Ipilimumab and stage 4 Melanoma
The Problem - Skin Cancer (Melanoma):
Evidence suggests that skin cancer is caused by prolonged and repeated exposure to UV rays (NHS, 2013). The main source of UV rays is from direct exposure to the sun. When large amounts of ultraviolet radiation pass through your DNA they can damage it. However, not all skin cancers develop from UV rays, some forms are hereditary. A faulty gene can be passed through generations and cause Familial Malignant Melanoma. People with paler skin or excessive numbers of moles are more likely to develop the disease as their body may not be producing enough melanin, which is responsible for blocking UV rays. If there is less melanin in a person’s skin then more UV rays pass through and more damage will be done. ((NHS, 2013).
The sun can be dangerous as it emits UV rays, which can penetrate and damage DNA (Cancer Research UK, 2013). This can change the nucleotide bases, which are what DNA is made up of. When the DNA is copied the base is incorrect and damaged, this leads to a mutation (University of Utah, 2013). Figure 1 shows how external factors can damage DNA. Prolonged exposure to UV rays can result in the mutation of cells, which then develop into a cancer.
Approximately 100,000 people a year in the UK are diagnosed with a form of skin cancer and 12,000 of these people are diagnosed with the deadliest form of the cancer: ‘Melanoma’ (Cancer Research, 2013). When the cancer is identified at an early stage, there is a greater chance of a successful treatment. Melanoma will usually be treated through a radiology course (using x-rays to destroy cancer cells) or through surgery (where the tumor(s) are surgically removed). (Macmillan, 2013). Survival rates for stage 1 Melanoma start at a one-year high of 95% in both men and women (Cancer Research UK, 2013). As with most cancers when they are identified early, the survival rate of the patient will generally increase, compared to late stage findings. For stage 4-skin cancer the average number people who survive to one year drops to 8% in men, and to 25% in women (Cancer Research UK, 2013). A recent report by Imperial College London states that treating skin cancer costs the NHS in excess of £102.3 million per year (Morris, 2013).
The stage of the cancer reflects the amount it has spread around the patient’s body. Cancer stages range from 1 – 4; stage 4 is the most severe and dangerous as it means tumors have spread to other distant organs. This makes treatment even more difficult, as there is a limit to the amount of chemotherapy a patient can receive. Patients will be put on chemotherapy courses in cycles. However, in many cases the body stops responding to the chemotherapy a ‘chemotherapy resistance’ has built up. The surviving cancerous cells have built up the resistance after the initial chemotherapy course (ChemoCare, 2013). The “limit” of chemotherapy is reached when it is no longer effective or cause to much discomfort...