Melanoma May Return Years Later in Some

But study also found those patients were less likely to die than those with early recurrence

By Robert Preidt

HealthDay Reporter

FRIDAY, June 28 (HealthDay News) -- New research shows that melanoma can recur decades after initial treatment in roughly 9 percent of patients.

The findings show that people who have had melanoma require lifelong follow-up, the study authors said.

The investigators looked at over 4,700 melanoma patients and found that recurrence occurred in 408 patients who had been disease-free for 10 or more years. The recurrence rates were nearly 7 percent after 15 years and 11 percent after 25 years, according to the study in the July issue of the Journal of the American College of Surgeons.

But the researchers also found that patients whose melanoma recurred 10 or more years later were less likely to die than those whose melanoma recurred within three years of treatment. Those with late recurrence were about 40 percent less likely to die of melanoma than those with early recurrence, and those with late recurrence also had a better overall survival rate.

Patients whose melanoma did not come back until at least 10 years after treatment were younger on average than those with early recurrence (age 41 versus 51).

Also, patients with a later recurrence tended to have had an original melanoma with less dangerous characteristics, the researchers noted. They also found that men accounted for 66 percent of patients with early recurrence, compared with 57 percent of those with late recurrence.

"For patients with melanoma, survival beyond 10 years without a recurrence has been considered nearly synonymous with a cure," lead investigator Dr. Mark Faries, a professor of surgery at the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, Calif., said in a journal news release. "However, most studies do not follow-up patients longer than 10 years. Our study found that late melanoma recurrence is not rare and that it occurs more frequently in certain patient groups," he noted.

"It appears the risk of melanoma recurrence is never completely gone," Faries said. "One change that should result from our study is that people need to be followed-up for life with a physician after a diagnosis of melanoma," he pointed out.

"Fortunately, the vast majority of melanoma patients who remain disease-free longer than 10 years will not have a recurrence," Faries added. "However, patients should be aware that persistent or unexplained symptoms anywhere in the body might indicate a recurrence of their melanoma, and they should return to their physician to make sure the symptoms are not related."

Nearly 76,700 new cases of melanoma will be diagnosed in the United States this year, according to the American Cancer Society.

View the original article here

Young Men Less Likely to Survive Melanoma Than Women: Study

White males made up about 40 percent of deadly skin cancer patients, but more than 63 percent of deaths

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 26 (HealthDay News) -- White male teens and young adults are more likely to die of melanoma skin cancer than their female counterparts, a new study finds.

Researchers looked at data from more than 26,000 white patients, aged 15 to 39, in the United States who were diagnosed with melanoma between 1989 and 2009 and followed for an average of seven and a half years.

During the follow-up, there were nearly 1,600 melanoma-related deaths. Although males made up about 40 percent of the melanoma patients, they accounted for more than 63 percent of the deaths, according to the study, which was published June 26 in the journal JAMA Dermatology.

After adjusting for various factors, the investigators concluded that males were 55 percent more likely to die of melanoma than females.

Continued public health efforts are needed to raise young men's awareness of the dangers of melanoma, said Dr. Christina Gamba, of the Stanford University Medical Center, and colleagues.

"This alarming difference in the outcome highlights the urgent need for both behavioral interventions to promote early detection strategies in young men and further investigation of the biological basis for the sex disparity in melanoma survival," the study authors concluded.

Melanoma is the third most common type of cancer in American teens and young adults.

View the original article here

Red Hair Pigment Might Raise Melanoma Risk: Study

Dermatologists say redheads must take extra care to check skin, avoid sun

By Dennis Thompson

HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- The red in redheads' hair is thought to put them at increased risk of the dangerous skin cancer melanoma, even if they don't spend a lot of time in the sun, according to a new study.

Study co-author Dr. David Fisher and his research team first uncovered the apparent link between red hair pigment and melanoma last fall. That study used genetically altered mice that had been given a mutant gene that increased their risk of contracting the skin cancer.

Now the researchers are taking the next step: asking why the body's creation of the red hair pigment -- called pheomelanin -- might prompt that risk.

Their new paper, published May 9 in the journal BioEssays, speculates that pheomelanin could increase skin cancer risk by leaving skin cells more vulnerable to DNA damage.

By determining the way pheomelanin increases cancer risk, the researchers hope to figure out a way to prevent future cases of melanoma.

"We are focusing on what the possibilities are, what the directions for new research are and how that could impact treatment," said Fisher, chief of dermatology at Massachusetts General Hospital in Boston.

The researchers had previously found that at least half of red-furred mice developed melanoma, even though none of them had been exposed to any ultraviolet (UV) radiation. By comparison, only about 10 percent of mice without red fur contracted melanoma.

"In the mouse studies, it was possible to completely remove UV and there was still a major incidence of melanoma that was attributable to the red pigment," Fisher said.

Scientists note, however, that animal studies often fail to produce similar results in humans.

Fisher speculated on two ways the red pigment might cause skin cells to be more vulnerable to melanoma.

It could be that the creation of pheomelanin in the body might also generate unstable oxygen-containing molecules that can damage cells. These molecules are known as reactive oxygen species, or ROS.

On the other hand, synthesis of pheomelanin might rob skin cells of crucial stores of antioxidants that would otherwise be used to prevent ROS damage.

"We think a new prevention opportunity exists if we can block the form of reactive oxygen damage that the red pigment is producing," Fisher said.

Despite his research, Fisher does not downplay the role that UV rays have in skin cancer risk for everyone -- particularly redheads.

"I want to emphasize that we strongly believe UV is a contributor to melanoma, and UV may actually amplify this red pigment phenomenon," he said. "It still is absolutely crucial for people to avoid sun exposure."

But the knowledge that sun exposure is only one factor in their increased risk of melanoma should prompt redheads to take additional precautions, said Dr. Jeanine Downie, a spokeswoman for the Skin Cancer Foundation.

View the original article here

More Than a Quarter of Melanoma Survivors Skip Sunscreen, Study Finds

And 2 percent continue to use tanning beds, researchers report

By Amy Norton

HealthDay Reporter

MONDAY, April 8 (HealthDay News) -- Even people who have survived melanoma, the deadliest form of skin cancer, often fail to protect themselves from the sun, a new study suggests.

Researchers found that of 171 melanoma survivors in a U.S. survey, more than 25 percent said they never used sunscreen when spending more than an hour outside on a sunny day. What's more, 2 percent said they had used tanning beds in the past year.

"They did do a better job of protecting themselves than the average person," said lead researcher Dr. Anees Chagpar, an associate professor of surgery at Yale University's School of Medicine. "But there is room for improvement," she added.

"Maybe we need to be more vigilant about education," said Chagpar, who was to present the findings Monday at the American Association for Cancer Research annual meeting, in Washington, D.C.

The results are based on a 2010 government health survey that included 27,120 U.S. adults, 171 of whom reported a history of melanoma.

Melanoma is the least common form of skin cancer, accounting for less than 5 percent of skin cancers in the United States, according to the American Cancer Society. Still, most deaths from skin cancer are due to melanoma -- which often spreads to other parts of the body if it's not caught early.

Because too much ultraviolet (UV) light is a major melanoma risk factor, experts advise everyone to limit their exposure. That means staying in the shade, donning sunscreen and covering up when you're in the sun, and avoiding the tanning salon altogether.

You would expect that if anyone would follow that advice, it would be melanoma survivors, Chagpar said.

And some did, her team found. On days when they were going to be in the sun for more than an hour, one-third of melanoma survivors "always" wore sunscreen, versus 17 percent of other Americans. They were also more likely to always wear a cap (31 percent did) or a long-sleeved shirt (12 percent).

On the other hand, 27 percent of melanoma survivors said they never slathered on sunscreen before spending more than an hour in the sun.

"We were very surprised by that," Chagpar said. What "blew her mind," though, was the fact that 2 percent of melanoma survivors visited tanning beds.

She noted that other researchers are studying the possibility that tanning is addictive for some people. It's possible, Chagpar speculated, that even some melanoma survivors may be hooked on the experience.

A dermatologist not involved in the study agreed that some of the findings are troubling. "It is certainly concerning that a quarter of the melanoma survivors never wear sunscreen," said Dr. Hensin Tsao, a melanoma expert at Massachusetts General Hospital in Boston.

View the original article here

Melanoma Rates Rising in U.S. Children

Deadly skin cancer still rare in kids, but long-term study found 2 percent yearly increase among whites

By Denise Mann

HealthDay Reporter

WEDNESDAY, April 3 (HealthDay News) -- Melanoma, the most deadly form of skin cancer, doesn't usually occur in kids, but a new study shows that it's happening more often.

While melanoma in children is still extremely rare, the rate increased by about 2 percent per year from 1973 to 2009 among U.S children from newborns to age 19. Melanoma accounts for up to 3 percent of all pediatric cancers, according to the Skin Cancer Foundation.

According to the study, 1,317 children were diagnosed with melanoma during the study time frame. Of these, 1,230 children were white. Because the number of melanoma cases among other racial and ethnic groups was so small, researchers focused the analysis on white children.

The biggest jump in melanoma rates was seen among adolescents aged 15 to 19, especially girls, the study showed.

The new findings were published in the May print issue of Pediatrics.

Recent studies have also shown that melanoma is on the rise among adults as well. Exactly what is driving these trends is not fully understood, but increased exposure to ultraviolet radiation from both the sun and tanning booths as well as greater awareness of melanoma may be responsible, according to study authors led by Jeannette Wong of the U.S. National Cancer Institute.

The researchers used a database to capture trends in childhood melanoma, but they did not have any information on participants' tanning habits or sun exposure history.

Boys were more likely to develop melanomas on their face and trunks, while girls were more likely to have melanoma on their lower legs and hips, the investigators found. Other risks for melanoma among children and adults include fair skin, light-colored hair and eyes, moles, family history of melanoma and a history of sunburns.

Dr. Amy Forman Taub, a dermatologist in Lincolnshire, Ill., said that tanning behaviors have a lot to do with the increasing rates of melanoma in children and adults. "It's the tanning booths and the fact that we go away on vacation where we are exposed to a lot of intense sun," she said.

Genes may also play a role, suggested Taub, who was not involved in the new study.

Melanoma in kids looks pretty similar to melanoma in adults, Taub said. They have irregular borders, are asymmetrical -- if you cut them in half, you would not get two equal sides -- have uneven colors, and a diameter that is greater than 6 millimeters (about one-fifth of an inch). "Parents should be aware of any new or changing moles in their children," she advised.

Choosing a sunscreen that blocks both ultraviolet A and ultraviolet B rays and reapplying it frequently is important, she said. Sun-smart clothing can also help protect children.

Dr. Ana Duarte, director of pediatric dermatology at Miami Children's Hospital, agreed. "Early diagnosis of melanoma is beneficial," she said, and the importance of protection can't be overstated. "Sunscreen and or sun protection are so important for children," Duarte said, and whatever you do, "don't ignore changing moles, even in children, because melanoma can occur in kids."

Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City, said the new study puts childhood melanoma on the radar, and that's a good thing.

"It is rare, but children do get melanoma," Green said. "When in doubt, get it checked out. The good news is that we know how to prevent melanoma, and when we catch it early, we have really good cure rates."

View the original article here

More Than a Quarter of Melanoma Survivors Skip Sunscreen, Study Finds

And 2 percent continue to use tanning beds, researchers report

By Amy Norton

HealthDay Reporter

MONDAY, April 8 (HealthDay News) -- Even people who have survived melanoma, the deadliest form of skin cancer, often fail to protect themselves from the sun, a new study suggests.

Researchers found that of 171 melanoma survivors in a U.S. survey, more than 25 percent said they never used sunscreen when spending more than an hour outside on a sunny day. What's more, 2 percent said they had used tanning beds in the past year.

"They did do a better job of protecting themselves than the average person," said lead researcher Dr. Anees Chagpar, an associate professor of surgery at Yale University's School of Medicine. "But there is room for improvement," she added.

"Maybe we need to be more vigilant about education," said Chagpar, who was to present the findings Monday at the American Association for Cancer Research annual meeting, in Washington, D.C.

The results are based on a 2010 government health survey that included 27,120 U.S. adults, 171 of whom reported a history of melanoma.

Melanoma is the least common form of skin cancer, accounting for less than 5 percent of skin cancers in the United States, according to the American Cancer Society. Still, most deaths from skin cancer are due to melanoma -- which often spreads to other parts of the body if it's not caught early.

Because too much ultraviolet (UV) light is a major melanoma risk factor, experts advise everyone to limit their exposure. That means staying in the shade, donning sunscreen and covering up when you're in the sun, and avoiding the tanning salon altogether.

You would expect that if anyone would follow that advice, it would be melanoma survivors, Chagpar said.

And some did, her team found. On days when they were going to be in the sun for more than an hour, one-third of melanoma survivors "always" wore sunscreen, versus 17 percent of other Americans. They were also more likely to always wear a cap (31 percent did) or a long-sleeved shirt (12 percent).

On the other hand, 27 percent of melanoma survivors said they never slathered on sunscreen before spending more than an hour in the sun.

"We were very surprised by that," Chagpar said. What "blew her mind," though, was the fact that 2 percent of melanoma survivors visited tanning beds.

She noted that other researchers are studying the possibility that tanning is addictive for some people. It's possible, Chagpar speculated, that even some melanoma survivors may be hooked on the experience.

A dermatologist not involved in the study agreed that some of the findings are troubling. "It is certainly concerning that a quarter of the melanoma survivors never wear sunscreen," said Dr. Hensin Tsao, a melanoma expert at Massachusetts General Hospital in Boston.

View the original article here

Experts Dispel Common Melanoma Myths

Think you're safe because your skin rarely burns?

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, June 7 (HealthDay News) -- As you head to the beach or pool, here are some sun-sense tips to keep in mind: Skin that tans is not invulnerable to cancer, and one application of sunscreen daily is not enough protection against the sun's harmful ultra-violet rays, according to skin cancer experts.

Melanoma, the deadliest form of skin cancer, claims more than 9,000 lives in the United States every year. The rate has been rising over the past 30 years and it's now one of the most common cancers in people younger than 30 years old, particularly young women.

Although genetics can increase your risk of melanoma, the best way to prevent skin cancer is to reduce sun exposure by wearing protective clothing, applying sunscreen and simply staying out of the sun.

The Melanoma Research Alliance has teamed up with experts from the charitable initiative Stand Up to Cancer to clear up common myths about melanoma.

Myth: If your skin tans but doesn't burn, you cannot get skin cancer.

Fact: Sun exposure of all levels can contribute to cancer development. Even people who don't usually burn can get melanoma.

Myth: Tanning booths are safe because they are not "real sun."

Fact: Tanning beds are not safer than natural sun exposure. Most tanning beds utilize UVA rays, which penetrate to the deeper layers of the skin and may increase the risk of melanoma. They also use UVB rays, the cause of most sunburns. The World Health Organization classifies tanning beds as "carcinogenic to humans." Women who use tanning beds more than once a month are 55 percent more likely to develop melanoma, the U.S. National Cancer Institute reports.

Myth: One application of sunscreen daily is sufficient to protect against sun damage.

Fact: Sunscreen must be applied frequently throughout the day during sun exposure, particularly if it could be washed off by sweat or water.

Myth: "Adequate" use of sunscreen will prevent melanoma.

Fact: Although sunscreen can help prevent skin cancers, it only provides minimal protection. It's also important to limit sun exposure and cover up with protective clothing and gear.

Myth: If a spot that has been on your body for years changes but hasn't gotten much bigger, it can't become melanoma.

Fact: Many melanomas occur in pre-existing spots or moles. A doctor should evaluate all moles, lesions or spots that have changed. People with multiple moles should undergo routine full-body exams by a dermatologist.

Myth: Melanoma can only develop on body parts where the "sun can shine."

Fact: Some types of melanoma are not related to sun exposure and can occur in unexpected places, such as the vagina, the rectum, inside the mouth, the soles of the feet and the palms of the hands.

View the original article here

Drug Shows Promise Against Advanced Melanoma

In preliminary trial, nivolumab shrank tumors in 30 percent of tough-to-treat patients

By Alan Mozes

HealthDay Reporter

SATURDAY, June 1 (HealthDay News) -- Nearly one-third of patients with advanced melanomas who received nivolumab, a new immune-based drug, experienced reductions in the size of their tumors, a preliminary study reveals.

Since these types of drugs have typically shrunk tumors in only 5 percent to 10 percent of patients in prior studies, the new results are a boost for immunotherapy generally, the researchers noted.

"I think nivolumab is a real breakthrough drug for patients with metastatic melanoma, and probably for other diseases, too," study author Dr. Mario Sznol, a professor of medical oncology at the Yale Cancer Center in New Haven, Conn., said in a news release.

"The high level of activity observed with this drug opens up a number of avenues for future research to understand and challenge the ways tumors evade the immune system. We're very excited that there is potential for even more activity in combination with other drugs," Sznol added.

One expert not connected to the study was also optimistic about the results.

"Nivolumab shows exciting promise for patients suffering from an otherwise fatal disease -- metastatic melanoma," said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. "The fact that 30 percent of patients showed improvement from this immunotherapy drug is remarkable since these patients had some of the worse disease."

The study was funded by drugmaker Bristol-Myers Squibb and is scheduled for presentation Saturday at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

According to the researchers, nivolumab works by honing in on PD-1 cellular receptors located on immune system T-cells. These receptors are known to function as immune system "gatekeepers," and by working to open such gates the patient's immune system is triggered into cancer-fighting action.

The new study involved 107 patients, all of whom had been previously treated with multiple forms of standard therapies that failed to halt their disease.

Following treatment with one of five different doses of nivolumab, the team found that 31 percent of the patients went on to experience a minimum tumor shrinkage of 30 percent across the various doses.

Forty-three percent of the patients are estimated to have survived two years after treatment, the researchers said, and average survival for patients across all treatment doses is now projected to be nearly 17 months.

In an ASCO news release, melanoma expert Dr. Lynn Schuchter called the results "truly remarkable."

The findings "confirm that 'revving' up the immune system is a powerful approach in shrinking melanoma," said Schuchter, who is also a spokeswoman for ASCO. "Melanoma patients are living longer and better with these new treatments."

View the original article here