My dad died in July 1996 from a nasty mole on his back. He would ask me to scratch his back and I remember being 8 or 9 years old and having to scratch around it as it was near the seam of his tank top (which likely aggravated it daily). And would make comments about it being "gross". We just didn't know what we know today.
He was drying off after showering one morning and got blood all over the towel from the mole. He went to the dermatologist and was told he had malignant melanoma. This was in September 1995 and he was in the ground before the middle of July 1996. Nine months to get his affairs in order. I remember driving around and seeing his old college pals (one of which I still see once a year or so for lunch to this day). I remember him buying a bag phone, a "car phone" so we could keep in touch as he drove from Eastern KY to Duke University for experimental treatments (I believe it was the one that led to the immunotherapy treatments used today). He told my mom even if it didn't help him he hoped it would help someone.
I avoid the sun with the exception of the back of my neck and the top of my hands. He has no clue (nor do the dermatologists) what caused it but, like other posts mention, likely sunburns in childhood.
I am so hopeful for this treatment and thankful for the progress made on the immunotherapy fronts.
Melanoma in adults is typically tied back to acute blistering sunburn events that happened before the age of 18 (as you seem to be aware). The most common sites of melanoma are chest and back in men and legs in women, areas that are more often than not covered by clothing and not in need of sunscreen.
Cumulative sun exposure on the other hand causes the other types of skin cancer - not melanoma, which this vaccine is targeting.
The most common chemical sunscreen ingredients cause cancer themselves and are wildly overdue for FDA review and removal (that has been held up for political reasons). For those who wish to wear sunscreen I recommend non-nano zinc mineral sunscreen such as Thinksport. Look for "non-nano" and zinc oxide (not titanium oxide, which is often nano in part and also a carcinogen) on the label.
At the same time make sure you are getting enough sun exposure to avoid bottoming out your Vitamin D levels. Low Vitamin D is linked to a number of bone and muscle issues.
> He told my mom even if it didn't help him he hoped it would help someone.
He did help. Absolutely. A friend was diagnosed with stage 4 melanoma 5 years ago, and she's in full remission today with an optimistic prognosis. Her life is possible because of researchers and people like your dad.
Tell that to my GP. Both my parents had melanoma, and they each had one additional type of skin cancer each. Their dermatologist is insistent that I get checked, but my GP doesn't think it's necessary, so my HMO won't pay for it.
~20 years ago a young father on my block had a mole on his neck that ended up being a fatal melanoma. He otherwise looked so healthy.
He said it might have been from sunburns when he was in the Boy Scouts.
I will never forget the look on his face when I spoke with him, a look of bewilderment wrestling with anger.
His wife teetered with grief and confusion, trying her best to be strong while trying to bear the sickening reality that nobody could have prepared their family for.
I always get an annual dermatology checkup now because of him.
Please explain to someone that has never seen a melanoma - this person had a single 'mole-like' mark on his neck (presumably small?), and that alone killed him? or was it 'mole-like' and eventually got so big that it killed him?
Having a hard time understanding how something so small, and so easily removed can kill someone.
I have so many 'moles' on me, I wouldn't even know what to look for.
The combination treatment has won U.S. breakthrough therapy and European Medicines Agency PRIME scheme designations, regulatory programs that aim to speed development of innovative treatments. Still, Hoge said that even with the new data it would be some time before the companies can file for approval of the treatment.
But also remember the other invisible graveyard - the people who aren't dead because they received ineffective treatments.
I do agree that drug approval processes need to consider the negative cost of delay, but in this specific case, from further in the article we see:
> Moderna is currently building a dedicated facility in Massachusetts to produce the vaccine at commercial scale, which it hopes to finish sometime next year.
> "We need to make sure that we have that near completion before we could even contemplate asking for approval," Hoge said.
And the reason for this is that you typically need to submit detailed manufacturing information as part of your new drug approval process. This allows the FDA assess how likely the drug you actually sell will provide the same benefits as those in the trial, as well as make sure you don't like... dunno forget to serialize stuff and ship out contaminated product.
I understand the temptation to blame the FDA when some exciting, revolutionary therapy seems to be slow getting approval.
In my case, the therapy that finally worked for my cancer was only allowed as third-line after I had gone through two rounds of heavy chemo. Now it's second-line, which means way less toxicity for those after me. In hindsight, I definitely could be angry they didn't at least try it on me before BMT.
But that's the problem, you only know what's safe in hindsight. Two-arm clinical trials are expensive and slow but they are the gold standard that continues to deliver countless life-prolonging therapy.
There is so much money being made in cancer treatment these days which in the US is all coming from private for-profit companies. One unsuccessful (non-toxic) trial I was in saw the company bragging about its progress in its annual report while the trial was still going!
The FDA is the only thing stopping these companies. Every time a standard-of-care treatment is safe and effective you can thank the FDA for doing the unglamorous work of holding these companies accountable.
This is great news. We can always use better treatments. I had a case of metastatic melanoma (III-A) in my early 20's and the drug of choice at that time was interferon, which was not a particularly pleasant experience. There were experimental vaccines at the time as well, so these new vaccines have been multiple decades in the making.
As some unsolicited practical advice, yes, it's always good to protect one's self from the sun using long sleeves or sunscreen. However, melanoma can and often does occur in areas that does not receive sun exposure. This could be between your toes or inside your butt cheeks. As a result, it's worthwhile to have a dermatologist conduct a skin exam once a year. Normally, this is covered under a specialist visit for insurance and for many insurance plans this is a flat fee.
Outside of a regular exam, any growth that has unusual size, shape, or color should be checked by a dermatologist, especially if it changes. My lesion was raised off the skin and red in color. It also changed and grew over time. If one can not immediately see a dermatologist, lacks insurance, or money for a visit, regular pictures of the skin blemish or growth can help track changes. If it changes, though, it really does require a dermatologist to look at it.
Lastly, dermatologists can and do make mistakes. In my case, my lesion was dismissed as a benign nevus at first visit. When I revisted the physician six months later, it was larger and was finally biopsied to discover it was melanoma. It is possible that the cancer metastasized in the interim period, but we'll never know. That said, if one is concerned about a growth and the physician defers, it is very simple to tell the dermatologist that you'd feel more comfortable if we biopsied the growth just to be sure. You don't have to be mean and I've never been refused. At that point, they take a small sample of the growth and send it to the lab. Then, you know for sure. Normally, the sample is taken by using a razor blade and skimming off some of the surface. It's fast, easy, and while not painless, it is not particularly painful. Generally, this is rolled into my specialist visit fee for insurance, but they may send an additional billing code to insurance.
Finally, dermatolgists can be difficult to schedule with. Honestly, their schedule is often filled with cosmetic procedures like skin peels and botox because it's so profitable. That said, any dermatologist can do a biopsy, so just call around to find one with an opening that takes your particular insurance.
I apologist for the side talk. I often find the whole talk to your doc discussion regarding skin lacks details, so hopefully this helps. Great to hear that the treatments are progressing.
Thanks for the advice. I haven't had any type of skin cancer but will definitely keep this in mind since a lot of family members have had it in the past.
A friend's kid had a specific rare childhood melanoma that, when Googling, showed a 90% mortality rate. Thankfully that number is apparently before recent immunotherapy advancements, but it was pretty terrifying. This article is a happy click for me.
A little bittersweet for me, lost an uncle to this about 10 years ago...but still happy and a little inspired, proud of our species. I really hope ours is the last generation(s) that have to suffer through that awful disease.
I'm guessing that this vaccine is only used post-diagnosis.
Anyone know if there's talk of using this profilactically, like the HPV vaccine? (I realize that viruses != cancers, but IIUC hpv can sometimes lead to cancer, which is why I thought to ask.)
“The vaccine is custom-built based on an analysis of a patient's tumors after surgical removal. The vaccines are designed to train the immune system to recognize and attack specific mutations in cancer cells.”
Looks like their is a level of personalization going on that requires actual existing cancer.
The short answer is, we sequence their genomes, identify mutations that change a protein sequence and are highly expressed, then run those all through suites of algorithms that predict how well they'll be presented to the immune system. (mostly neural networks trained on far-too-sparse experimental data). This prediction is the hard part right now - we still don't understand enough about how the immune system identifies and interacts with these altered peptides to do really accurate predictions of which ones will be most effective. Throw in that these tumors are actively suppressing the immune system in various ways, and it's complicated! There is lots of research going on, though, and lots of promising early results, like this one
Two out of three Australians will be diagnosed with some form of skin cancer at some point their lives [1] due to the higher atmospheric UV. This is going to prevent a lot of unnecessary death. Modern medicine is fantastic.
Weirdly, while this is not the first time i read about this vaccine, this is the first time i read an explanation about how it work.
Seems to be a tad expensive, but also generalizable. Hopefully it can replace hormone therapy for breast cancers, and be extended to all common cancers.
Didn’t see any pricing information? Sadly all incentives are to not make it less expensive and to simply extort the institutions on the payment side and give rebates to everyone who doesn’t have an institution to back them. Much of medicine is intentionally expensive to prop up revenues (and indirectly profits while maintaining a defensible percent of revenues margin).
But maybe not here - Moderna got a lot of experience with mass scale production in the pandemic. If they orient it here we could see biopsy based / pre surgical vaccination of cancer at mass scales which would require scaled out pricing.
Moderna and its mRNA vaccines is truly magic. Like someone born 500 years ago - if they saw what Moderna was making, they would think this is God like power.
Because it is. DNA/RNA is the language of all life. Moderna is literally working at the language of life layer to produce their vaccines.
Side note: in the article, I find it a bit inappropriate that the first paragraphs only talk about the effects on the stock prices of both involved companies, before going into details of the research and how the vaccine works…
This is very neat! The effect has only been observed up to three years out, but this seems like it could become a pretty cost-effective option?
Also, misc side note: I keep reading the words "Madonna" and "Cults" in the title even though they're not there. Was very confused when I first clicked the link.
[+] [-] leetrout|2 years ago|reply
Get your moles checked.
My dad died in July 1996 from a nasty mole on his back. He would ask me to scratch his back and I remember being 8 or 9 years old and having to scratch around it as it was near the seam of his tank top (which likely aggravated it daily). And would make comments about it being "gross". We just didn't know what we know today.
He was drying off after showering one morning and got blood all over the towel from the mole. He went to the dermatologist and was told he had malignant melanoma. This was in September 1995 and he was in the ground before the middle of July 1996. Nine months to get his affairs in order. I remember driving around and seeing his old college pals (one of which I still see once a year or so for lunch to this day). I remember him buying a bag phone, a "car phone" so we could keep in touch as he drove from Eastern KY to Duke University for experimental treatments (I believe it was the one that led to the immunotherapy treatments used today). He told my mom even if it didn't help him he hoped it would help someone.
I avoid the sun with the exception of the back of my neck and the top of my hands. He has no clue (nor do the dermatologists) what caused it but, like other posts mention, likely sunburns in childhood.
I am so hopeful for this treatment and thankful for the progress made on the immunotherapy fronts.
[+] [-] hammock|2 years ago|reply
Melanoma in adults is typically tied back to acute blistering sunburn events that happened before the age of 18 (as you seem to be aware). The most common sites of melanoma are chest and back in men and legs in women, areas that are more often than not covered by clothing and not in need of sunscreen.
Cumulative sun exposure on the other hand causes the other types of skin cancer - not melanoma, which this vaccine is targeting.
The most common chemical sunscreen ingredients cause cancer themselves and are wildly overdue for FDA review and removal (that has been held up for political reasons). For those who wish to wear sunscreen I recommend non-nano zinc mineral sunscreen such as Thinksport. Look for "non-nano" and zinc oxide (not titanium oxide, which is often nano in part and also a carcinogen) on the label.
[+] [-] jandrese|2 years ago|reply
[+] [-] laveer|2 years ago|reply
He did help. Absolutely. A friend was diagnosed with stage 4 melanoma 5 years ago, and she's in full remission today with an optimistic prognosis. Her life is possible because of researchers and people like your dad.
I'm sorry for your loss.
[+] [-] aidenn0|2 years ago|reply
Tell that to my GP. Both my parents had melanoma, and they each had one additional type of skin cancer each. Their dermatologist is insistent that I get checked, but my GP doesn't think it's necessary, so my HMO won't pay for it.
[+] [-] jncfhnb|2 years ago|reply
[+] [-] sys32768|2 years ago|reply
He said it might have been from sunburns when he was in the Boy Scouts.
I will never forget the look on his face when I spoke with him, a look of bewilderment wrestling with anger.
His wife teetered with grief and confusion, trying her best to be strong while trying to bear the sickening reality that nobody could have prepared their family for.
I always get an annual dermatology checkup now because of him.
[+] [-] ejb999|2 years ago|reply
Having a hard time understanding how something so small, and so easily removed can kill someone.
I have so many 'moles' on me, I wouldn't even know what to look for.
[+] [-] jseliger|2 years ago|reply
These delays help fill graveyards in the meantime: https://marginalrevolution.com/marginalrevolution/2021/01/th.... The tragedy goes mostly unremarked on, because the dead don't agitate or vote.
[+] [-] icegreentea2|2 years ago|reply
I do agree that drug approval processes need to consider the negative cost of delay, but in this specific case, from further in the article we see:
> Moderna is currently building a dedicated facility in Massachusetts to produce the vaccine at commercial scale, which it hopes to finish sometime next year.
> "We need to make sure that we have that near completion before we could even contemplate asking for approval," Hoge said.
And the reason for this is that you typically need to submit detailed manufacturing information as part of your new drug approval process. This allows the FDA assess how likely the drug you actually sell will provide the same benefits as those in the trial, as well as make sure you don't like... dunno forget to serialize stuff and ship out contaminated product.
[+] [-] spopejoy|2 years ago|reply
In my case, the therapy that finally worked for my cancer was only allowed as third-line after I had gone through two rounds of heavy chemo. Now it's second-line, which means way less toxicity for those after me. In hindsight, I definitely could be angry they didn't at least try it on me before BMT.
But that's the problem, you only know what's safe in hindsight. Two-arm clinical trials are expensive and slow but they are the gold standard that continues to deliver countless life-prolonging therapy.
There is so much money being made in cancer treatment these days which in the US is all coming from private for-profit companies. One unsuccessful (non-toxic) trial I was in saw the company bragging about its progress in its annual report while the trial was still going!
The FDA is the only thing stopping these companies. Every time a standard-of-care treatment is safe and effective you can thank the FDA for doing the unglamorous work of holding these companies accountable.
[+] [-] kxyvr|2 years ago|reply
As some unsolicited practical advice, yes, it's always good to protect one's self from the sun using long sleeves or sunscreen. However, melanoma can and often does occur in areas that does not receive sun exposure. This could be between your toes or inside your butt cheeks. As a result, it's worthwhile to have a dermatologist conduct a skin exam once a year. Normally, this is covered under a specialist visit for insurance and for many insurance plans this is a flat fee.
Outside of a regular exam, any growth that has unusual size, shape, or color should be checked by a dermatologist, especially if it changes. My lesion was raised off the skin and red in color. It also changed and grew over time. If one can not immediately see a dermatologist, lacks insurance, or money for a visit, regular pictures of the skin blemish or growth can help track changes. If it changes, though, it really does require a dermatologist to look at it.
Lastly, dermatologists can and do make mistakes. In my case, my lesion was dismissed as a benign nevus at first visit. When I revisted the physician six months later, it was larger and was finally biopsied to discover it was melanoma. It is possible that the cancer metastasized in the interim period, but we'll never know. That said, if one is concerned about a growth and the physician defers, it is very simple to tell the dermatologist that you'd feel more comfortable if we biopsied the growth just to be sure. You don't have to be mean and I've never been refused. At that point, they take a small sample of the growth and send it to the lab. Then, you know for sure. Normally, the sample is taken by using a razor blade and skimming off some of the surface. It's fast, easy, and while not painless, it is not particularly painful. Generally, this is rolled into my specialist visit fee for insurance, but they may send an additional billing code to insurance.
Finally, dermatolgists can be difficult to schedule with. Honestly, their schedule is often filled with cosmetic procedures like skin peels and botox because it's so profitable. That said, any dermatologist can do a biopsy, so just call around to find one with an opening that takes your particular insurance.
I apologist for the side talk. I often find the whole talk to your doc discussion regarding skin lacks details, so hopefully this helps. Great to hear that the treatments are progressing.
[+] [-] s3p|2 years ago|reply
[+] [-] ceejayoz|2 years ago|reply
[+] [-] edc117|2 years ago|reply
[+] [-] CoastalCoder|2 years ago|reply
Anyone know if there's talk of using this profilactically, like the HPV vaccine? (I realize that viruses != cancers, but IIUC hpv can sometimes lead to cancer, which is why I thought to ask.)
[+] [-] sbelskie|2 years ago|reply
Looks like their is a level of personalization going on that requires actual existing cancer.
[+] [-] blackbear_|2 years ago|reply
[+] [-] fnordpiglet|2 years ago|reply
I wonder how they identify the targets in each genome. Is there an optimizing expert system? Generative AI?
[+] [-] chrisamiller|2 years ago|reply
[+] [-] deminature|2 years ago|reply
[1] https://www.phrp.com.au/media/media-releases/two-in-three-au...
[+] [-] victorbjorklund|2 years ago|reply
[+] [-] orwin|2 years ago|reply
Seems to be a tad expensive, but also generalizable. Hopefully it can replace hormone therapy for breast cancers, and be extended to all common cancers.
[+] [-] fnordpiglet|2 years ago|reply
But maybe not here - Moderna got a lot of experience with mass scale production in the pandemic. If they orient it here we could see biopsy based / pre surgical vaccination of cancer at mass scales which would require scaled out pricing.
[+] [-] nojvek|2 years ago|reply
Because it is. DNA/RNA is the language of all life. Moderna is literally working at the language of life layer to produce their vaccines.
[+] [-] rafaelero|2 years ago|reply
[+] [-] briane80|2 years ago|reply
[+] [-] sexy_seedbox|2 years ago|reply
[+] [-] bkummel|2 years ago|reply
Side note: in the article, I find it a bit inappropriate that the first paragraphs only talk about the effects on the stock prices of both involved companies, before going into details of the research and how the vaccine works…
[+] [-] BurningFrog|2 years ago|reply
Science news go in the opposite order.
[+] [-] lawrenceyan|2 years ago|reply
[+] [-] sunshine_reggae|2 years ago|reply
[deleted]
[+] [-] s1artibartfast|2 years ago|reply
[+] [-] YellOh|2 years ago|reply
Also, misc side note: I keep reading the words "Madonna" and "Cults" in the title even though they're not there. Was very confused when I first clicked the link.
[+] [-] seydor|2 years ago|reply