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Last Updated: Apr 22, 2008 - 6:18:27 AM |
TUESDAY April 21, 2008 (foodconsumer.org) -- Two studies were released last week. One published on April 16 in the April issue of the journal Archives of Dermatology shows that people with scalp or neck melanomas are twice as likely as people with melanomas elsewhere on the body to die from the disease.
The study conducted by Nancy Thomas, M.D., Ph.D., at the University of North Carolina at Chapel Hill analyzed 51,704 melanoma cases in the U.S. for the association between the death rate and the location of the disease.
Specifically, Thomas and colleagues found those with scalp or neck melanomas die at a rate 1.84 times higher than those who had melanomas on the extremities. The association held true even after age, gender, tumor thickness and ulceration were considered.
"Only six percent of melanoma patients present with the disease on the scalp or neck, but those patients account for 10 percent of melanoma deaths. That’s why we need to take extra time to look at the scalp during full-skin examinations," said Thomas.
Some researchers argued the poor prognosis for the scalp and neck melanomas may be caused by delayed diagnosis, but Thomas and colleagues suggested that the presence of the disease on the scalp and neck in itself is an indicator of a poorer prognosis.
In the study, the researchers observed that patients with scalp or neck melanomas tended to be older than those with other melanomas (59 versus 55) and were more likely to be male (74 versus 54 percent). The scalp and neck melanomas were thicker than cancers on other locations (0.8 mm versus o.6 mm and more likely to be ulcerated and involved with lymph nodes.
The five-year survival rate for the scalp and neck melanomas was different from that for melanomas elsewhere, 83 percent versus 92 percent. The ten-year survival rates were 76 and 89 percent respectively.
The 6 mm rule still holds true
Another study published in the April issue of Archives of Dermatology showed that skin lesions with about the size of a pencil eraser were more likely to be melanomas than smaller moles.
The study conducted by David Polsky, M.D., Ph.D. at New York University and colleagues confirmed an important warning sign of melanoma - moles that are larger than 6 millimeters, the size of a pencil eraser, are more likely to be melanomas.
The finding may serve as a reminder that larger moles are more likely to be melanomas as some researchers have argued that adherence to the guideline may make doctors miss smaller melanomas.
"Lesions that are smaller than 6 millimeters are unlikely to be melanoma. New and changing lesions are the most concerning, and lesions that are multiple colors are especially suspicious," says Dr. Polsky.
NYU dermatologists developed the widely used ABCD rule for recognizing growths on the skin that could be early melanomas. They have recently added the letter E to the list. The five signs are "A for asymmetrical lesions; B, lesions with irregular borders; C, lesions with multiple colors; D, for lesions larger than 6 millimeters; and E for evolving lesions that change in size, color, shape or symptoms such as itching over time."
In the study, the researchers found 5.1 percent of lesions with a diameter larger than 6 millimeter were invasive melanomas compared to 1.5 percent of lesions equal or smaller than 6 mm. In situ melanomas were found in 7.7 percent of lesions larger than 6 mm compared to 2.6 percent of lesions equal or smaller than 6 mm.
© 2004-2008 by foodconsumer.org unless otherwise specified
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