Melanoma, an aggressive form of skin cancer that accounts for 75% of all skin cancer-related deaths, is often detected later in people with darker skin complexions, and the consequences can be devastating, a study reveals. Mayo Clinic study.
While melanoma may be found less frequently in people with darker than lighter complexions, this potentially serious form of cancer can affect anyone. The study, which included 492,597 melanoma patients, suggests that greater vigilance in early detection is needed particularly for black men, whose cancers are often found in more advanced stages, leading to worse outcomes compared to men. white patients.
“We compared non-Hispanic black patients with white patients and saw striking differences in the way the patients presented with the disease,” says surgical oncologist Tina Hieken, MD, lead author of the study and a researcher at the Mayo Clinic Comprehensive Cancer Center. “We saw more melanomas on the extremities and more advanced-stage disease.”
Melanoma of the extremities refers to skin cancer that can develop on the arms, legs, hands and feet. Several factors could be at play, including social risk factors and biological components, but more research is needed to help determine why these differences exist.
Revealing differences in immune response based on sex
The research found that black female melanoma patients fared better than black male patients.
Men tended to be older at diagnosis and were more likely to have cancer that had spread to the lymph nodes compared to women. This resulted in worse survival rates. Researchers found that black men with stage 3 melanoma have only a 42% chance of surviving for five years, compared to 71% for black women.
Most melanoma research has not focused on how race and sex affect outcomes and has not looked at the influence of race and ethnicity across groups. Dr. Hieken says the study highlights the need to better understand these differences, noting that this is the first large study to confirm that there are sex-based differences in melanoma outcomes within the non-Hispanic black population.
“When we talk about late-stage melanoma patients who are female versus male in that cohort of non-Hispanic black patients who ended up getting worse, there may be some biological things going on that are interesting,” Dr. Hieken says.
One theory focuses on variations in the immune response.
“Several immune signals suggest that women may respond better than men to some immunotherapies,” says Dr. Hieken.
Identifying the need
The researchers note that more studies focusing on melanoma in a broader range of people, including more black participants in clinical trials, is key to closing this knowledge gap and potentially identifying more effective treatments.
“We want to broaden and deepen our reach to better understand the disease that affects all patients,” says Dr. Hieken.
He highlights the role played by Mayo Clinic’s Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery in this study.
“What we’ve done with the Kern Center, with this study and others, is identify the need,” says Dr. Hieken. “We have a rich, integrated, multidisciplinary clinical research practice in melanoma, and we want to address clinical needs and knowledge gaps relevant to our practice.”
A wake-up call in the battle against melanoma
Dr. Hieken notes that this study is a wake-up call for everyone struggling to diagnose and cure melanoma, regardless of the patient’s sex or skin tone.
She emphasizes that health professionals should carefully examine areas such as the palms, soles, and under the nails, where melanoma might be harder to detect on darker skin.
“We can incorporate screening for skin or under-nail lesions into patients’ visits as part of their regular checkups,” says Dr. Hieken. “What we want to do is improve care for our patients.”
Mayo Clinic’s Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery and Breast and Melanoma Surgical Oncology in the Department of Surgery supported this research.