Pregnancy does not increase expectant mothers' melanoma risk

April 27, 2017
Credit: Wikimedia Commons/National Cancer Institute

Expectant mothers need not be concerned that they are more prone to develop melanoma, or will have a worse prognosis if they do get this serious skin cancer, than women who are not pregnant, according to study results published online as an "article in press" on the Journal of the American College of Surgeons website ahead of print publication.

Melanoma is known for its aggressive nature and ability to spread to other organs. But what is less known is that it's the most common cancer arising during pregnancy, accounting for 31 percent of all malignancies among expectant mothers.1.2

For decades there has been some belief that pregnancy has an adverse effect on the course of , increasing the risk of its development, ability to spread throughout the body, and recurrence, said study coauthor Mark Faries, MD, FACS, who was director of therapeutic immunology at the John Wayne Cancer Institute, Santa Monica, Calif. at the time the study was conducted.

To determine whether this long held belief is true, investigators from John Wayne Cancer Institute utilized their institution's melanoma database to analyze data on 2,025 age 18 to 50 diagnosed with stage I to IV melanoma who were treated at their institution between 1971 and 2016.

"In general what is important to note about melanoma is that its incidence continues to increase fairly rapidly, particularly among young women in their 20s and 30s, the same group that would be affected by a pregnancy-associated melanoma," Dr. Faries said. "So it's crucial to make sure that these women are getting appropriate screening and treatment."

For this study, Dr. Faries and colleagues identified 156 women who had developed melanoma during pregnancy. They analyzed patient factors such as age, stage at diagnosis, histologic type, Breslow thickness (a measurement of how deep the tumor is), and ulceration.

Further, they conducted multiple analyses to compare overall survival rates, disease-free survival rates, and melanoma specific survival rates of to their non-pregnant counterparts diagnosed with melanoma.

They found that patient factors were similar for pregnancy-associated melanomas and non-pregnancy associated melanomas with no significant differences in Breslow thickness, histologic type, or where the tumor first appeared on the skin. There was also no difference in stage at diagnosis, on average.

In addition, the investigators found that recurrence rates were similar between the two groups. About 38 percent of pregnant women had a melanoma recurrence compared with 36 percent of their non-pregnant counterparts.

Importantly, analyses of overall survival rates and melanoma-specific for pregnancy-associated melanomas versus non-pregnancy-associated melanomas in stages 0 to III melanoma showed no differences (due to the lack of patients with stage IV melanoma, those patients were excluded from the analyses). At 10 years, disease-free survival was 65.7 percent and 62.3 percent for the non-pregnant women and pregnant women, respectively.

This study upends the long held belief that pregnancy and melanoma are an adverse combination. Instead, it shows that the prognosis for patients who are pregnant is not different from patients who are not pregnant, Dr. Faries explained. "Pregnant patients should be screened for melanoma in a similar manner to non-pregnant patients and should be counseled that their prognosis is not adversely affected by pregnancy. This finding should be very reassuring to both the patients and physicians who are involved in their care."

Melanoma causes the death of about 9,700 lives in the U.S. each year, according to the American Cancer Society.3 That's why everyone should be aware of skin cancer prevention and take steps to detect it early. In fact, pregnancy might be an opportune time for who are at risk for melanoma to get examined for irregular spots on their skin, since they are probably seeing physicians more often than they otherwise would, Dr. Faries added.

Explore further: Cleveland clinic finds pregnancy-associated melanoma is associated with higher death rates

More information: Maris S. Jones et al, Is Pregnancy-Associated Melanoma Associated with Adverse Outcomes?, Journal of the American College of Surgeons (2017). DOI: 10.1016/j.jamcollsurg.2017.02.011

References:

1 Stensheim H, Moller B, van Dijk T, Fossa SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol. 2009;27:45-51.

2 Lee YY, Roberts CL, Dobbins T, et al. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994-2008: a population-based linkage study. BJOG. 2012;119:1572-1582.

3 Key Statistics for Melanoma Skin Cancer. American Cancer Society. Available at: www.cancer.org/cancer/melanoma … /key-statistics.html. Accessed April 21, 2017.

Related Stories

Cleveland clinic finds pregnancy-associated melanoma is associated with higher death rates

January 20, 2016
Melanoma, the deadliest form of skin cancer, is on the rise in women of child-bearing age. Those at the greatest risk, according to new Cleveland Clinic research, are women younger than 50 who are pregnant or have recently ...

Surgeons report melanoma recurs after 10 years in more than 6 percent of patients

June 27, 2013
Recurrence of melanoma skin cancer 10 or more years after initial treatment is more common than previously thought, occurring in more than one in 20 patients. However, according to a new study, these patients tend to live ...

Patient self checks are critical to avoid potentially deadly melanoma recurrence

February 8, 2017
Recurrences of early stage (stage II) melanoma are more often detected by patients and their physicians than by routine imaging tests, according to study results published online as an "article in press" on the Journal of ...

More than half of melanomas are self-detected

October 25, 2016
(HealthDay)—More than half of melanomas are self-detected, and more melanomas are self-detected by women than men, according to a study published in the November issue of the Journal of the American Academy of Dermatology.

Large-scale skin cancer screening initiative feasible

February 25, 2017
(HealthDay)—Large-scale skin cancer screening, including full-body skin examination (FBSE) is feasible and increases diagnosis of melanoma and thinner invasive melanoma, according to a study published online Feb. 23 in ...

State, regional differences in melanoma rates 2003 vs 2013

December 28, 2016
A new research letter published online by JAMA Dermatology compares melanoma death and incidence by states and in four geographic regions.

Recommended for you

Alternative splicing, an important mechanism for cancer

September 22, 2017
Cancer, which is one of the leading causes of death worldwide, arises from the disruption of essential mechanisms of the normal cell life cycle, such as replication control, DNA repair and cell death. Thanks to the advances ...

'Labyrinth' chip could help monitor aggressive cancer stem cells

September 21, 2017
Inspired by the Labyrinth of Greek mythology, a new chip etched with fluid channels sends blood samples through a hydrodynamic maze to separate out rare circulating cancer cells into a relatively clean stream for analysis. ...

Drug combination may improve impact of immunotherapy in head and neck cancer

September 21, 2017
Checkpoint inhibitor-based immunotherapy has been shown to be very effective in recurrent and metastatic head and neck cancer but only in a minority of patients. University of California San Diego School of Medicine researchers ...

Whole food diet may help prevent colon cancer, other chronic conditions

September 21, 2017
A diet that includes plenty of colorful vegetables and fruits may contain compounds that can stop colon cancer and inflammatory bowel diseases in pigs, according to an international team of researchers. Understanding how ...

New kinase detection method helps identify targets for developing cancer drugs

September 21, 2017
Purdue University researchers have developed a high-throughput method for matching kinases to the proteins they phosphorylate, speeding the ability to identify multiple potential cancer drug targets.

Poliovirus therapy induces immune responses against cancer

September 20, 2017
An investigational therapy using modified poliovirus to attack cancer tumors appears to unleash the body's own capacity to fight malignancies by activating an inflammation process that counter's the ability of cancer cells ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.