Mitch Rolin loves the outdoors. But, the outdoors hasn't exactly loved him back. Since he was a teenager, Rolin has fought case after case of skin cancer.
"I've had hundreds of procedures, ranging from shave biopsies to surgeries to excise lesions on the skin," Rolin said.
The lesions were the result of basal cell carcinoma. It's the most common form of skin cancer, and strikes an estimated 2 million Americans a year. In most cases the lesions are small and easily removed. But in more extreme cases like Rolin's removing the larger lesions can be badly disfiguring.
"And most of these cancers arrive in the head and neck, from sun damage, so scars are very visible as well," Dr. Sarah Arron said.
Arron is directs the high risk skin cancer clinic at UCSF. She says in the worst cases, the lesions may not be operable all.
"It can be deadly if it spreads and again, that's a rare thing, but like any cancer it can spread to the brain, lungs and bone," Arron said.
But several years ago, researchers began working with a well known protein signaling system in the body known as the hedgehog pathway. It's been linked to the development of several cancers including basal cell carcinoma. That work ultimately led to a breakthrough drug, approved just this year by the FDA, called Erivedge. It's manufacturer, Bay Area-based Genentech says in clinical trials, the drug shrunk basal cell tumors in up to 40 percent of cases.
Rolin was one of a hundred patients to participate in that research.
"I was hoping for a quick change and sure enough within 5-6 weeks I noticed a change," Rolin said.
Rolin says his lesions turned into scar tissue, and then began to fade.
"The scar tissue has become thin and pliant," Rolin said.
Arron says there are still important questions about the long-term effect of the drug on patients, including a subset who developed resistance to it.
"We don't know the mechanism of resistance, and that's something that we're exploring now," Arron said.
But for Rolin, having an alternative to serial surgeries has been life changing.
"To have something come out of the blue like this...it's given me kind of a second chance," Rolin said.
To be clear, the drug is for specific cases, and can cause significant side effects in some patients, including muscle spasms, hair loss, and even loss of taste.
Written and produced by Tim Didion