May is Skin Cancer Awareness Month. More than 5 million cases of skin cancer are diagnosed in the United States each year. There are several types of skin cancer. Melanoma is the third most common and the deadliest because it tends to metastasize, spread to other parts of the body.
Charles Dimitroff, executive associate dean for research at the Herbert Wertheim College of Medicine (HWCOM) has studied melanomas for 15 years, most recently at the Translational Glycobiology Institute at FIU (TGIF), where he serves as director. The institute focuses on studying glycans—sugars or carbohydrates found in the surface of cells—and their impact on cancer progression.
“Just a few years ago, we identified profound differences between the carbohydrates on the surface of melanoma cells that had metastasized and those that had not metastasized,” said Dimitroff.
He is now exploring whether this difference is behind the cell’s ability to spread.
“Studying these carbohydrates is critical for us to learn how melanoma cells proliferate, migrate, and invade distant tissue,” he said.
The Dimitroff Lab is a world leader in identifying these glycan differences. Dimitroff and his team hope their research can lead to a biomarker to predict whether the melanoma has or will spread.
“That’s the essence of translational medicine—use what we discover in the lab to develop diagnostic tests or treatments for the patient,” Dimitroff said.
A biomarker to detect and predict cancer progression would help doctors determine the best course of treatment and improve a patient’s chance of survival. At the moment, there is no such predictor.
The American Cancer Society estimates more than 148,000 cases of melanoma in Florida this year and more than 48,000 deaths. Fortunately, skin cancers are highly preventable by limiting sun exposure—85 percent of melanoma cases are associated with overexposure to the sun’s ultraviolet rays. Other risk factors include a family history of melanoma, having fair skin and light-colored eyes. However, even though melanoma is less common in people of color, Blacks are more likely to be diagnosed at an advanced stage and have higher mortality.
Skin cancer prevention starts with practicing safe sun—avoiding too much sun exposure (and tanning beds), wearing the proper clothing and using sunscreen.
You should also routinely check your skin for changes like new spots or moles. If you notice that an existing spot or mole has changed in color, shape or size, consult your doctor.
If melanoma is localized and can be removed surgically, the 5-year relative survival rate is 99 percent. But if it has spread to organs like the lungs and liver, the chance that the person will live for at least 5 years after diagnosis drops to 27 percent.
Glycobiology research at FIU
Glycobiology is a rapidly growing area of science partly due to innovations in technology.
“We are doing things now that we couldn’t 10 years ago,” Dimitroff said.
But the latest technology does not come cheap. The TGIF’s state-of-the-art mass spectrometer, used to analyze glycans, is a multi-million dollar machine. It also requires someone with the expertise to operate it. Like Dimitroff, researcher Kevin Chandler was recruited from Harvard to oversee mass spectrometry at the TGIF.
Then there is the investment in time. Dimitroff estimates that one of the most recent papers his team published on glycans and melanoma took about seven years and a million dollars in funding. “And that’s just one lab’s effort to add a piece of the puzzle to cure metastatic melanoma!”
The TGIF houses three of only 10 glycobiology labs in the nation funded by the National Cancer Institute Alliance of Glycobiologists for Cancer Research—Dimitroff’s Lab focusing on skin cancers, Karen Abbott’s Lab, which studies the role of glycans in breast and gynecologic cancers, and Dr. Robert Sackstein’s Lab, which focuses on malignancies of the blood (leukemias, lymphomas, myelomas), GI and lung cancers.