U.S. Sees Big Drop in Deaths From Melanoma
New treatments for melanoma have dramatically reduced deaths from this often fatal skin cancer.
Leaders of a new study report that the death rate from aggressive melanoma that spread to other organs plummeted 18% between 2013 and 2016, after jumping 7.5% between 1986 and 2013. The figures apply to white Americans, the group that accounts for nearly all cases of melanoma in the United States, researchers said.
"This is a stunning example of the power of scientific and medical research to identify the weak points in this deadly tumor, methods to boost the immune system and to use this knowledge to develop the highly effective medicines that have led to the sharp reductions in deaths that we have seen, and are continuing to see," said lead researcher Dr. David Polsky. He's a professor of dermatology and pathology at New York University Langone Health Perlmutter Cancer Center in New York City.
The drop in melanoma deaths was greater than the drop in deaths from prostate, breast and lung cancer, researchers said.
It dovetailed with introduction of 10 new skin cancer therapies that either use the body's immune system to fight the disease or target melanoma cells directly.
These new treatments are more effective and less toxic than regular chemotherapy, but come at a high cost, researchers said.
One group of drugs targets the BRAF gene, which is mutated in about half of melanoma patients. The other group is immune checkpoint inhibitors, which prevent melanoma tumors from appearing normal to the immune system.
For the study, Polsky and colleagues used data from the U.S. National Cancer Institute and the U.S. Centers for Disease Control and Prevention.
"We have more than simply turned the corner toward curing melanoma, we are likely to have cured many patients and are keeping many more alive with these new treatments," Polsky said.
He added that catching melanoma at its earliest stages, before cells can travel to internal organs, has the highest cure rates.
Dr. Ali Hendi is a dermatologist from Chevy Chase, Md., and a spokesman for the Skin Cancer Foundation. He said that while melanoma cases continue to increase, the decline in deaths due to new treatments is great news.
"In the past eight years or so, a number of immunotherapies have been approved to treat metastatic melanoma and have saved so many lives," said Hendi, who wasn't involved with the study.
These drugs help a patient's immune system identify and attack cancerous cells.
"There are also a new class of treatments called targeted therapies," Hendi said. "These are oral medications that identify and attack specific types of cancer cells, without killing healthy cells."
These treatments are used only when melanoma has already spread from the original tumor site, he said.
The last year has brought a flurry of research on vaccines and combination immunotherapies that may be better and faster treatments for melanoma, Hendi noted.
"The earlier you detect and treat melanoma, the greater your chances of long-term survival and avoiding recurrence," he said.
Patients diagnosed early have an estimated 98% five-year survival, Hendi said, compared to 63% for stage 3 patients and 20% for stage 4 patients, even with the new drugs.
"Your chances of stopping melanoma cold are far better if you can attack it effectively at stage 3 rather than stage 4," he said.
Both melanoma and non-melanoma skin cancer have been on the rise, Hendi said.
Skin cancer is the most common cancer in the United States. Overexposure to the sun is a key cause.
"We're treating people today who didn't have the knowledge we have today to protect their skin when they were younger, and now they're paying the price," Hendi said.
The report was published online March 19 in the American Journal of Public Health.
To learn more about melanoma, visit the Skin Cancer Foundation.
SOURCES: David Polsky, M.D., Ph.D., professor, dermatology and pathology, NYU Langone Health Perlmutter Cancer Center, New York City; Ali Hendi, M.D., dermatologist, Chevy Chase, Md., and spokesman, Skin Cancer Foundation, New York City; American Journal of Public Health, March 19, 2020, online
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