From Expressly My Health
If you've already had melanoma, you have a greater risk of developing a second, or even third, round of this often deadly skin cancer.
And, according to a new study, your risk is even higher of developing additional melanomas if you have other family members who've had the disease, or you have a history of abnormal moles, called dysplastic nevi.
"If you've had melanoma, there's a very significant risk you'll get a second," said study author Dr. Daniel Coit, an attending surgeon and co-leader of the melanoma disease management team at
"If you have the other risk factors -- family history or dysplastic nevi -- that risk is even higher, and you should go back [to your doctor] for skin surveillance at least twice a year," he said.
The findings appear in the Oct. 5 issue of the Journal of the American Medical Association.
Almost 60,000 Americans are diagnosed with melanoma each year, according to the American Cancer Society, and nearly 8,000 people die from the disease annually.
The good news is, when caught early, melanoma is curable, said Dr. Jean-Claude Bystryn, a professor of dermatology at New York University School of Medicine.
For the current study, Coit and his colleagues included 4,484 people who had been diagnosed with melanoma for the first time between 1996 and 2002. All were patients at
During the study period, 385 people from the original group -- or 8.6 percent -- developed two or more melanomas. Seventy-eight percent of this group had two melanomas. Fifty-nine percent developed the second tumor during the year following the diagnosis of the first.
Twenty-one percent of those who had more than one melanoma had at least one family member who also had melanoma. Just 12 percent of those with a single melanoma had a family history of the disease.
Almost 40 percent of those who had a second or third melanoma also had dysplastic nevi, while only 18 percent of those with a single tumor had a history of these abnormal moles.
The researchers estimated that the overall five-year risk of a second melanoma in those who have had the disease already is 11.4 percent. For those with a family history of the disease, that risk jumps to 19.1 percent and for those with dysplastic nevi, the risk is even higher at 23.7 percent.
"If you've had a melanoma, your new best friend is your dermatologist," Coit said. "Go back for skin surveillance at a minimum twice a year. If you have the other risk factors, you may need to be seen more often than that. The only intervention we have is skin surveillance, and if you're diagnosed in surveillance, melanoma is quite curable."
Bystryn said this study confirms what dermatologists have known for a long time: "If you have one melanoma, you're likely to get another one."
He added that this study "reaffirms the need to be followed closely by your physician, to look at your own skin once a month and to minimize your sun exposure."
To prevent melanoma from occurring in the first place, Bystryn recommended keeping sun exposure to a minimum.
"A lot of melanoma is due to too much sun exposure," he said. "Don't go out in the sun to deliberately tan. If you're going to be out in the sun, try to do it in the early morning or late afternoon. If you're out when the sun is strong enough to give you a tan, use a sunscreen with an SPF of 30 or more, and reapply every couple of hours between
Checking your own skin is also important. Bystryn said if you have any mole that looks or feels unusual, is itching, bleeding or enlarging, have your doctor exam it. He recommended examining your own skin monthly, and having a physician check your skin at least once a year, more if you have a family history of melanoma, have a lot of moles, suffered a lot of sunburns or have fair skin, blue eyes and blond hair.
