Oncology

Multiple Melanoma

There is strong evidence showing that the deadliest form of skin cancer, melanoma, is a growing threat. Now, new research shows that cases of multiple melanomas are on the rise. People who get melanoma don’t just get one; they’re at risk for two or even more.

We don’t completely know why we see more than one of the same type of cancer in an individual person. It’s likely that genetic susceptibility plays a role. Or, it might be simply due to heavy exposure to the toxic agent causing the cancer, like smoking in the case of lung cancer, and sun exposure in the case of skin cancer.

This study shows a large portion of people with melanoma aren’t done with the problem even after their first cancer is successfully removed, but might have to contend with multiple melanomas.

“I didn’t notice it for the longest time. It was a mole that was fairly routine looking.” Bernard Korman used to go to the Jersey Shore for the first 12 years of his life. “I got badly sunburned. Every summer I would get red and peel.”

Who knew that that mistake would rear its ugly head six decades later! He had melanoma on his arm which was, fortunately, easily removed.

“Then a couple of years later there was a mole on my upper left arm,” says Bernard. Biopsy showed that it was a melanoma…again! “And a more serious one than the first,” Bernard recounts.

Bernard’s story is not unusual. According to the latest research in the Journal of the American Medical Association, just because you’ve had one skin cancer doesn’t make you immune to another.
In fact, you’re at greater risk for multiple melanomas.

Dr. Daniel Coit, who lead the research at Memorial Sloan Kettering Hospital in New York, says, “Previous studies have suggested that the incidence of a second primary melanoma may be 3 or 4%. What we found was an 8% risk.”

Bernard was now being checked every three months. Still, there was another cancer on his chest, and that wasn’t the end of it.

The fact is, there are risks associated with multiple melanomas. “A history of someone else in the family having a melanoma and also a history of an odd lesion called a dysplastic nevus. These are kind of large ugly freckles that aren’t quite melanoma, but under the microscope look very unstable,” says Dr. Coit.

After having a first one, having either of these risk factors increases the risk of a second melanoma to one in every four!

Bernard was losing count. “In the course of one of those evaluations another melanoma was discovered on my forehead,” he states.

Dr. Coit says, “If a patient’s had two melanomas, they have a 30% risk getting a third melanomas within five years. So they represent perhaps the highest risk group.”

Fortunately, with close follow ups, the multiple melanomas were caught early, before they had spread. “So being seen regularly by a doctor accounts for my still being here. Because as you know melanoma is a deadly disease, let alone multiple melanomas,” says Bernard.

The authors argue family members of someone with melanoma are also at very high risk of multiple melanomas, and should see the dermatologist regularly.

Melanoma is the 5th leading cause of death in the U.S. Around 7600 people die of it each year. Most, if not all, death from multiple melanomas are completely preventable with proper screened.

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