According to U.S. News and World Report, researchers with the Cleveland Clinic have found that delaying treatment of melanoma even one month reduces a patient’s chance of survival. Melanoma is the most deadly form of skin cancer, on average, killing one American an hour.
“The ideal timing for melanoma treatment, predominantly surgery, had yet to be determined — until now,” said primary investigator Dr. Brian Gastman. He is director of melanoma surgery at the Cleveland Clinic in Ohio.
Gastman and colleagues used the National Cancer Database to identify and study the data of 153,218 adult patients who were diagnosed with stage I-III melanoma from 2004 to 2012. They recently published the results of this study in the Journal of the American Academy of Dermatology.
“We saw significantly worse prognoses and outcomes for those surgically treated after 30 days of stage I melanoma diagnosis. Knowing for certain that a more expedient time to surgery to remove an early melanoma improves the chances of survival is a game-changer in treating this life-threatening skin cancer,” Gastman said in a clinic news release.
Postponing surgery for more than 29 days did not affect the survival rate for those with stage 2 or 3 melanoma, like it did for those with stage 1; however, waiting longer than 90 days increased risk of death for all stages.
For those with stage 1 melanoma the risk went up with each month of waiting for surgery. When compared with those treated within the first 30 days of diagnosis, patients treated between 30 and 59 days had a 5 percent increased risk of death. For those treated between 60 and 89 days the risk increased to 16 percent. It rose to 29 percent when treatment was between 91 and 120 days, and patients treated 120 days after diagnosis were 41 percent more likely to die than those treated during the first month.
The researchers noted that those most likely to have a longer time before treatment initiation were older men with other health problems.
This particular observation is especially concerning as more men than women die as a result of melanoma. 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. Along with liver cancer and esophageal cancer, melanoma is one of only three cancers with an increasing mortality rate for men according to the Skin Cancer Foundation.
Many men have been exposed to further risk through use of the drug sildenafil, the active ingredient in Pfizer’s erectile dysfunction drug Viagra. 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. The U.S. Food and Drug Administration (FDA) is evaluating the need for regulatory action regarding the class of drug known as phosphodiesterase type 5 inhibitor (PDE5 inhibitor) and the potential serious risk of skin melanomas.
Just last week, researchers from Australia reported that in the last 20 years melanoma rates in Queensland have stabilized or decreased in all population groups except men older than 60, in which the rates of incidence of invasive melanoma and melanoma mortality have increased.
Education about the serious risk of melanoma may need to be targeted to men, particularly older men. Lives can be saved through prevention, early detection and prompt treatment.
U.S. News and World Report
National Cancer Institute
Skin Cancer Foundation
Skin Cancer Foundation