Women More Likely to Survive Melanoma Than Men: Study

TUESDAY, May 1 (HealthDay News) — When it comes to surviving the
skin cancer known as melanoma, nature appears to have dealt women a better
hand than men, new research suggests.

By almost every measure, an analysis of four European studies found
that women can expect a 30 percent better outcome than men following an
early stage melanoma diagnosis. That gap, researchers say, may be rooted
in basic differences in gender biology.

“The 30 percent advantage applies to survival,” said study author Dr.
Arjen Joosse, from the department of public health at Erasmus University
Medical Center in Rotterdam, the Netherlands. “It also applies to having a
metastasis [spread]: women have a 30 percent lower chance to experience a
metastasis to the lymph nodes and to other organs.”

Joosse and colleagues from Belgium, Switzerland, Germany and France
published their findings in the April 30 online edition of the Journal
of Clinical Oncology
.

In an editorial accompanying the study, Dr. Vernon Sondak, chair of the
department of cutaneous oncology at the Moffitt Cancer Center in Tampa,
Fla., noted that just over 70,000 Americans were diagnosed with invasive
melanoma in 2011, and about 43 percent of those were women. But, among the
roughly 8,800 melanoma-related deaths that year, only 35 percent were
female patients.

Joosse noted that the fact that women tend to fare better than men
following a melanoma diagnosis is a well-established observation based on
prior research, some of which was conducted by the current study team.
However, the reasons behind the prognosis gap have remained elusive.

And the new research found an association between gender and melanoma
survival, not a cause-and-effect.

To explore the question, Joosse and his team analyzed data concerning
nearly 2,700 melanoma patients that was gleaned from four different
melanoma treatment trials conducted in Europe.

All of the male and female melanoma patients had been diagnosed with
either stage 1 (early) or stage 2 (localized) cancer. During and following
treatment, all the patients were tracked for disease remission, relapse,
spread and death.

The result: male melanoma patients were found to have worse disease
characteristics at diagnosis and worse disease progression.

On the latter measure, female patients were found to have a “highly
consistent and independent advantage” over men in terms of overall
survival, both before and after menopause.

The sole exception was seen in cases of head and neck melanomas, where
the gender differences disappeared. But the team cautioned that even this
exception could ultimately be dismissed as misleading, due to key study
peculiarities.

It is not that the initial tumor starts out worse in men than women,
the authors stressed. Rather it is something gender-related that causes
the cancer to unfold in a more deadly way in men.

In theory, estrogen level differences could play a role, although the
team noted that the evidence so far suggests the hormone does not have
much effect on melanoma.

Other possibilities include gender differences with respect to vitamin
D metabolism, immune system function, male testosterone levels and what is
known as “oxidative stress” in the body.

“However, our data could not support or disprove any of these
hypotheses,” Joosse acknowledged.

Sondak said that while the gender gap is probably real, it is likely a
function of both biology and environment.

“I believe that the message here is that if you’re a man, think like a
woman,” said Sondak. “And that’s because most of us feel that a big part
of this has to do with the fact that women are a little more likely to be
paying attention to their skin and to notice something on their skin, and
most importantly, to do something about it right away. And with melanoma,
early detection is key,” he stressed.

“So, I think in large part this is a behavioral issue, not a genetic
issue,” Sondak added. “However, that’s not the whole issue. It is also the
case that what we now call melanoma, one disease, may actually be many
different diseases caused by many different things. And with that there
may be genetic differences, all else being equal, in how men and women get
these different diseases in the first place. This study didn’t look at
that. But that’s another important aspect to consider.”

More information

For more on melanoma, visit the U.S. National Cancer Institute.

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