Melanoma Isn't as Deadly as It Used to Be

Sally Wadyka

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Between 2013 and 2016, the mortality rate for melanoma declined by almost 18 percent, despite continued increases in the incidence of melanoma, according to a new study published online in the American Journal of Public Health.

Melanoma is by far the most serious type of skin cancer, and it’s also among the most common types of cancer in the U.S. According to the American Cancer Society, just over 100,000 cases of melanoma are diagnosed every year.

In the new study, researchers analyzed melanoma incidence and melanoma death rates between 1986 and 2016. During that period, the incidence of melanoma among Caucasians increased by an average of 2.7 percent every year. For white men over age 50 (the group with the highest rates of the disease), cases increased 3.4 percent each year.

Between 1986 and 2013, overall deaths from melanoma also increased by a total of 7.5 percent. But starting in 2013, that began to change. Even for men over 50, death rates declined 8.25 percent. “This very sharp drop over such a short time is unprecedented in cancer,” says study author David Polsky, M.D., Ph.D., the Alfred W. Kopf, MD, professor of dermatologic oncology at NYU Langone Health and Perlmutter Cancer Center. “It’s an incredibly significant improvement over a three-year period, and it appears that the rates are continuing to go down.”

New Treatments, New Hope

What’s causing this dramatic change? The study authors believe it mostly comes down to several advances in treatments over the past decade. “We looked at how the dates of approval of the new therapies aligned with the drops in mortality,” says study author Polsky.

Historically, the outlook for someone diagnosed with invasive (or metastatic) melanoma was not very promising. Once the disease has spread to other areas of the body, it can be very difficult to treat, and traditional chemotherapy isn’t a very effective weapon against it. “Melanoma cancer cells are very resistant to dying,” says Polsky. “In order to deliver enough chemotherapy to kill them, you have to give an amount that’s poisonous for the patient.”

However, there have been some hopeful advances. Starting in 2011, the Food and Drug Administration had approved 10 new treatments for advanced melanoma.

These newer approaches fall into two categories, Polsky says. One type is called immune checkpoint inhibitors. “These drugs block the ability of cancer cells to switch off your immune system,” says Polsky. So instead of your immune system ignoring the cancer cells, it attacks and kills them.

The other type of treatment includes drugs that target the BRAF gene. The BRAF gene is mutated in about half of melanomas, according to Polsky. By targeting the mutated protein in the gene, these drugs shrink cancerous tumors or slow their growth.

Experts Are Cautiously Optimistic

This downward trend in melanoma deaths was also noted last year in the National Cancer Institute’s annual report on the progress of cancer treatment. The new study looked more specifically at the trends in mortality before and after the introduction of new melanoma therapies. “I’m not given to hyperbole, but you don’t see numbers like that often over the lifetime of a cancer career,” says J. Leonard Lichtenfeld, M.D., deputy chief medical officer at the American Cancer Society. “This data represents an incredible change in outlook for people with advanced melanoma. It shows that the mortality curve is starting to reverse.”

The Best Cure

Despite the positive news and the availability of new treatments, experts still urge people to practice sun safety and emphasize the importance of early detection. “Even though these new drugs are amazing, there are still too many people who die from melanoma,” says Polsky. “Catching skin cancer early—when it can be cured by surgery—is by far the better approach.” According to the American Cancer Society, if melanoma is treated when it's still confined to the skin, the survival rate is 99 percent.

It’s important for everyone—at every age—to check their skin for possible signs of cancer. If you see any changes to existing moles or unusual new growths, see your dermatologist right away. Follow the ABCDE guidelines when examining your moles, looking for:

• Asymmetrical shape

• Border that’s irregular

• Color that’s uneven

• Diameter greater than the size of a pencil eraser

• Evolving changes to size or color over the past few weeks or months

And don’t forget the importance of prevention. Smart sun protection can dramatically lower your risk of ever getting melanoma. The experts recommend wearing sun protective clothing and broad-brimmed hats, plus covering any exposed skin with a broad spectrum sunscreen (SPF 30 or higher), every time you head outdoors. Below are some top performers from Consumer Reports' tests. 

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