Treatment timing critical for melanoma survival

Melanoma accounts for just 1 percent of all skin cancers but is responsible for the vast majority of deaths from skin cancer, according to the American Cancer Society.
By Amy Wallace  |  Oct. 18, 2017 at 3:56 PM
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Oct. 18 (UPI) -- Diagnosis and treatment for any cancer is key to survival, but a new study finds that in the case of melanoma, timing of treatment is critical.

Researchers at Cleveland Clinic's Dermatology & Plastic Surgery Institute found that the sooner a patient is treated after diagnosis of melanoma, the deadliest type of skin cancer, the significantly better their survival outcome.

Melanoma accounts for just 1 percent of all skin cancers, but is responsible for the vast majority of deaths from skin cancer, according to the American Cancer Society.

For many patients, surgery is included in treatment, however the urge for patients to immediately begin treatment surpasses the number of surgeons or hospitals available for the procedure. This, researchers write in the study, was a major impetus for attempting to define the safest period of time after diagnosis for patients to undergo surgery.

"The ideal timing for melanoma treatment, predominantly surgery, had yet to be determined -- until now," Dr. Brian Gastman, a plastic surgeon, director of melanoma surgery at Cleveland Clinic, said in a press release.

For the new study, published Tuesday in the Journal of the American Academy of Dermatology, researchers analyzed data from the National Cancer Database of 153,218 adults diagnosed with stage I-III melanoma between 2004 and 2012.

Results showed that delayed surgery for melanoma dramatically decreased the overall survival rate of patients, especially in stage I melanoma -- delaying surgery to remove melanoma lesions after the first 29 days after diagnosis reduced overall survival in stage I, but not stage II or III.

When treated for melanoma between 30 and 59 days from diagnosis, patients with stage I melanoma had a 5 percent higher risk of dying than patients treated within the first 30 days from diagnosis.

These numbers increased as the length of time between diagnosis and treatments were extended. Patients were 16 percent more likely to die when treated between 60 and 89 days from diagnosis, 29 percent between 91 and 120 days from diagnosis and 41 percent when treated after 120 days from diagnosis.

The risk for melanoma diagnosis increases as people age, and is more than 20 times more common among white people than in African Americans. The overall risk of being diagnosed with melanoma in a person's lifetime is 2.5 percent for whites, 0.1 percent for African Americans and 0.5 percent for Hispanics.

"Patients and referring physicians are not only concerned with how a melanoma is removed, but also when it's removed," Gastman said. "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."

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