Researchers who recently published in the Journal of the American Academy of Dermatology call special attention to scalp melanomas. “Scalp melanomas have more aggressive clinicopathological features than other melanomas and mortality rates more than twice that of melanoma located elsewhere,” the authors said.
They studied 900 patients with invasive cutaneous head and neck melanoma (CNHM) seen over a 20-year period at a tertiary referral center at the Alfred Hospital in Melbourne, Australia. Results indicated 26.3 percent of the patients had scalp melanoma, 42.9 percent had face melanoma, 19.3 percent had neck melanoma, and 11.4 percent had ear melanoma, according to Healio Dermatology’s review of the study.
The researchers found that the patients with scalp melanoma had worse melanoma-specific survival (MSS) than patients with other types of CHNM. One of their objectives was looking to see if scalp location had a possible independent negative impact on CHNM survival.
They noted that in analysis of all tumors, scalp location was not associated with MSS. Scalp location did have an independent association with melanoma-specific survival in analysis of tumors of a very specific Breslow thickness strata, the 0.76- to 1.50-mm thickness stratum.
“Several characteristics differed between patients with scalp melanoma and other CHNM, in particular, the scalp melanoma group had a higher proportion of male patients, thicker tumors and more tumors with lymphovascular invasion, neurotropism and satellite metastases,” the researchers wrote according to Healio Dermatology.
They concluded by saying, “The poorer survival of scalp melanoma is largely explained by greater Breslow thickness and a higher proportion of male patients.”
Men are at higher risk for melanoma. In 2012, an estimated 44,250 new cases of invasive melanoma were to be diagnosed in men compared to 32,000 in women, according to the Melanoma International Foundation. Based on the National Cancer Institute’s most recent statistics from its Surveillance, Epidemiology, and End Results (SEER) Program, for approximately every one woman who dies of melanoma, two men die, with a 1.7 to 4.1 ratio. According to the Skin Cancer Foundation, melanoma, along with liver cancer and esophageal cancer, is one of only three cancers with an increasing mortality rate for men.
Many men have unknowingly been exposed to further risk through use of the erectile dysfunction drug sildenafil. Recent studies have shown that the drug accelerates melanoma growth and that men who’ve taken sildenafil are 84 percent more likely to develop melanoma than men who do not.
Sildenafil is the active ingredient in Pfizer’s blockbuster drug Viagra, and the pharmaceutical company is being sued by men who have developed melanoma and claim the drugmaker should have warned them of the drug’s risk. Viagra and other drugs of its class, which are known as phosphodiesterase type 5 inhibitors (PDE5 inhibitors), are currently on the U.S. Food and Drug Administration (FDA)’s watch list. The FDA is evaluating the need for regulatory action regarding the potential serious risk of skin melanomas.
Journal of the American Academy of Dermatology
National Cancer Institute Surveillance, Epidemiology, and End Results Program
Skin Cancer Foundation
U.S. Food and Drug Administration