Squamous cell carcinomas: 8 things to know about the ‘cancer of the surfaces’
Could Fiber Be The Missing Link To Better Cancer Treatment?
Melanoma is often thought of as a disease that primarily affects white patients, but that misconception has deadly consequences. While melanoma is less common in Black individuals, Black patients are significantly more likely to die from it. One of the biggest reasons? Delayed diagnosis.
Melanoma is often caught at later stages in Black patients, when it's harder to treat and more likely to be fatal. A rare but aggressive form—acral lentiginous melanoma—is more common in Black individuals and typically appears in areas often overlooked, such as the palms, soles of the feet, or under the nails.
Although the incidence is lower, the mortality rate is higher, which points to systemic gaps in awareness, screening, and care.
But what if something as accessible as diet could help shift the odds?
Emerging research presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago is uncovering how a fiber-rich, whole-foods-based diet may help support better outcomes for patients receiving immunotherapy, a treatment increasingly used in melanoma care. And this approach may offer an affordable, scalable way to support Black patients, many of whom face barriers to early diagnosis and high-quality treatment.
RELATED: Melanoma: What It Is, Causes, Types, Symptoms & Treatments
The Gut-Immune Connection: Why Fiber and Food Matter in Cancer CareAt MD Anderson Cancer Center, Dr. Jennifer McQuade, Associate Professor of Melanoma Medical Oncology, is leading cutting-edge research on the link between diet, the gut microbiome, and response to immunotherapy.
The gut microbiome—trillions of bacteria that live in your digestive system—has a surprising influence on how well the immune system works. In 2015, research teams discovered that certain gut bacteria improve how the body responds to immunotherapy, a treatment that helps the immune system attack cancer.
Those helpful bacteria? They thrive on dietary fiber.
This insight sparked a new hypothesis: if we feed the right bacteria through diet, can we boost immunotherapy's effectiveness?
RELATED: Do You Need More Dietary Fiber?
Inside the Study: High-Fiber Diets, Real ResultsDr. McQuade's team conducted a rigorous, controlled feeding study. They recruited melanoma patients about to begin immunotherapy and split them into two groups:
The findings were striking:
Even though the study was exploratory and more research is needed, the message is clear—what you eat can influence how your body fights cancer.
Why This Matters for Black Patients With MelanomaMelanoma in Black patients is too often detected late, and access to cutting-edge treatments like immunotherapy can vary based on where and how someone receives care. But diet? That's something patients can begin to change today—if they have the right information and support.
This research opens the door to a low-cost, widely accessible strategy that could help level the playing field in melanoma care, especially when integrated into community-based education and prevention efforts.
Dr. McQuade emphasizes that this isn't about fad diets or supplements—it's about going back to the basics: whole, plant-based foods, rich in fiber, prepared in ways that fit the cultural diets of each community.
RELATED: 5 Reasons to Fill Up On Fiber
Breaking It Down: What Patients Can Do Right NowYou don't need to jump to 50 grams of fiber overnight. Dr. McQuade says even 30 grams per day can make a meaningful difference. The bigger shift is moving from processed foods to real, whole ingredients.
Here's what she recommends:
Dr. McQuade and her team are now working on sustainable approaches that patients can stick with. That includes combining prebiotic-rich foods with nutrition coaching to help people build long-term habits.
She's also pushing to expand this research to other types of cancer—and to diverse patient populations, including those often left out of traditional clinical trials.
That means customizing dietary interventions to reflect cultural food traditions, like incorporating familiar ingredients and preparation methods used in Black, Hispanic, and other communities.
"We know that one-size-fits-all won't work," Dr. McQuade tells BlackDoctor.Org. "Food has to be familiar, accessible, and something people actually enjoy if we want these changes to last."
The Bottom LineFor Black patients with melanoma, who face higher mortality despite lower incidence, early detection and better access to treatment are critical. But diet could become a powerful complementary tool.
A fiber-rich, whole-food diet isn't just about prevention anymore—it may play an active role in how the body responds to cancer treatment. And that makes it an important conversation to have with your doctor, no matter your background or diagnosis stage.
"We all know what we should be eating," Dr. McQuade adds. "But now we're showing that it might actually help the immune system do its job. That's empowering."
Resources & Next Steps for Patients:
Skin Cancer Awareness Month: Addressing Misconceptions And Promoting Prevention
Michael E. Kasper, MD, FACRO, discussed unmet needs in skin cancer treatment and addressed misconceptions among patients and health care providers.
While skin cancer is one of the most common cancers in the US and worldwide, with 1 in 5 Americans developing skin cancer in their lifetimes,1 unmet needs still exist. An estimated 90% of skin cancers are considered preventable,2 and gaps in the field include a need for more therapies for advanced disease, enhanced prevention, and early detection.
In an interview with Targeted OncologyTM, Michael E. Kasper, MD, FACRO, board-certified radiation oncologist and director of radiation oncology at the Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health, discussed these topics for Skin Cancer Awareness Month.
Targeted OncologyTM: What are the most significant advancements in the diagnosis and treatment of skin cancer in recent years?
Michael E. Kasper, MD, FACRO
Kasper: There have been many advances throughout medicine, and many of those have spilled over into skin cancer and dermatology, not the least of which has been immunotherapy for things like metastatic melanoma and other advanced skin cancers. We also have targeted agents for very large basal cell cancers and other targeted agents in immunotherapy for squamous cell [cancer].
In my mind, what is probably been one of the best advances and an area for improvement in many places is the multimodality approach that we are able to take here at the [Eugene M. & Christine E.] Lynn Cancer Institute. Patients are seen by all the skin cancer specialists all at the same visit. Usually, the dermatologist refers them in especially difficult cases, like Merkel cell [carcinoma] or melanomas. We see a lot of those cases; whereas dermatologists may see 1 or 2 Merkel cell [carcinoma cases] in their whole career, we see maybe 20 a year.
[Once they have been referred], the surgical oncologist, the medical oncologist, radiation oncologist, all who have specialized in skin cancers see the patient at the same time. The patients may also be seen by the psychosocial [team] to deal with any family or logistical problems. They will be seen by a dietitian, if necessary, and the patient has a nurse navigator who can help with appointments that may be made in the future, surgical appointments or imaging appointments. Then, the physicians get together with radiology and pathology and review the case, all looking at the same images, the same pathology, the same MRIs and PET scans. That is rare in the dermatology world, but it is so important in these more advanced cases. Not many places have an advanced cutaneous malignancies multimodality clinic, and I think it is a shame, because so much of the time, it is difficult to pull together the different path[ology] reports. When you have a coordinated effort like this and an expert team, I think it can make a huge difference.
What are some of the persistent challenges for skin cancer prevention and early detection that you believe need more attention in the health care community?
We know the easy things we can do. In fact, in many cases, we know how we can prevent over one-third of all cancers. It is just a collective will and a focus in the medical community and a collective will by society to make it happen in skin cancer. We know that by limiting sun exposure, particularly in the first 20 years of life, we can dramatically reduce, if not eliminate, skin cancers. There will still be some rare cancers that develop, but by and large, most of the later-in-life basal cell and squamous cell [carcinomas] could be avoided by limiting sun exposure early in life.
That takes an education piece. Certainly, we can do a better job with education, and it takes a changing of norms in society, where it is okay to go to tanning beds and really sit out when you are 15 years old and get fried by the sun. We need to educate people to know that that may seem like a good idea now, but you are going to be paying for it later. We know that over 90% of our sun exposure usually comes by age 20. So, if we can have better protection as babies, as kids growing up, going to the beach, and as teenagers lying out in the sun, we can greatly impact what happens down the road. It seems simple, almost too simple, but it's still one of the greatest challenges. But it is something so doable; it just takes a change of collective will.
What are some common misconceptions or knowledge gaps about skin cancer that you encounter?
I hear this from my patients all the time, particularly patients who are referred in late for radiation. They say, "I wish I had known about this sooner." There's no question that surgery, and [often] Mohs surgery, [is] the gold standard and the main approach to most skin cancers. But particularly for frail and elderly patients, or in sites where there is possibly functional or structural damage that could occur and the reconstruction is going to be complex, radiation should at least be considered as an alternative, and patients should be given that option. I am told it is never brought up. It is only after their 10th, 11th, 12th Mohs surgery, after they complain or it's become a problem, [that radiation is an option]. It is a shame that radiation is not considered as an equivalent or a good alternative for managing skin cancers in the right positions. We know that it's not for everyone, and we would not recommend this for a 25-year-old who needs surgery. But in many cases, it is a reasonable and even a superior option for many patients.
More and more dermatology offices are putting in radiation, and there's a huge marketing push on "gentle" radiation or "soft" radiation, and it's come across as something that is new or different. It is superficial radiation that's been around for about 80 years, and it is one type of radiation that fits one tiny little scope of skin cancer. It comes off as perhaps a turf battle, but I think I can say with certainty that if you come into a radiation oncology office, you will get many different options of radiation treatment based on the exact specifications of the tumor. Deeper tumors may not be amenable to the superficial radiation, but patients are coming in and dermatologists are treating quite a few of these lesions that they may not be quite sure [about]. I do get a lot of referrals from dermatologists who do have their own radiation machines. If they're not sure, they do send them over. But I think that there is a misconception that this "soft" radiation or this "gentle" cure is something that's new or different or better for all skin cancers. Radiation should be given by radiation oncologists. We have extensive training in radiation biology and physics, and we have a career full of seeing radiation skin reactions and cancer care. That's not always the case in dermatology.
How has AI impacted skin cancer screening and diagnosis? What are the implications of its use?
I know in many dermatology practices that they are using new imaging tools to document and follow lesions across the body. I think that is great tool [because] we are able to find subtle changes and utilize AI now and make good choices about biopsying and targeting lesions that may be different or should be checked. There's no question that AI is going to have a huge role in in all of medicine, but dermatology and dermatopathology as well.
Do you see any disparities across racial and ethnic groups when looking at skin cancer incidence?
Northern European cultures who have migrated to South Florida are at great risk, so there's a huge disparity in in people with fair skin [and] blue eyes. They are much more likely to develop skin cancers, and they are at higher risk for melanomas and Merkel cell [carcinomas]. There is a misconception, however, that people of color do not develop skin cancers. That is incorrect. I think it is important to educate our patients of color that they also can be at risk and to not ignore suspicious skin changes and to not bake in the sun as well.
REFERENCES: 1. Skin cancer facts & statistics. Skin Cancer Foundation. Accessed May 16, 2025. Https://tinyurl.Com/r3f9cf9p 2. Surgeon General call to action to prevent skin cancer. US Department of Health and Human Services. Accessed May 16, 2025. Https://tinyurl.Com/3tnx73jtFrom An Overlooked Bump To Melanoma, One Survivor Shares His Journey
For CJ, a busy restaurant general manager getting ready for his 38th birthday, life was moving fast. Juggling 60-hour work weeks and preparing for a trip to Spain, he barely noticed the small, itchy bump on his thigh. "I didn't think anything of it," CJ said. "If anything, I thought it was a mosquito bite."
But this bump was different. It grew quickly, and within three months, it became a mass half an inch off his skin that started bleeding. Even though he still thought it was harmless, the rapid change in its appearance led CJ to schedule an appointment with a dermatologist.
The reality was that CJ had a very serious condition. The diagnosis came fast: melanoma. CJ describes his experience as "the fastest moving train I've ever seen." Within two weeks after that first dermatology appointment, CJ had imaging tests and an urgently scheduled surgery. The cancer, classified as stage IIIB melanoma, had already spread to the lymph nodes in his groin.
Finding strength through his journeyCJ and his husband had to cancel their trip to Spain, and instead, CJ spent the week recovering from surgery. Going from a healthy guy with what he thought was a mosquito bite to becoming a cancer patient facing treatment in such a short time was difficult.
Despite the temporary heaviness and depression he felt from this rapid change in life, CJ held onto his positivity while being supported by his husband. "He was my cheerleader," CJ said. "I needed someone to remind me that it would be OK, and he was there, nurturing me."
CJ moved forward with treatment, which included receiving several cycles of medicine through intravenous (IV) infusion. Once complete, he had follow-up care to be sure the melanoma hadn't returned. This included having a routine ultrasound and CT scan of his chest and pelvis for five years. He approached this as a checklist. "Cancer never defined me," CJ said. "I'm just one of millions of people impacted, and I just wanted my life to go on."
Living cancer-freeRecently, CJ received the news that he is five years cancer-free.
When facing a new diagnosis, CJ says it's best to acknowledge the mental health aspect and seek support. While he relied on his own resilience, he recognized the value of shared experience. "Being around people who have been through what you have is beneficial," he said. That is why he shares his story. It's also why he has reached out to help others facing cancer by volunteering, including working with the American Cancer Society's Men Wear Pink campaign.
CJ's experience highlights the importance of paying attention to changes in your body and seeking medical attention for changes that don't go away. What seemed like a small inconvenience turned into a serious, life-threatening condition that needed immediate medical attention.
His journey also serves as a needed reminder about sun protection. While anyone can get skin cancer, CJ's doctors believe his melanoma may be connected to extensive sun exposure during his youth. He recognizes that his 1980s childhood didn't involve staying in the shade or applying daily sunscreen since the science that led to regulations about sunscreen and SPF (sun protection factor) was fairly new at that time. However, as someone with fair skin and red hair, studies have shown that he is at much higher risk for skin cancer than people with darker hair and skin color.
These days, CJ and his husband are new parents and make sure their son is protected from the sun every day. "He is always the first one getting the sunscreen," CJ says. "These choices we make every day impact our health — physically and mentally — and I want to do everything I can to protect him."
CJ views his cancer journey as a significant event in his life, leading him toward making proactive choices, including more sun protection and a healthier diet. His career is now focused on fitness and nutrition, and he considers these events a part of his past, thanks to the work of organizations like American Cancer Society.
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