Jerry Jones: Ten-Year 'Stage 4' Melanoma Survivor
August 18, 2025
Dallas Cowboy's owner Jerry Jones recently revealed details about his decade-long battle with Stage 4 melanoma. As a 10-plus-year survivor, Jones credits the advancements in targeted immunotherapy for his success. Co-captain of the 1964 national champion Arkansas football team, Jones said he was thankful to have qualified for an experimental drug trial combined with surgeries that helped him achieve remission.
In August of this year, the general manager of America’s Team was very transparent and shared details about his diagnosis and the treatment protocols for his drug-therapy trial using a PD-1 inhibitor. The three-time Super Bowl champion revealed he was diagnosed with stage 4 melanoma in 2010 and began cancer treatment soon after. Now well-past ten years later, his story underscores the importance of the early detection of the potentially deadly skin disease.
“Although melanoma only represents a small percentage of the skin cancers diagnosed each year,” says Orlando Mohs cancer surgeon Dr. Michael Steppie, “it is the most invasive type of skin cancer and the leading cause of skin-related deaths. When diagnosed early in a localized stage, survival rates are very good. And, now with advances in immunotherapy, later-stage protocols are also more effective.” Dermatologists are now able to analyze melanoma tumor characteristics using biomarker testing to help determine the best combination of therapies to attack the invasive disease.
Over the decade that followed his June 2010 diagnosis, Jones underwent four surgeries to remove two tumors from his lungs as well as the surgical removal of two lymph nodes. Due to melanoma's propensity to spread, Jones joined a clinical trial for PD-1 immunotherapy at Houston’s MD Anderson Cancer Center. The experimental drug had shown promise with success noted in over 35 percent of trial studies. In addition to being thankful for the immunotherapy, Jones shared with the media that the treatments were a little rough on his bones, as the 82-year-old former football player had two hip replacements over the same decade.
Biomarkers Are Making a Difference
Biomarkers offer crucial insights into the genetic makeup and behavior of cancer cells, and can distinguish them from normal cells. This plays a critical role in helping doctors today prescribe more targeted therapies. These biomarkers can include proteins, genes or genetic mutations and are often identified using abbreviations. One such biomarker is TMB, which is short for tumor mutational burden, which is an important measure of genomic instability in cancer cells. When classified as TMB-H (high tumor mutational burden), it means the cancer cells have an elevated number of mutations in their DNA.
High TMB suggests much greater genomic instability and a higher likelihood of producing tumor-specific antigens (or neoantigens) that the immune system, particularly T cells, will recognize as abnormal. Though TMB-H is a relatively new biomarker, it is commonly found in solid tumors in the lungs, liver, kidneys, bladder, head or neck, and melanoma skin cancers. While it may not perfectly predict outcomes, high TMB is often seen as a promising indicator that patients might respond favorably to PD-1 inhibitor therapy.
What is “programmed cell death protein 1”?
PD-1 inhibitors are a groundbreaking form of immunotherapy that harnesses the body's natural immune system to combat cancer. Unlike chemotherapy or radiation, which directly attack cancer cells, PD-1 works by activating the immune system's own anti-tumor responses. This unique approach has led to lasting results in the treatment of several cancer types. As a checkpoint protein on T cells, PD-1 also regulate immune responses that help prevent damage to healthy cells.
Some tumors, however, overexpress PD-L1, which is a molecule that binds to PD-1 and suppresses the immune response, allowing the cancer to evade detection. By blocking this interaction, PD-1 inhibitors restore the immune system's ability to detect-and-fattack cancer cells. Often combined with treatments like chemotherapy or targeted therapies, these inhibitors are tailored to each patient’s unique cancer type, stage, and long-term health needs.
How PD-1 Immunotherapy Works
PD-1 drugs have demonstrated effectiveness against cancers such as melanoma, non-small cell lung cancer, and Hodgkin's lymphoma. Known as immune-checkpoint inhibitors, PD-1 works by blocking the interaction between PD-1 and PD-L1 proteins. This essentially releases the "brakes" on the immune system, enabling T cells to identify and attack cancer cells more effectively. Similarly, PD-L1 inhibitors target the PD-L1 protein on cancer cells, achieving the same goal of disrupting its pathway.
1) PD-1 & PD-L1 Interaction – PD-1 is a receptor protein found on immune cells (T cells). It acts as an off switch by binding to PD-L1, which is also a protein found in many cells, including some normal and some cancer cells.
2) Immune Suppression – When PD-L1 binds to PD-1, it signals the T cell to stop its activity to prevent it from attacking the cell expressing PD-L1. This helps cancer cells avoid the immune system.
3) Blocking the Interaction – PD-1 inhibitors are monoclonal antibodies that bind to PD-1 to prevent it from interacting with PD-L1. This prevents the “off switch” from being activated and allows the T cells to attack the cancer.
4) Immune Activation – By blocking interactions, PD-L1 inhibitors target the PD-L1 protein itself, preventing it from binding to PD-1 and triggering the "off switch". This allows T cells to recognize and attack cancer cells.
PD-1 inhibitors are administered through intravenous infusions. While they can cause side effects, which in some cases may be serious, they are generally better tolerated than traditional chemotherapy. These inhibitors have demonstrated remarkable success in treating various types of cancer, often delivering longer-lasting responses compared to conventional therapies. To enhance their effectiveness, researchers are continually exploring combination therapies with other treatments. Efforts are underway to identify the biomarkers that can help predict which patients are most likely to benefit from PD-1/PD-L1 inhibitors.
Do PD-1 inhibitors cause side effects?
PD-1 inhibitors are effective treatments, but they can trigger side effects by activating the immune system, which may mistakenly attack healthy cells and tissues. These immune-related adverse events can impact various organs and systems, sometimes becoming severe or even life-threatening. It’s essential to discuss potential side effects with your skin cancer specialist before starting PD-1 inhibitor therapy.
While PD-1 inhibitors often present fewer severe side effects compared to traditional chemotherapy, treatment decisions should be approached with nuance. A comprehensive evaluation goes beyond considering tumor mutational burden alone. Integrating TMB with other biomarkers and analyzing the tumor’s immune microenvironment can provide a more thorough understanding of how likely a patient is to respond to PD-1 inhibitors.
Increased Survival Rates for Melanoma
According to the National Cancer Institute’s SEER training modules for oncology data specialists, initial prognosis with melanoma usually depends on the thickness of the tumor or how deeply the cancer has penetrated the skin, and whether an open sore (ulceration) is present. According to NCI’s Physician Data Query system, approximately 83% of melanomas are diagnosed at the localized stage with a 5-year survival rate for all stages of the disease above 90 percent.
Listed below are the 5-year survival percentage rates for melanoma diagnoses, according to the American Cancer Society:
- Stage 0 (In Situ): The 5-year survival rate of the earliest precancerous stage, where abnormal cells are found only in the place where they formed and haven't spread to nearby tissues, is 100%.
- Stage 1 & Stage 2 (Localized): The 5-year survival rate when not spread to lymph nodes but confined to the skin is 99% to 98.4%.
- Stage 3 (Regional): The 5-year survival rate where disease has spread to lymph nodes is around 71%.
- Stage 4 (Distant): The 5-year survival rate where it has spread to distant parts of the body (metastatic) is about 32%, but improving.
An ongoing study at the Institue of Cancer Research on the long-term survival rate of patients with advanced metastatic melanoma that was once regarded as untreatable have shown remarkable results using immunotherapy. 43% of the stage 4 melanoma patients treated with immunotherapy are still alive after more than ten years. In addition, 52% of patients treated with dual immunotherapies have exceeded a ten-year survival. It's important to note that these are general statistics and individual outcomes can vary due to factors like the stage, patient age, general health, and overall treatment response.
Will Melanoma Ever Be Curable?
Skin cancer has become highly treatable, especially when detected early. Non-melanoma skin cancers, such as basal cell and squamous cell carcinoma, have impressively high cure rates. Early-stage melanoma also responds well to treatment, significantly boosting survival rates when identified and treated before it spreads beyond the skin to lymph nodes or other organs. The five-year survival rate for localized melanoma stands at an exceptional 99-100%, depending on specific staging and data sources.
Although “cure” is a nuanced term in cancer care, later-stage melanoma becomes considerably more challenging to cure as it progresses, particularly in Stage 4, when it metastasizes to distant areas like lymph nodes or vital organs. Nonetheless, for advanced regional and distant stage melanomas recent breakthroughs in immunotherapy and other targeted therapies have dramatically improved long-term remission rates, so much so that there may eventually be a cure for many patients. However early detection still remains a critical factor.
Even with these remarkable advancements in FDA-approved therapies for melanoma, advanced metastatic melanoma remains a particularly aggressive and life-threatening disease. Many patients with metastasized melanoma still face significant mortality risks, underscoring the urgency to develop more effective treatment options. With options such as PD-1 inhibitor therapy, some studies report five-year survival rates for advanced melanoma approaching 50%. While this signals a brighter horizon for some patients, vigilance remains essential.
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A better understanding of biomarkers and the use of checkpoint inhibitors have revolutionized the outlook for patients with metastatic melanoma, but early detection will always be key for improving cancer survival rates. At Associates in Dermatology, our professional staff can accurately diagnose your skin condition and will recommend the most appropriate treatment plan to ensure optimal skin health. Call 800-827-7546 today or schedule your appointment online at one of our sixteen Central Florida offices in Orlando, Altamonte Springs, Apopka, Celebration, Clermont, Davenport, Dr. Philips, Hunter's Creek, Kissimmee, Mount Dora, Ocoee, Poinciana, Sanford, or St. Cloud for effective treatment options.
