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Melanoma is a type of cancer that affects the skin and is considered the most dangerous type of skin cancer. Exposure to ultraviolet light is one of the biggest risk factors for melanoma and the tumors begin as moles on the skin or develop and look like moles. Melanoma is treatable if caught early, but it spreads rapidly, like mesothelioma does. Research has found that there is a connection between these two types of cancer.

The connection is related to a gene, called BAP1, and the discovery of this link means that there may be a new way to predict who is at risk for mesothelioma. Someone with a cancerous mole is more likely to develop mesothelioma than someone who does not. This connection could help doctors detect mesothelioma in patients earlier, which could help make treatments more effective.

What is the BAP1 Gene?

While many people develop cancer after exposure to certain environmental factors, these are not always the ultimate or only cause of cancer. Some people have genetic mutations that predispose them to developing the cancer and environmental factors increase the risk. In some people who develop melanoma or mesothelioma, it is not necessarily just the exposure to ultraviolet light or asbestos that is to blame; these people may also have mutations in certain genes, like BAP1.

BAP1 is an abbreviation for BRCA1 associated protein 1. It is a gene that codes for a protein called ubiquitin carboxy-terminal hydrolase BAP1, or just BAP1 for short. BAP1 is an enzyme that acts in the body by removing a molecule from some proteins. This action is thought to be an important part of preventing cells from growing out of control and multiplying rapidly. In other words, it inhibits cancer cells and tumor growth. It is known as a tumor suppressor and the BAP1 gene as a tumor suppressor gene. If this gene is missing or mutated in some way, it may predispose someone to developing certain types of cancer.

BAP1 and Mesothelioma

Researchers have determined that one of the types of cancer that a BAP1 mutation predisposes a person for is mesothelioma. They looked at patients diagnosed with mesothelioma and found that the mutation in the gene was common as compared to people without mesothelioma. A mutation in BAP1 is considered a genetic risk factor. Someone with this mutation is more likely to develop mesothelioma, especially if also exposed to asbestos fibers. This may help explain why some people exposed to asbestos will develop the cancer while others will not.

BAP1, Mesothelioma, and Melanoma

Another type of cancer that has been found to be associated with the BAP1 mutation is melanoma. Melanoma that results from a BAP1 mutation causes the formation of tumors called melanocytic BAP1-mutated atypical intradermal tumors (MBAITs). In simple language, these are tumors on the skin that resemble moles or that developed from normal moles. Melanoma develops in the skin cells that create the pigment melanin, which is why the tumors that grow are either moles or look like moles.

What researchers have discovered most recently is that all three things are linked: a BAP1 mutation, a risk of developing melanoma, and a risk of developing mesothelioma. Mesothelioma is not visible, but melanoma is clearly visible as a mole or multiple moles on the skin. This means that by identifying cancerous moles, doctors could potentially have an easier and quicker way than ever before of identifying patients who may have or be at risk for developing mesothelioma. A cancerous mole may be the first sign of BAP1-related cancer, which may eventually develop into mesothelioma.

The study that led to this conclusion involved 118 participants from several different families. They were separated into two groups: those with a BAP1 mutation and those with a normal BAP1 gene. Those with the mutation—63 people—were much more likely than people in the other group to have MBAITS and mesothelioma.

The Potential for Early Detection of Mesothelioma

An ongoing struggle in treating people with mesothelioma is the fact that the cancer is difficult to diagnose and is often not diagnosed until it is in late stages and very challenging to treat. An important factor in helping treat people more effectively is to make earlier diagnoses. Because researchers now know that there is a definite connection between cancerous moles and mesothelioma, doctors and patients can use screenings for moles to also detect mesothelioma before it is too late to treat.

Not everyone who has an MBAIT, or cancerous mole, will develop mesothelioma, but they are clearly at a greater risk for it. By screening patients who have these moles on their skin, doctors may be able to catch mesothelioma early and identify patients who will benefit from regular screening for mesothelioma to help diagnose it earlier.

The prognosis for most patients currently diagnosed with mesothelioma is not positive. Most people are given a year or less to live, primarily because the cancer is too often diagnosed at a late stage when it has already begun to spread aggressively and quickly. With advances like those seen in the BAP1 melanoma study, patients may now have more hope. It is important to monitor skin for signs of skin cancer, but now it is even more important to connect that to a risk for mesothelioma and an early, and more hopeful, diagnosis.

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