Amid all the genuinely terrible news right now, some genuinely encouraging developments related to melanoma. A new study shows an 18 percent drop in deaths from metastatic melanoma — the most aggressive form of skin cancer – between 2013 and 2016, among white Americans. The study, which analyzed data from nearly a million patients, was published in the American Journal of Public Health.
“No other cancer has had this large of a drop in this short time,” says Dr. David Polsky, of NYU’s Perlmutter Cancer Center and the study’s co-senior author. “Most advances in cancer happen gradually.” The drop is also remarkable because it
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Doctors credit ten new therapies for melanoma, which were introduced during this time. These treatments either harness the body's immune system to fight the disease — immunotherapy — or directly target melanoma cells that reveal specific gene mutation — targeted therapy. The positive results outstrip comparable decreases in death from prostate, lung, and breast cancers. The study highlights the enormous role of these new drugs in helping Americans survive melanoma, says Dr. Polsky.Melanoma is among the most common forms of cancer in the United States, with an estimated 100,000 new cases diagnosed every year. Once tumors spread throughout the body, melanoma had been notoriously difficult to treat. Conventional chemotherapy has had a limited effect against the disease. The newer therapies, which came into use in the last decade, are far more effective and less toxic than standard chemotherapy, but are much more expensive, the investigators say.
While the specific causes of melanoma are unclear, genetics and exposure to UV radiation in sunlight and tanning beds are known to increase risk, particularly among fairer-skinned people.
The drugs fall into two broad categories: those that target the BRAF gene, which is mutated in a little less than half of melanoma patients; and immune checkpoint inhibitors, which prevent melanoma tumors from tricking the immune system into ignoring the cancer.
Polsky notes that the steep drop in deaths cannot be readily explained by better detection methods because death rates did not drop steadily over time, but sharply. In addition, many health care groups have been pushing for early detection exams since the 1980s, so the timing of these declines matches up better with the introduction of the new therapies.
Dr. Anna Pavlick, Professor of Medicine and Dermatology at NYU’s Perlmutter Cancer Center on new immunotherapy medicines that reduce melanoma recurrence.
Nevertheless, the researchers caution that early detection is still important, allowing for less toxic forms of treatment and lowered health care costs. They emphasized that prevention, avoiding excessive UV light exposure, and promptly seeking medical care when there is a change in the skin's appearance, are crucial to reducing the risk of developing metastatic melanoma. Polsky says future studies should investigate socioeconomic factors that may affect access to the newer therapies, as well as the effect of these treatments on other ethnic groups.
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