't see a health care provider until the disease is in advanced stages.

Dr. Markovic also says that men traditionally may have outdoor occupations that expose them to the sun, and they could be less likely to use sunscreen. "Pollution and the diminishing ozone layer in the atmosphere could contribute, as well," adds Dr. Markovic.

Learn more about melanoma

Melanomas also can develop in areas of your body that have little or no exposure to the sun, such as the spaces between your toes and on your palms, soles, scalp or genitals. These are sometimes referred to as hidden melanomas because they occur in places most people wouldn't think to check. When melanoma occurs in people with darker skin, it's more likely to occur in a hidden area.

Hidden melanomas include:

• Melanoma under a nail
  Acral-lentiginous melanoma is a rare form of melanoma that can occur under a fingernail or toenail. It also can be found on the palms of the hands or the soles of the feet. It's more common in blacks and in other people with darker skin pigment.
• Melanoma in the mouth, digestive tract, urinary tract or vagina
  Mucosal melanoma develops in the mucous membrane that lines the nose, mouth, esophagus, anus, urinary tract and vagina. Mucosal melanomas are especially difficult to detect because they can easily be mistaken for other far more common conditions.
• Melanoma in the eye
  Eye melanoma, also called ocular melanoma, most often occurs in the uvea — the layer beneath the white of the eye (sclera). An eye melanoma may cause vision changes and be diagnosed during an eye exam

The exact cause of all melanomas isn't clear, but exposure to ultraviolet (UV) radiation from sunlight, or tanning lamps and beds increases your risk of developing melanoma. Limiting your exposure to UV radiation can reduce your risk of melanoma.

Factors that may increase your risk of melanoma include:

• Fair skin
  Having less pigment (melanin) in your skin means you have less protection from damaging UV radiation. If you have blond or red hair, light-colored eyes and freckles, or sunburn easily, you're more likely to develop melanoma than is someone with a darker complexion. But melanoma can develop in people with darker complexions, including Hispanics and blacks.
• A history of sunburn
  One or more severe, blistering sunburns can increase your risk of melanoma.
• Excessive UV light exposure
  Exposure to UV radiation, which comes from the sun, and tanning lights and beds can increase the risk of skin cancer, including melanoma.
• Living closer to the equator or at a higher elevation
  People living closer to the earth's equator, where the sun's rays are more direct, experience higher amounts of UV radiation than those living in higher latitudes. In addition, if you live at a high elevation, you're exposed to more UV radiation.
• Having many moles or unusual moles
  Having more than 50 ordinary moles on your body indicates an increased risk of melanoma. Also, having an unusual type of mole increases the risk of melanoma. Known medically as "dysplastic nevi," these tend to be larger than normal moles, and have irregular borders and a mixture of colors.
• A family history of melanoma
  If a close relative, such as a parent, child or sibling, has had melanoma, you have a greater chance of developing melanoma, too.
• Weakened immune system
  People with weakened immune systems, such as those who've undergone organ transplants, have an increased risk of skin cancer.

The post Middle-aged men and melanoma risk appeared first on Mayo Clinic News Network.

Here's your Mayo Clinic Radio podcast.

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Listen to the program on Saturday, Dec. 10, at 9:05 a.m. CST, and follow #MayoClinicRadio.

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Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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Listen to the program on Saturday, Dec. 10, at 9:05 a.m. CST.

Miss the show?  Here's the Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

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The nation is buzzing this week over what sounds like miraculous news for former President Jimmy Carter. The 91-year-old Carter announced he is cancer-free, just months after revealing he was battling malignant melanoma, which had spread. In August, he had a cancerous mass removed from his liver. Four lesions were then found on his brain and were treated with radiation. Additionally, Mr. Carter was given a relatively new immunotherapy drug, called pembrolizumab.

"Fundamentally, in the treatment of metastatic melanoma, it's a three-pronged attack," says Mayo Clinic Cancer Center oncologist and hematologist, Svetomir Markovic, M.D., Ph.D. Dr. Markovic says combinations of immunologic treatments that use the body's own disease-fighting abilities, targeted therapies that focus on the genetic makeup of specific tumors and conventional cytotoxic chemotherapy have given patients much more reason to be hopeful. "One is hard-pressed to find another example, in all of medicine, where there has been such a tremendous revolution in the success of therapy, as [there] has been in melanoma."

Journalists: Broadcast-quality sound bites with Dr. Markovic are available in the downloads.  
https://www.youtube.com/watch?v=_110rub8RcY

The post Melanoma Researcher says Odds Continually Improving for Patients appeared first on Mayo Clinic News Network.

On the evening of Sept. 5, Mayo Clinic buildings in Rochester Minn. and Phoenix be illuminated with orange, red and yellow lights to show support for Stand Up To Cancer (SU2C) A charitable program of the Entertainment Industry Foundation, SU2C raises funds to accelerate the pace of research to get new therapies to patients quickly and save lives.

Mayo Clinic physicians Svetomir, Markovic, M.D., Ph.D. in Rochester and Alexander Sekulic, M.D., Ph.D. in Phoenix both participate on the SU2C melanoma Dream Team. Dream Teams are ccollaborative, multidisciplinary, scientific research teams that form the cornerstone of SU2C’s commitment to developing cancer breakthroughs. SU2C currently funds ten Dream Teams and an International Translational Research Team that includes 92 institutions worldwide.

Friday is also the day SU2C will broadcast its fourth star-studded, one-hour fundraising telecast featuring performances and appearances from top recording artists and celebrities. The live, commercial-free program will be broadcast on all major networks including ABC, CBS, FOX and NBC as well as HBO and Showtime.

Journalists: broll of the Plummer building in Rochester and the Phoenix hospital with the Stand Up To Cancer lighting is available in the downloads below.

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