Is Opdivo the melanoma answer?


News came through to me the other day of a very expensive treatment for Malignant Melanoma. Called Opdivo, the specialist from Royal Adelaide Hospital said, “The most striking thing is that at one year 73 percent of patients are alive on Opdivo,” this compares to just 43 percent who survived on standard chemotherapy treatment.

“The other striking thing is patients had tumors shrink 40 percent on Opdivo compared to 17 percent shrinkage on standard chemotherapy,” he said.

And patients whose tumors shrank maintained that shrinkage whereas on standard chemotherapy tumors began to grow again after six months, he said.

Typically only 15 percent of patients with advanced melanoma survive for five years, a third of patients treated with Opdivo lived at least five years and the trial is still continuing. (You can also read that as two thirds are dead by five years!)

“I’ve seen many big tumor masses shrink, it really can be dramatic,” Professor Brown says.

Around eight percent of tumors shrink completely on the drug while one in three have some shrinkage.

Around 1500 patients in Australia, with advanced melanoma, are expected to benefit from the treatment that is delivered by injection every two weeks. And the price? $A170,000, which puts it out of the reach of most people.

While researching an item on the cancers of women, I also came across the somewhat disquieting figures that Malignant Melanoma has the second fastest increasing incidence of cancer for women. In fact, the age-standardized rates have risen by 46 percent in the last decade. Some of the apparent increase may be due to increased surveillance and early detection as well as improved diagnosis, but most is considered to be real and linked to changes in recreational or holiday exposure to UV rays (including sunlight and sunbeds), and we do get the odd bit of sunshine here in Thailand.

I remember the first time I went to a beach in Thailand and saw all these people emerging from the sea fully clothed, that I thought the Thaitanic must have gone down offshore. However, I later realized that Thai people are not silly when they go fully clothed to the beaches to swim! It is generally just the pale skinned farangs that go there to fry.

When we first began to keep statistics on the incidence of melanoma in Australia, it became quickly evident that the further north you went (towards the equator) the greater the numbers of melanomas. White skin and UV radiation did not go well together.

It did not need rocket science to see that perhaps the reason the indigenous native aboriginals did not have the same incidence of melanoma as the white settlers was linked to skin color.

However, human nature being as perverse as it is, the white folks want to be brown (which is why solariums are popular in Australia) and the brown folks want to be white (which is why whitening creams are the number one cosmetic cream sold in Thailand).

Having myself emigrated to Australia from sunless Scotland as a young teenager, I can remember my Mum chasing me out of the house to get my shirt off and get a “healthy tan”! How times and our knowledge have changed! And we can thank all those medical professionals who have kept the statistics to be used by the epidemiologists who could then impart these findings to us all. Statistics which we hopefully take on board to take ourselves out of the danger.

The bad news about malignant melanoma you have already read above, but there is some good news. Protect yourself by covering up and using a very strong sun blocker of SPF 30 and above any time you are at the beach. And re-apply after swimming each time.

However, if you have any dark colored ‘spot’ that has changed shape, color, or become itchy you should get some expert advice from our specialist dermatologists. It is too dangerous to ‘wait and see’. Catch it early enough, before it begins to spread, and you can escape!

I get my spots and dots checked each year and have had a couple removed “just in case!” I suggest you do the same.