Cancer of the skin is the most common of cancers, probably accounting for at least half of all cancers. Melanoma accounts for less than 5% of skin cancer cases but causes a large majority of skin cancer deaths. Unlike many other common cancers, melanoma has a wide age distribution. It occurs in younger as well as older people. Rates continue to increase with age and are highest among those in their 80s, but melanoma is not uncommon even among those younger than 30. In fact, it is one of the more common cancers in adolescents and young adults, especially young women.

Hensin Tsao, MD, PhD is a Wellman Center researcher and also Clinical Director of the MGH Melanoma and Pigmented Lesion Center. He is at the forefront of clinical investigators who want to “personalize” preventative and therapeutic approaches to this disease. Dr. Tsao and his colleagues are focused on going beyond the study of large population groups to identify general population predictors of risk of developing melanoma, like fair skin, red hair etc. These investigators are intent on building upon the tremendous advances in knowledge provided by the human genome project to be able to identify and quantify risk in specific individuals and target therapies for specific cases of melanoma.

At the preventative level, this work involves identifying the specific genetic signatures that make an individual more susceptible to the disease in the first place. Success at this level will allow screening techniques to be developed that will warn high risk individuals of their genetic susceptibility to developing melanoma well before the disease develops or manifests itself. Prevention is still the most effective way to deal with this disease, and informed and forewarned individuals have more incentive to adopt and maintain preventative practices.

To personalize treatment once an individual develops melanoma, Dr. Tsao and his colleagues are working to “deconstruct” melanoma to identify the molecular profile(s) of the disease and host factors that drive the actual development of disease within an individual. By combining knowledge of an individual’s specific genetic susceptibility to melanoma with the molecular profiles, individualized therapies can be developed. Such personalized therapies will target each individual’s genetic weaknesses and disease profile to interrupt the molecular interactions and drivers that allow the melanoma to grow.

While we have not achieved so comprehensive a knowledge of the genetic mutations and molecular character that interact to allow melanoma to thrive, we are much closer than we have ever been before.