Despite advances in the fight against many types of cancers, survival rates for people who have advanced melanoma have not improved in more than three decades, according to new research.
"There has not been a substantial change in survival [for people who have] metastatic melanoma," says Dr. Vijay Trisal, an assistant professor of surgical oncology at City of Hope Cancer Center in Duarte, California.
Researchers identified 822 patients who had been diagnosed and treated for stage III melanoma. None of the participants had been receiving experimental treatments, such as melanoma vaccines.
The researchers found no differences in survival except in the most recent group of patients, and that may have reflected improvements in staging rather than any real survival differences, says study author Dr. Shawn E. Young, a surgical oncology specialist at the John Wayne Cancer Institute in Santa Monica, California.
"It's disappointing, but it doesn't surprise me," says Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.
The finding stands in stark contrast to other cancers. But, as Trisal points out, the major advances in breast and colorectal cancers, along with other malignancies, have occurred with chemotherapy, radiation or biological therapies. In melanoma, there are no such proven treatments.
The only chemotherapy that works for melanoma is interferon, and that has, at best, only a 15% to 20% response rate. And "that [only] means tumor shrinkage. It's not a cure rate," Trisal explains.
"We have produced a lot of [post-surgical] therapies, but they don't work," says Young.
And experimental therapies, such as vaccines, are so far not showing promise.
While there have been some improvements in the treatment of stage I and II melanoma, Trisal adds, melanoma that has spread has been more intractable.
According to the study authors, only 35% to 50% of people who have stage III melanoma will achieve long-term survival. Only 5% to 10% who have stage IV disease will survive. And surgery, they say, is still the only treatment that has "stable and predictable success."
"I think the amount of research that went into melanoma development 15 years back was minimal. 'We had not recognized melanoma as a serious threat," Trisal says. But, the incidence of melanoma is increasing faster than any other cancer in the US.
Early Detection Important
Melanoma is both preventable and detectable. When caught early, the five-year survival rate is at least 91%, according to the American Academy of Dermatology (ADA).
"It is highly detectable," Trisal says. "Stage I or II detection is the most important thing."