SALT LAKE CITY — Utahns face plenty of risks each summer — wildfires, lightning, extreme heat — but one of the most dangerous threats may be the one we often underestimate: the sun. Its powerful UV rays are a leading cause of skin cancer, including melanoma, the deadliest form.
Melanoma is a growing concern in Utah, which has double the national average of cases.
“And that's — really for a number of different reasons, right? We love being outdoors, we enjoy our beautiful Utah landscape here. And we live at altitude, so the sun's rays are that much brighter, and that UV index is that much higher here in Utah,” said Dr. Caroline Nebhan, a medical oncologist with Intermountain Health who specializes in melanoma.
“Most of us, by the time we reach adulthood, have at least one blistering sunburn in our life, and that increases our risk of melanoma right there by about 9 times,” Nebhan said.
While prevention remains the best defense — avoiding peak sun hours, using sunscreen, and wearing protective clothing — many Utahns already have or will develop melanoma. The disease is especially dangerous because of how easily it spreads through the body.
“So, if you have, say, a melanoma on your arm, it's most likely going to spread to the lymph node basin in your armpit there first, because that's where those cells kind of drain up if they start to escape,” Nebhan said. “And then from there melanoma can go anywhere. It can go to the lungs, to the brain, to the liver, to other parts of the skin — so it can really do whatever it wants. That's part of what makes us, you know, so nervous with melanoma as a diagnosis in general.”
Now, there’s a new treatment bringing hope to patients in Utah: tumor infiltrating lymphocyte therapy, or TIL therapy.
“So, this TIL therapy, that stands for tumor infiltrating lymphocytes — this is the biggest, and the most recent advancement that we have in melanoma,” Nebhan said. “We're really proud that we just got this treatment available and it's now available here at Intermountain.”
The therapy works by enhancing the cancer-fighting cells that already exist in a patient’s body.
“The way this treatment works is a patient actually has surgery to have about a walnut-sized piece of their tumor removed by one of our surgical oncologists, and then from there that is sent off to the company,” she said.
“The company will actually make or extract the tumor infiltrating lymphocytes, or the TIL cells, from the patient's tumor, and in the lab they will expand them,” Nebhan said. “So, we want more of those good anti-cancer immune cells to be expanded. So, we're really just kind of tipping the scales of the patient's own immune system in favor of those cells that will hopefully be more cancer toxic, right, that will go fight the cancer for us more.”
Because the treatment is derived from the patient’s own cells, it’s considered highly personalized.
“It's really kind of the epitome of personalized cancer medicine, which is something we all want more of because it's specific to a patient's own tumor,” said Nebhan.
TIL therapy is currently only approved for melanoma. It has shown strong results in about one-third of patients — and while it’s too soon to call it a cure, researchers are hopeful and continuing to study its long-term impact.
