A Surprising Phenomenon Discovered in a Study on Melanoma In Situ

Melanoma in situ is also known as melanoma stage 0, as it is the earliest stage of malignant melanoma, a potentially deadly skin cancer when it spreads.  But in the earliest stages of the cancer, cells are limited to the top layer of the skin (the epidermis) and have not yet invaded deeper layers of the body. Melanoma in situ is highly treatable and often curable with surgical removal of the affected area of the skin.

Because it is so early in the development, it is not surprising to learn that the melanoma specific survival rate, which targets the survival rate of individuals who have been diagnosed with melanoma, is much higher than all other stages of the diseases.  In fact, the 15-year melanoma survival rate was 98.4% in a recent public health research examining survival rates of 137,8872 patients.

What is surprising is a recent study published in JAMA Dermatology comparing patients with MIS survival rates to the general population.  They found that patients with a history of melanoma in situ, compared to the general population had a survival rate of 112.4%, meaning that patients with melanoma in situ tend to outlive the general population.

So why would having an early form of melanoma result in patients living longer?  Lets look at some possibilities:

1. Early Detection. Melanoma in situ is often detected at an early stage, usually before it has penetrated into the deepest layers of the skin or metastasized to other organs.  Early detection and treatment save lives and definitely leads to better survival rates because the disease is easier to treat and manage.
2. Monitoring and Surveillance.  Patients with a melanoma at any stage are encouraged to see their dermatologist for regular appointments following the diagnosis and this continues throughout their lifetime.  This lowers the risk of future development of melanoma that is allowed to progress and reduces the risk of the deadly outcome.
3. Improved Awareness. Increased awareness of the dangers of sun exposure leads to greater understanding for the need to prevent skin cancer through the use of sunscreen and limitation of time in direct sunlight.  The chance for relative survival is ticking up.
4. Overall Mindfulness Regarding Health. A patient’s reaction to hearing the words “Malignant Melanoma”, even when in its earliest stage, is often to take self-assessment and work harder on preventing all kinds of health problems.  This may lead to a lifestyle and future medical care which helps increase longevity, supporting the results of the study.

The study’s findings show that patients with MIS outlive the general population because there is significant detection of low-risk disease among health-seeking individuals.  One way to be proactive is to be your own detective when it comes to skin cancer.  Practice monthly self-exams and see your dermatologist if something is suspicious.  And take advantage of total body skin checks, allowing your dermatologist to examine you from head to toe and identify any moles or growth that require biopsy or watchful waiting.

What to look for?  The warning signs of melanoma, or what dermatologists call the ABCDE’s provide a good guideline:

Asymmetry:  When one half of a mole or skin lesion does not match the other in shape, size or color, it’s a red flag.  Healthy moles are usually symmetrical.

Border Irregularity:  If the edges of a mole are uneven, jagged or notched, it’s time to have that lesion checked.  Benign moles typically have smooth, well-defined borders.

Color Variation:  Melanomas often have multiple colors or uneven color distribution within the same mole.  Colors may include shades of brown, black, red, blue or white.  Benign moles are usually a single, uniform color.

Diameter:  Melanomas are often larger in diameter than benign moles.  Concerns grow when a mole is larger than the size of a pencil eraser (about ¼ inch), but melanomas are tricky and can sometimes be smaller.

Evolution:  Think of this as change.  Any change of a mole or skin lesion is a significant indicator.   If you notice a lesion that is evolving in terms of size, shape, color, elevation or if it becomes itchy, painful or bleeds, it should be evaluated.  These are all warning signs of skin cancer.

Melanoma in situ needs immediate treatment to get the kind of good outcome sited in this study.    The presence of any melanoma cells – even at stage 0, is an alarm that should not be ignored.   Treatment consists of an excision that is wide enough to remove all the cells that may be affected.

If you have a suspicious mole or skin lesion, contact our office to schedule an examination at (402) 933-0800 or (402) 371-3564 in Norfolk.  Appointment can also be scheduled online at www.midwestderm.com.