Christy Redican grew up in Connecticut, spending summers sailing and playing tennis.
“I was a sun worshipper,” she said. “I did all the things you’re not supposed to do. I have fair skin, blonde hair and light eyes. I burned a lot.”
Redican, 58, now of Fox Chapel, thought she had escaped her bad habits unscathed until two years ago when she discovered a pink, freckle‑like spot on the unlikeliest of places — her heel.
It didn’t look like the melanomas most people warn about — it wasn’t dark or asymmetrical — but she followed her gut and had it removed. It was a decision that potentially saved her life.
The biopsy revealed malignant melanoma, the deadliest form of skin cancer.
According to the American Cancer Society, melanoma accounts for only 1% of all skin cancers but contributes largely to skin cancer-related deaths. That’s because of its higher likelihood of metastasizing compared to other skin cancers.
Recent advancements, namely immunotherapies, are providing renewed hope for patients. The medications have revolutionized patient care, improving long-term survival rates.
“Immunotherapy reduces the risk of recurrence by 50% or more,” said Dr. Deanna Huffman, Allegheny Health Network medical oncologist.
She was among the team to treat Redican, whose cancer was diagnosed at Stage 3.
“If we did nothing but surgery, there was a high likelihood of the cancer returning in her lifetime — well over 35% risk and probably approaching 50%,” Huffman said.
About 112,000 new diagnoses of melanoma are expected this year — 65,400 in men and 46,600 in women, according to the American Cancer Society.
Across the U.S., melanoma rates doubled from 1982 to 2011 and have continued to increase, with the incidence in people 30 and younger developing faster than any other demographic group, according to the Melanoma Research Foundation. Data by the International Agency for Research on Cancer predicts that melanoma will be the second most commonly recorded cancer by 2040.
Immune system brakes
The body’s immune system has built-in regulatory mechanisms, commonly referred to as brakes, that prevent it from attacking healthy cells.
Cancer cells exploit the brakes and evade detection — but immunotherapy, used as a post-surgical treatment, stimulates the body’s natural defenses and takes the brakes off — allowing the body to fight cancer more effectively. It can mark cancer cells so the immune system finds and destroys them.
The medications, also called checkpoint inhibitors, have grown the median survival rate for advanced/metastatic melanoma from about 6½ months to more than 10 years for some patients, according to a 2024 report by the Cancer Research Institute.
Immunotherapy is most frequently ordered for Stage 3 and 4 melanoma. It can also be diagnosed for high-risk melanoma or disease that has spread to the lymph nodes.
Findings betrayed pathology
Redican discovered the mole on her foot just before Thanksgiving 2024. Surgery followed, with her medical oncologist, Dr. Howard Edington, removing a golf‑ball‑sized section of her ankle.
A sentinel lymph node biopsy was performed despite expectations that they would be clear.
“I got a call the day after Thanksgiving,” Redican said. “The melanoma had spread to one of three lymph nodes in my groin. I wasn’t expecting that at all because all of my markers before surgery were so good.
“They say melanoma kind of has a mind of its own. It moves quickly, like Pac-Man.”
She credits Edington with urging her to pursue immunotherapy.
The surgeon said early but invasive melanoma like Redican’s was previously rare but has grown common.
“Which patients should get a sentinel node biopsy is currently a controversial area, but in this case, it might have been lifesaving,” he said.
The biopsies are typically designated for patients with a significant risk of metastasis, related to the thickness of the tumor, according to the digital platform Medscape.
Melanoma is thought to be caused by a mix of genetics — having lighter skin color is a major risk factor — and environmental exposure, namely, UV light, Edington said. He recommends people avoid excessive sun as well as tanning beds to cut the risk.
UV exposure is the primary modifiable risk factor — 92% of melanomas are attributable to sunlight and indoor tanning, Huffman said.
“When caught early, melanoma is really curable,” Edington said. “One of the things that worries us, though, is when the cancer has spread.”
Since the onset of immunotherapies about a decade ago, melanoma deaths have dropped from 9,500 in 2013 to about 7,650 in 2022, according to the American Cancer Society.
“It’s a game-changer,” said Edington, who worked in the 1980s with immunotherapy pioneer Dr. Steve Rosenberg at the National Institutes of Health. “That’s how long the game has been going on.
“It’s so great to see the work has come to the clinic in a gangbuster way.”
Immunotherapies also have proven successful in treating other types of cancer, like small-cell lung cancer and Hodgkin lymphoma.
“I’m delighted that the research is paying off,” Edington said. “For me, it’s an incredible delight to see people responding so well.”
He called the advances “nothing short of spectacular,” noting the Nobel Prize in 2018 was awarded to James P. Allison and Tasuku Honjo for research that helped revolutionize cancer therapies, allowing the immune system to better target and destroy cancer cells and significantly improve patient outcomes.
Intense regimen, stark results
Redican’s post-surgical treatment included a one-year course of the immunotherapy, Keytruda, an infusion of which she got every six weeks.
Though some reported effects of the medications have included skin rash, poor appetite and joint pain, Redican said her side effects were minimal. She didn’t lose her hair and suffered only minor nausea and fatigue.
“I was able to continue working normally,” said Redican, an interior designer. “I did develop hypothyroidism, but that’s not that big of a deal. I was lucky.”
She finished treatments in January and is cancer-free. She called the ending bittersweet.
“There’s a certain sense of security while you’re getting the extra medication,” she said. “You feel protected. That said, I’m glad it’s over.”
Follow-up care will continue indefinitely. An aggressive surveillance plan includes bloodwork, PET scans, skin checks and routine scans through the VECTRA WB 360, a whole-body imaging system offered at only 20 clinics across the country. AHN is the only facility in Western Pennsylvania with the technology.
Prevention
Public awareness and prevention that includes routine skin checks will be the most critical tools to help control melanoma, Edington said.
The Pittsburgh Melanoma Foundation, founded by Jessica Rogowicz and Lauren Simko, has raised awareness about the illness and provided support for survivors and their families. The nonprofit hosts an annual fundraising walk, scheduled this year on June 13, both virtually and in person at South Park. Since 2012, it has donated more than $500,000 to advance research in novel imaging, prevention and treatment.
Redican said the best advice she received was from Edington to pursue the additional year of treatment.
“Technically, the immunotherapy was an option because that spot on my lymph node was so small, it wouldn’t have shown up on a PET scan,” she said. “He told me I could have 10 more of those little spots and for that reason alone, immunotherapy should be a must-do. It probably saved my life.”
May is Melanoma Awareness Month
Here are some facts about the disease:
• Melanoma is the deadliest form of skin cancer, but early detection yields a five-year survival rate of 99%.
• The incidence of people 30 and younger developing melanoma is growing faster than any other demographic group, soaring by 50% in women since 1980.
• About 112,000 cases are expected to be diagnosed this year.
• Lifetime risk is 1 in 33 for white men and women, 1 in 200 for Hispanics and 1 in 1,000 for Black people.
• The average age at diagnosis is 66, but melanoma is one of the most common cancers in young adults from 25 to 39.
• The majority of cases are attributable to UV exposure from the sun or tanning beds. Five or more blistering sunburns between the ages of 15 and 20 increase melanoma risk by 80%.
Source — Melanoma Research Foundation
