Jimmy Carter’s Diagnosis: What the News of Stage 4 Melanoma Means

News broke late last week that former President Jimmy Carter has been diagnosed with Melanoma, first on his liver, and now 4 spots on his brain have been identified by doctors. Many people are unaware that Melanoma can actually occur internally, not just on the skin. The former President announced he will be undergoing radiation treatments targeted at the spots on his brain.

The scary thing is doctors are unsure where the cancer has originated and many wonder about the likelihood of pancreatic cancer due to his aggressive family history of the disease.

Skin cancer is the most common type of cancer. It accounts for over 76% of cancer deaths each year. The American Cancer Society estimates that in 2015, about 73,870 new cases of melanoma will be diagnosed in the United States. For melanoma, there are more than 75,000 people diagnosed with melanoma every year. While only 4 percent of skin cancers are melanoma, the disease makes up about 75 percent of all deaths caused by skin cancer. 

Melanoma is a deadly type of skin cancer that is often more severe than other types due to its ability to metastasize or spread, beyond the initial site of the tumor and to distant lymph nodes or organs within the body. Stage 4 is the most advanced stage of melanoma. Melanoma is a type of skin cancer which develops in melanocytes, which are the cells of the skin that produce melanin (the pigment that gives skin its color). 

As melanoma grows and spreads throughout the body, it becomes more and more deadly. The melanoma tumors within the skin grow larger as cancer becomes more advanced. However, the reason this type of cancer is so dangerous is because of what happens elsewhere in the body. 

When melanoma has reached stage 4, the cancer has spread to the lymph nodes, internal organs, and other areas of the body. It is often difficult and sometimes impossibly to treat melanoma at this stage without surgery, chemotherapy, radiation, or biotherapies.

The most common location in the body that melanoma spreads to is the lungs. It is also common for melanoma to spread to other areas within the body such as the liver, brain, gastrointestinal tract, and bones, as President Jimmy Carter has experienced.

Stage 4 melanoma is diagnosed when it has been determined that the cancer has spread beyond the original area of skin in which the tumor was located. Therefore, a diagnosis cannot be made based on how the tumor looks on the outside of the skin. This is why symptoms for stage 4 melanoma are not always the same for each case. Symptoms include tumor size, ulceration, and tumor matting. 

Tumor matting is another symptoms of stage 4 melanoma. When melanoma metastasizes or spreads to nearby lymph nodes, the nodes can become matted, or joined together. These matted lymph nodes are easier to feel then they are to see. When you push down on matted lymph nodes, you will feel a lumpy and hard surface. Most often, the doctor will identify matted lymph nodes when assessing a patient for advanced melanoma. 

On a higher note, Melanoma has been at the forefront for testing new cancer therapies such as immunotherapy, using a specific drug to activate the immune system, strengthening it to fight off cancer cells. In the past few years, researchers have made a lot progress towards finding treatments for this aggressive cancer.

Perhaps most notable were results of an earlier study this year conducted at the Utah Cancer Institute. Why Utah? The state has the highest rate of Melanoma among all 50 states. Researchers customized mutated viruses, injecting them directly into melanoma tumors to “train” healthy cells to attack cancer cells. What’s unique about this study is that they are not just taking any virus, but the herpes virus, and altering the way it works. This type of treatment -- also known as cancer immunotherapy -- uses a person’s immune system to fight cancer. The viruses are being engineered to only kill cancer cells, not healthy cells – which is a problem with standard cancer treatments like chemotherapy and radiation.

Fortunately, stage 4 melanoma can be treated if it is caught in time and aggressively treated. The earlier the cancer is identified, the earlier it can be treated and removed. And the earlier it is treated and removed, the higher the survival rate and chances for recovery are. The type of treatment a patient receives for stage 4 melanoma depends on where in the body the cancer is, how advanced the cancer is, and the patient’s overall  health and whether they have other health conditions that may get in the way of treatment. Regardless of how advanced the cancer may be, getting treatment is better than not getting treatment because without any treatment, the cancer can quickly progress from treatable to untreatable and deadly. We wish President Carter all the best in his treatment and for a speedy recovery.