We are delighted to announce that our loyal supporters Swim 4 Tri are running their annual Lou Parker Open Water Charity Race Day again on the 15th September.
This event is run in memory of open water swimmer and friend of the club, Lou Parker who died of melanoma in 2010. The 4k course, set in Stubbers, Upminster, Essex is available to swim as an individual or as a relay. This is a relaxed event so swimmers can complete as much or as little as they want.
The event is always very popular, with SFT members and non-members, providing a scrumptious and well deserved BBQ breakfast after the final swimmer has finished the course, ensuring the race is not just fun but also memorable.
The event is designed to get as many people in the water as possible and also a timely reminder that sun protection is a vital part of all swimmers kit when the weather warms up.
The event is run by Keeley Bullock and her brother Dan who are dedicated to helping raise money for their chosen charity, the Melanoma Fund, helping raise awareness of sun protection and skin checking to all those who enjoy a healthy outdoor lifestyle.
Says Harry Townsend, founder of the Melanoma Fund; “Keeley and Dan are amazing people who consistently support us, showing not only loyalty to the charity but to their good friend who died tragically from this awful disease. We hope this event will not only encourage people get people fit, but raise awareness of melanoma and the importance of sun protectio at the same time.”
The club aims to raise funds for the charity via sale of tickets and BBQ takings. For full details on how to enter etc. click HERE
With the help of our supporters, the Melanoma Fund was able to support a melanoma microRNA biomarker project, run by the Brighton and Sussex Medical School and headed up by Prof. Sarah Newbury. We have been work closely with the team and here is their final report.
By Professor Sarah Newbury, Brighton and Sussex Medical School (BSMS)
Melanoma remains the most aggressive form of skin cancer with an increasing incidence worldwide. Survival rates depend heavily on the stage of disease at the time of diagnosis. When detected in the early non-metastatic stages (I and II), melanoma has good prognosis with a 5-year survival rate of ~100% in stage I melanoma patients and 80%-90% in stage II melanoma patients, as thin local tumours are highly curable by surgery.
Unfortunately, recurrence is common and often results in progression to locally advanced melanoma and subsequently to metastatic melanoma (stages III and IV), with a 5 year survival rate of ~50% in stage III melanoma patients and 10-25% in stage IV melanoma patients. Therefore there is a pressing need to establish robust biomarkers that allow the identification of patients at high risk of metastatic recurrence after surgical removal of a non-metastatic melanoma.
Early detection will maximise the chances of patient survival, as there are now a number of treatment options available that are effective against certain subtypes of stages I, II and III melanoma.
Circulating microRNAs are emerging as promising non-invasive cancer biomarkers that can be detected from a blood sample. MicroRNAs are small non-coding nucleic acids that function in gene silencing and are often associated with cancer progression.
These microRNAs are stable in the circulating blood because they are encapsulated in small vesicles (exosomes) or are bound to protective proteins. Previous work carried out at the Blond McIndoe Research Foundation and the Brighton and Sussex Medical School identified 3 potential microRNA biomarkers that can distinguish Stage I/II from Stage III/IV melanoma, plus three potential reference controls.
Support from the Melanoma Fund
Generous funding from the Melanoma Fund provided us with the exciting opportunity to check and validate the microRNA biomarkers identified in these initial experiments. The technician employed on the grant, Sophie Mumford, used the serum of 20 healthy, 20 melanoma stage I/II and 20 melanoma stage III/IV donors, which were originally collected at the Queen Victoria Hospital, East Grinstead.
Sophie performed 2,034 careful experiments to validate these 3 potential biomarkers and 3 reference controls as well as checking 2 new potential biomarkers identified following the re-analysis of the original data and evaluating the effect of different extraction kits and experimental conditions.
Sadly, despite all this careful experimentation, we have not found any microRNA biomarkers which clearly and consistently distinguish between non-metastatic and metastatic melanoma. We are all deeply disappointed with this result. The circulating microRNA biomarker field is still in its infancy; therefore techniques are difficult and are not yet well established.
The techniques being used to detect microRNA biomarkers in serum have improved immensely since the start of this project and continue to improve, therefore if we started this project again, we would have much more likelihood of success. With this is mind, we thought that it would be very useful to provide an up-to-date review of the literature on circulating miRNA biomarkers in melanoma, using our experience to focus on the pre-analytical and analytical variables that challenge this field.
Interestingly, none of prognostic melanoma microRNA biomarkers published have used the rigorous normalisation procedures that are now required in the field. Therefore there are, as yet, no reliable circulating microRNA biomarkers which can distinguish metastatic from non-metastatic melanoma.
Despite our difficulties in identifying microRNA biomarkers for melanoma this time, we have been successful in providing a number of outputs for the Melanoma Fund. These include our monthly reports, invitations to speak at International Conferences, poster presentations at International conferences, grants and training.
These outputs are detailed below:
2013-2015: £20,000 for a BBSRC “Sparking Impact” Award to fund a post-doc, consumables, patent searches and market surveys. Title of project “Investigating the potential of microRNAs as biomarkers in malignant melanoma.”
2016-2017: £75,588 from Cancer Research UK (through the Experimental Cancer Medicines Centres “ECMC” Network) for a project over four centres (Universities of Leeds, Sussex, Cambridge and Newcastle on a project entitled “Standardisation of analysis and reporting of miRNA biomarkers in plasma from circulating blood. £17,896 (Co-PI: 24%) per centre, with Prof. Sue Burchill (Principal Applicant (28%), University of Leeds).
2017: £1395 from the University of Sussex Research Opportunities Fund to support two “Research Strengths in Cancer” Workshops. (Co-applicants: Dr George Giamas (University of Sussex) and Dr Mel Flint (University of Brighton)).
Presentation of research at International Conferences:
Smalley, S., Gilleard, O., Aspden, J., Pacifico, M., Banwell, P., Metcalfe, A.D., Newbury, S.F. and Martin, Y. microRNAs as biomarkers for melanoma. Translation UK, Leicester, July 2014. Poster presentation.
Smalley, S., Gilleard, O., Aspden, J., Pacifico, M., Banwell, P., Metcalfe, A.D., Newbury, S.F. and Martin, Y. (2014) microRNAs as prognostic biomarkers for melanoma progression. Poster presented at the conference Non-coding RNA – From basic mechanisms to cancer, Heidelberg, Germany, June 2014. Poster presentation.
Smalley, S., Gilleard, O., Aspden, J., Pacifico, M., Banwell, P., Metcalfe, A.D., Martin, Y. and Newbury, S.F microRNAs as prognostic biomarkers for melanoma progression. BSMS Integrated Health Care Research Day. November 2014. Poster presentation.
Jones, C.I., Zabolotskaya, M.V., Smalley, S.K., Pashler, A.L., Caserta, S., Gilleard, O., Pacifico, M., Metcalfe, A.D., Martin, Y. and Newbury, S.F. “Identification of microRNAs for use as prognostic biomarkers in myeloma, melanoma and sepsis.” Circulating biomarkers 2015 Glasgow conference. Glasgow, UK. October 2015. Poster presentation.
Invitations to give research talks at International conferences
March 2016: Invited to present our work on microRNA biomarkers at BSMS to the Health and Life Sciences Networking Event (10/3/16). This has led to a number of new links with Industrialists who are likely to be helpful in facilitating Industrial funding.
October 2016: Invited by the conference organiser, Dr Ed Quazi, to be a guest speaker at the Circulating Biomarkers conference at Abertay University, Dundee, Scotland.
February, 2018: Invited by the conference organiser, Cerlin Roberts of Oxford Global, to be a guest speaker at the 13th Annual Biomarkers Congress in Manchester, UK.
Sophie Mumford has increased her expertise in the cancer biomarker field and is eager to continue her work in Cancer Research by carrying out a Ph.D.
Sarah Smalley increased her expertise in analysis of circulating biomarkers in melanoma and is now working in a Biomarkers company in the U.S.A.
Amy Pashler increased her expertise in analysis of circulating biomarkers in melanoma and is now completing her PhD in cancer.
Five reports detailing the progress on our work.
Burchill, S., Droop, A., Jones, C. I., Brownhill, S., Amankwatia, E., Prokoph, N. Viprey, V., Thorne, J., Hughes, T., Towler, B.P., Pashler, A., Murray, M., Greystoke, A. and Newbury, S.F. A systematic review of the methodologies used in the detection and analysis in circulating microRNAs in cancer: recommendations for good practice. Nature methods (in prep).
Mumford, S., Towler, B.P., Pashler, A.L., Gilleard, O., Metcalfe, A.D., Martin, Y. and Newbury, S.F. Circulating microRNA biomarkers in melanoma: tools and challenges in personalised medicine. (to be submitted to Biomolecules)
Celebrity gardeners are getting behind a national campaign, using humour to help fight melanoma. David Domoney, Adam Frost and David Stevens will all appear dressed up looking ‘ridiculous’ in a campaign urging us all to think twice about our sun protection habits.
Watch Your Back! – launched in 2016 by the Melanoma Fund – specifically targets men over 50 who are the least likely to cover up, but are most likely to die from the effects of excessive sun exposure. The message is; ‘don’t be ridiculous, remember sun protection when out in the garden this summer’.
Men and melanoma
Skin cancer is now the most common cancer in the UK and melanoma is the most dangerous type. It is the fastest growing cancer in men and the second fastest in women, with men 70% more likely to develop the disease, typically on their backs and in areas that are hard to spot, making the warning signs easier to miss, leading to a later diagnosis, leading to higher death rates.
Why raise awareness?
Melanoma rates in the UK have more than quadrupled over the last 30 years, however many of us still forget to protect, check skin for signs of change or know what to look out for. This may explain why death rates from melanoma are higher in the UK than in Australia or New Zealand, both of which have the highest incidence in the world.
Harry Townsend, founder of the Melanoma Fund says; “Sun protection campaigns can sound like broken records. We all know the facts, but many of us still lack a regular skin care habit and men in particular dislike applying sunscreen, so we have decided to give it to them straight; don’t be ridiculous!
Skin health clinic bus tour
The Melanoma Fund is organising a bus tour of major garden centres in the South East during May and June. Surgeons from the Queen Victoria Hospital in East Grinstead and dermatologists from RTWSkin in Tunbridge Wells will offer FREE pre-booked appointments for skin checking and skin health analysis.
The ridiculous sunflower growing competition
Major garden centres will be urging customers to grow the tallest or biggest sunflower in the UK. They will be retailing packs of the ‘ridiculous’ seeds for a £1 donation to the charity. Prizes include Landmann BBQ’s and a year’s supply of Altruist sunscreen.
Campaign ambassadors; Alan Titchmarsh, Charlie Dimmock, Andy Sturgeon, Charlie Dimmock, Joe Swift, Adam Frost, David Domoney, Anne Swithinbank and Toby Buckland have all agreed to provide their personal tips on growing giant blooms.
Alan Titchmarsh says; “This approach may appear light-hearted, but the message is serious. Sunburn can not only triple the risk of melanoma, it looks terrible, so look after your skin, whatever your age.”
Watch Your Back! is partnered with the Garden Centre Association, the Professional Gardeners Guild and The National Allotment Society. For further details visit www.watchyourback.co.uk from the 1st May.
1. Campaign logo in Hi Res on request
2. Campaign launches on-line and in stores from May 1st 2018.
3. For media enquiries, contact Michelle Baker at email@example.com or call on 07989551046
4. Quotes and interviews with all gardening ambassadors and organisations are available on request.
5. For a full list of participating garden centres visit www.watchyourback.co.uk
by Sophie Mumford, research technician working with Prof Sarah Newbury at Brighton and Sussex Medical School (BSMS) 4th December 2017
Recent funding from the Melanoma Fund has provided me with the exciting opportunity to work alongside Professor Sarah Newbury and her research team, to check and validate the microRNA biomarkers identified in these initial experiments.
The importance of early detection
Melanoma remains the most aggressive form of skin cancer with an increasing incidence worldwide. Survival rates depend heavily on the stage of disease at the time of diagnosis; when detected in the early non-metastatic stages (I and II), melanoma has good prognosis with a 5-year survival rate of 100% in stage I melanoma patients and 80%-90% in stage II melanoma patients, as thin local tumours are highly curable by surgical resection.
While surgical resection of a non-metastatic melanoma can result in disease-free intervals, recurrence is common often resulting in progression to locally advanced melanoma and subsequently to metastatic melanoma (stages III and IV), and a 5 year survival rate of ~50% in stage III melanoma patients and 10-25% in stage IV melanoma patients (Cancer Research UK).
This presents a pressing need to establish robust biomarkers that:
(1) Allow detection and diagnosis of melanoma in its earliest stages I and II, and
(2) Allow the identification of patients at high risk of metastatic recurrence after surgical resection of a non-metastatic melanoma.
Early detection will maximise the chances of patient survival, as there are now a number of treatment options available that are effective against certain subtypes of stages I, II and III melanoma.
The role of microRNA biomarkers
Circulating microRNAs are emerging as promising non-invasive cancer biomarkers. Previous work carried out at the Blond McIndoe Research Foundation and the Brighton and Sussex Medical School, identified 3 potential microRNA biomarkers that can distinguish Stage I/II from Stage III/IV melanoma, plus three potential reference controls.
Since our previous report, I have analysed all of the data obtained from the 474 qRT-PCR assays quantifying the relative levels of the three potential biomarkers in RNA extracted from the serum of 20 healthy, 20 stage I/II and 20 stage III/IV donors. I re-extracted RNA from the same patient serum samples using a different miRNA extraction kit, and repeated the qRT-PCR assays to assess whether the RNA extraction method influences the detection of these specific microRNAs from our samples.
Additionally, I added the C. elegans miR-39 spike-in to control for any inconsistencies in the extraction efficiency between samples. I re-analysed the initial Exiqon microRNA Array data obtained at the beginning of this project and identified two additional potential biomarkers. I have analysed the levels of these two microRNAs between our three patient groups, again using qRT-PCR against the RNA extracted using both extraction kits.
I am currently in the process of reviewing the literature on circulating microRNA biomarkers in melanoma, and the limitations of the circulating microRNA biomarker detection and analysis methods. I have designed a spreadsheet to document the microRNAs identified in these papers, as well as the detection and analysis methods used.
The information that I collect will be used to inform the introduction and/or the discussion in our publication. To assess the extraction efficiency of the two miRNA extraction kits used, I will collect serum from healthy donors, add the C.elegans miR-39 spike-in control and run an equal volume of each sample through each kit, followed by comparison using qRT-PCR.
Therefore we will obtain information on the consistency of the two RNA extraction used, which will be very useful for our further work and for other researchers in the field. The data for this experiment will be included in the publication we are currently preparing.
For further information on this report and the relevant melanoma research work contained herein please contact Sarah Newbury at S.Newbury@bsms.ac.uk.
I was delighted to be offered the opportunity to attend the World Melanoma Congress in Brisbane this year. This was a conference attended by over 1,000 medical practitioners and stakeholders, all of whom were involved and interested in the same subject, namely improving outcomes for people with melanoma.
The meeting, which was held in the Brisbane Convention & Exhibition Centre spanned four days and covered a breadth of topics ranging from prevention, cancer cell biology all the way through the pathway onto treatment and aftercare. This event was attended by the world’s leading experts on the melanoma. There was also a healthy representation from the United Kingdom, including Howard Peach from Leeds, Marc Moncrieff from Norwich and Alistair Mackenzie Ross from London.
Key note speakers included Prof Georgina Long who gave an update and overview of the latest medical evidence for melanoma treatment in 2017. Dr Jerry Gershenwald talked through the new AJCC Melanoma Staging; a tool that is to be implemented by all units across the world from January 2018. Prof John Thompson from the Melanoma Institute of Australia talked about the evolving role of surgery, especially in Stage IV melanoma. And Dr Caroline Robert from the University Paris Sud discussed all the latest research in melanoma immunotherapy.
The headline topic was surely the emerging and evolving role of immunotherapy for the treatment of Stage III melanoma. Numerous trials that have been performed and are still ongoing which suggest that immunotherapy can be used successfully as the first line treatment for many patient with melanoma that has spread. In some instances it may replace the need for morbid surgery and this was a hotly debated topic at the sentinel node session.
The consensus was that Sentinel Node Biopsy has an even greater role to play going forwards in identifying patients at risk of disease progression as we now have the tools to potentially treat these patients at an earlier stage. The final results of the adjuvant immunotherapy studies are to be published in 2018 and all the data so far suggests there is improved survival when used in Stage III melanoma patients.
Prevention & detection
There was also a large focus on prevention and early detection. It is well known that early detection of melanoma means less morbid surgery and a higher potential for cure. Further to this, it is widely recommended that each person performs regular skin self-exams to look for new or suspicious spots, and seeing their GP immediately to evaluate anything changing, itching or bleeding on the skin.
Because unprotected exposure to UV light is the most preventable skin cancer risk factor, the advice to everyone is to stay away from indoor tanning beds and seek protection from the sun’s harmful rays by using shade, wearing protective clothing and a broad-spectrum, water-resistant sunscreen; SPF30 or higher.
This advice is one of the founding aims of the Melanoma Fund; the charity that I represented at the event.
The Australians have had a lot of success with their health campaigns. Their public health messages are directed by each state in Australia and it was clear that in Queensland, where melanoma rates are the highest, there has been a big emphasis on developing new and out of the box ideas to deliver sun protection messages.
Perhaps the thing that struck me the most was the role that social media will play in education, especially in the case of informing younger people, and the role that technology is being used in ever increasing ways to help screen skin lesions with much more accuracy than ever before.
Take for example a new Photoageing App for melanoma prevention developed by a dermatology team in Essen Germany. It is a fun tool to use and the author has taken this App to various schools as an educational tool to inform teenagers on the dangers of sun exposure and in particular sunbeds.
Artificial intelligence (AI)
Adrian Bowling from MoleMap gave an interesting lecture on artificial intelligence and its usage in screening the population for melanoma. He made a valid point stating that dermoscopy is time consuming and there are only a limited number of dermatologists. Each year MoleMap assesses 1 million lesions but finds just 250 melanomas.
Obviously, this is not an effective usage of human time and one solution would be to use computer assisted diagnosis with sophisticated algorithms that spot suspicious lesions that help direct dermatologists to perform a hands on clinical diagnosis.
The increasing use of confocal microscopy often in conjunction with dermoscopy is increasing the accuracy of detecting early and in situ melanoma. This has two effects; firstly, melanomas that are detected earlier using this technique receive treatment earlier with a better chance of cure. Also, it is possible to detect benign lesions more accurately, meaning fewer patients are undergoing unnecessary surgical excisional biopsy.
Dr Sebastien Debarbieux and his team in Lyon proved the worth of confocal dermoscopy in pigmented lesions of the nail matrix, an area that is difficult to clinically diagnose accurately without the need for a surgical biopsy.
In summary, I believe we can all learn, borrow and adapt many of these ideas to promote protection and prevention of melanoma here in the UK. This knowledge is something I will bring to the table in my work in the MASCU at Queen Victoria Hospital and in my role as medical ambassador for the Melanoma Fund.
Brighton and Sussex Medical School (BSMS) working with the Melanoma Fund – By Sophie Mumford
Melanoma remains the most aggressive form skin cancer with an increasing incidence worldwide. Surgical resection of a non-metastatic melanoma (stage I/II) can result in disease-free intervals; however recurrence is common often resulting in progression to metastatic melanoma (stage III/IV) and death within 5 years.
This presents a pressing need to establish biomarker signatures that allow identification of patients at high risk of recurrence, to enhance their likelihood of survival, as there are now a number of drugs available that are effective against certain subtypes of melanoma.