Melanoma survivors at higher risk of other cancers

NEW YORK Tue Mar 16, 2010 5:27pm EDT

People sunbathe on Nobbys Beach on a hot autumn day in the city of Newcastle, March 11, 2007. REUTERS/David Gray

People sunbathe on Nobbys Beach on a hot autumn day in the city of Newcastle, March 11, 2007.

Credit: Reuters/David Gray

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NEW YORK (Reuters Health) - Melanoma survivors are at increased risk of other cancers as well as the return of their skin cancers, according to a new study, leading National Cancer Institute researchers to urge lifelong follow-up of such survivors.

The study included data from more than 89,500 patients collected from 1973 to 2006. There were 12,559 subsequent cancers, including 3,094 melanomas.

While not the most common form of skin cancer, melanoma is the most serious and most likely to be fatal. The American Cancer Society estimates that 68,720 Americans were diagnosed in 2009 with melanoma and that 6,850 Americans died from the disease.

Noting that most people with melanoma - more than 92 percent of white women, and nearly 87 percent of white men - survive at least 5 years after diagnosis, Dr. Portia T. Bradford and colleagues wanted to measure the risks of the disease coming back or of survivors developing a second melanoma or another type of cancer.

"The risk of subsequent cancer is important for melanoma survivors," they write in the March issue of the Archives of Dermatology.

Analyzing data collected by the Surveillance, Epidemiology, and End Results (SEER) program, they concluded that survivors had a 28 percent increased risk of a second cancer, mostly due to their 9-times greater likelihood of developing another melanoma than the general population. The most common second cancers after melanoma were breast, prostate, and non-Hodgkin's lymphoma.

Over the span of the study, doctors diagnosed 1,156 female breast cancers, 2,200 prostate cancers and 481 non-Hodgkin's lymphomas among the more than 89,000 melanoma survivors. In each case, the number of secondary cancers reported among survivors was higher than what would have been expected in the general population.

The risks of a second cancer were highest within the first year and declined somewhat over time but "remained quite elevated more than 20 years" after the first diagnosis.

Despite high survival rates for melanoma, there's no international consensus on how melanoma survivors should be followed-up.

The National Comprehensive Cancer Network, an alliance of 21 cancer centers and a respected authority on cancer practice guidelines, acknowledges that there's a wide variety of opinions about what a melanoma survivor follow-up program should look like - how long and how often survivors should be screened.

Because of the costs involved and the lack of clear data, "the optimal duration of follow-up remains controversial," they write in the 2010 version of the NCCN's melanoma practice guidelines.

Guidelines recommend exams more than once a year for anywhere from two to ten years, but they are often vague on what to do after that time. The NCCN recommends lifelong follow-up, but their guidelines are currently under review.

Dr. Bradford says the evidence is building for longer follow-up. "Our study adds to the scientific literature on melanoma, and provides further evidence for lifelong medical surveillance of patients who have been diagnosed with melanoma for new melanomas and other cancers," she wrote in an email to Reuters Health.

SOURCE: Archives of Dermatology, March 2010.

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Comments (3)
HealingNews wrote:
Skin cancer symptoms can be exacerbated from useage of SPF lotions. The chemicals in these can cause adverse skin conditions. Although over-exposure to sunlight can cause burning, there is little verifiable evidence that this actually causes cancer, though the lotions can. The body needs to create natural vitamin D, from sunlight, to prevent cancer, so 20 minutes of sunlight per day without SPF protection can actually prevent cancer. Best case: Drink carrot juice often, and it provides skin with carotene that works better than the SPF lotions to protect one from burning.

Mar 16, 2010 9:18pm EDT  --  Report as abuse
dedok wrote:
Carrot Juice?? Where did that come from?? What’s in it that protects the skin from sunburn??

Mar 17, 2010 1:40pm EDT  --  Report as abuse
dedok wrote:
Carrot Juice?? Where did that come from?? What’s in it that protects the skin from sunburn??

Mar 17, 2010 1:46pm EDT  --  Report as abuse
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