Australia study could help cut skin cancer deaths

MELBOURNE (Reuters) – Early detection of nodular melanomas, rather than the more common flat melanoma, could help reduce deaths from skin cancer, an Australian study published this week suggests.

Nodular melanomas – bumpy, round or oval, even-colored spots – account for 10 to 15 percent of melanoma cases, but lead to 60 to 70 percent of deep melanomas, which threaten life, researchers at Melbourne’s Alfred Hospital found.

Malignant melanoma is less common than other forms of skin cancer, but it is the deadliest.

“We’ve had success with early detection of melanomas, but we haven’t managed to get death rates down or get the number of high-risk melanomas down,” John Kelly, head of the Victorian Melanoma Service, who led the research, told Reuters.

“These nodular melanomas grow more quickly and account for most of the high-risk melanomas.”

The findings may signal the need for a change in the way the public has been taught to check for melanomas.

Typically, people focus on detecting the common types of melanomas that usually begin with changes in the size, color or shape of a flat, black or brown spot on the skin and take a long time to spread.

By contrast, nodular melanomas start as pink or red spots and grow quickly.

“People are going to worry about every pimple they’ve had, and they’re also going to worry about lumps they’ve had on their skin for years,” Kelly said.

“But,” he stressed, “nodular melanoma can be distinguished from both of those by the fact that unlike the pimple, it continues to grow for more than a month.”

Unlike a common melanoma, which can grow to five or six millimeters and still be curable, a nodular melanoma of that size can potentially be fatal.

“So it gives us less warning than the others, and we need to seek attention for them more quickly,” Kelly said.

For the study, reported in the Journal of the American Academy of Dermatology, researchers interviewed 125 patients with nodular and common melanomas to see how they were detected.

It follows a study published last year in the Archives of Dermatology, in which researchers examining 2,000 cases of melanoma found deep melanomas largely occurred because of failure to identify nodular melanomas early enough.

(Source: Reuters Health; cited on ASCO; May 08, 2003)