The plot twist ripens.
My endocrinologist opened up a door today. She's very concerned that I have a melanoma diagnosis on the mole on my arm.
With my history of other things, including the cervical and stomach/lower esophageal 'cancers', she is thinking it may be interrelated. So she gave me a few links, the one below being doubly important.
She also will be advocating for an omnipod and dexcom setup to control my insulin delivery.
After she said I've lost 75.3lbs in less than18 months, with 38 of it in less than 3 months, and I'm 4 lbs down just since Tuesday (water, it has to be water), yet my A1C hasn't budged, she's ordering a complete DNA panel to see if it's mutated gene(s) and will advocate to my insurance why it's necessary if they choose not to cover it.
She noticed, where I hadn't, that the outer edges on the left side of the surgical site on my neck is bruising and red. Utoh, it's the weekend...now I have to watch if I get a fever or it gets hot.
Well shit.
Below is one of the websites she gave me about melanoma and it's link with MIA protein.
How MIA Can Be Used to Help Detect and Suppress Melanoma
When researchers first found the MIA protein, it opened a much-needed door to cancer patients and the therapies that could be offered to them. “Practitioners finally had a key indicator on how melanoma could spread,” says Dr. Ilyas. “And, that’s not just for melanoma. MIA may play a role in other malignancies such as squamous cell carcinoma, cervical cancer, lung cancer, and esophageal cancer—which is incredible and valuable knowledge that can save lives.”
MELANOMA
What Is Melanoma Inhibitory Activity?
The MIA protein impacts how melanoma spreads. Here's what you need to know.
by
Andrea Dawn Clark Health Writer
GettyImages/Benjamin Toth
September 1, 2022
ONE OF THE scariest aspects of most any cancer diagnosis is having to face the possibility of the disease spreading throughout your body. In the case of
melanoma, a potentially life-threatening form of skin cancer that starts in your pigment-making cells (or melanocytes), it’s an especially pressing concern as melanoma tends to spread faster than other types of skin cancer, per the
American Cancer Society.
That’s why researchers are focused on staying a step ahead of the disease. One way they’re looking to do that is by potentially blocking and regulating a key element which contributes to melanoma’s spread—namely, the melanoma inhibitory activity (MIA) protein.
“Melanoma inhibitory activity, or MIA, is a protein involved in the metastasis, or spread, and immunosuppression in melanoma,” explains Hysem Eldik, M.D., a board-certified dermatologist at Marmur Medical in New York City. In other words, the MIA protein, which is
secreted by melanoma tumor cells, not only fuels the progression of the cancer, but also suppresses the immune system’s ability to fight it. A double jeopardy for your cancer prognosis, indeed.
Remind Me: What Are the Causes and Symptoms of Melanoma?
Basically, melanoma forms when melanocytes grow out of control. This can occur wherever these pigment-making cells exist in the body—and that’s not only on the stretches of skin that get the most sunshine: In rare cases, melanoma can also occur in the melanocytes
under your nails,
inside your eye, or within the mucus lining of your nose, throat, or GI tract.
So, what influences melanocytes to go haywire? “The development of melanoma is thought to be through a combination of genetic and environmental factors,” explains Erum Ilyas, M.D., a board-certified dermatologist with the Schweiger Dermatology Group in King of Prussia, PA. Genetics plays a role in who develops melanoma in that this cancer
can run in families, and those with fair skin and/or more moles are at higher risk for it. As for the environmental part of the equation, exposure to ultraviolet (UV) rays from sunlight or tanning beds is known to
increase your risk.
Frequently, the first
signs of melanoma are a change in an existing mole or the formation of an unusual-looking or strangely-pigmented mole. “It most often presents as a changing or darkening mole or freckle however it can present without pigment as well,” says Dr. Ilyas.
Dermatologists recommend assessing any suspicious growths with the same
ABCDE checklist that they themselves employ to identify melanomas. “We use this acronym to remind people to look for an [A] asymmetrical shape,
borders that are irregular, [C] colors that are uneven or dark, a [D] diameter that’s larger than six millimeters, and [E] evolving signs and symptoms,” says Dr. Eldik. “It’s also important to mention that about 25% of melanomas arise within pre-existing moles. This means that just because you have had a spot since childhood or adolescence does not mean it cannot become melanoma.” The remaining 75% of melanomas will be growths that appear anew.
Your dermatologist can remove any suspicious moles or growths and send them to a lab for a biopsy. If melanoma is detected, the next step is to determine which stage of development the cancer is in to guide the best course of treatment. In its most advanced stage, that is, stage 4, the melanoma is said to have metastasized, meaning that it has spread to other organs and is not considered curable.
While that may sound harrowing, early detection and treatment of melanoma can maximize one’s chance of making a full recovery. That’s why experts recommend monthly self-checks of your skin and having a standing appointment with your dermatologist for an annual skin-cancer screening.
Understanding the MIA Protein and Its Link to Melanoma
Ready for a quick biochemistry lesson? It’s important to note that the MIA protein which appears to accelerate melanoma is “absent in normal human melanocytes,” per a study in the journal Carcinogenesis. In other words, research shows that the MIA protein is produced once a malignant melanoma tumor has formed but markedly absent in both benign tumors and normal skin biopsies.
While Dr. Ilyas notes that there are not a lot of research on what actually induces the release of MIA, we do know how it works: “In melanoma, MIA is believed to regulate a protein called p54, which works in the nucleus of skin cells, potentially upregulating cell turnover,” she explains. Think of it as a deadly domino effect—MIA nudges p54 into action and it’s p54 that spurs the cancerous cells to proliferate and thereby speed the growth of melanoma.
In addition, this same process lowers your immune system’s response to melanoma by inhibiting cellular anti-tumor reactions. “This helps increase the spread by decreasing the body’s defense systems,” says Dr. Ilyas
lol. 
I'll give a more detailed rendition of the days events in another post below. There always seems to be a plot twist for me. 
He tells me that I am having a bigger biopsy on my upper arm. 
