Characteristcs of Fast-Growing Melanomas Identified

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    Potentially fatal skin cancers called melanomas are more likely to grow fast
    when they’re thicker, symmetrical, elevated, have regular borders or produce
    symptoms, a new Australian study found.

    “Rapidly growing melanomas can potentially
    kill in a matter of weeks,” said lead researcher Dr. Wendy Liu, of the Peter
    MacCallum Cancer Center, in East Melbourne.

    “They can occur in anyone, not necessarily
    those with large numbers of moles and freckles. In fact, they more often occur
    in those without large numbers of moles and freckles and elderly men. They are
    more often red, rather than brown and black, symmetrical, elevated and
    symptomatic,” Liu added.

    In the study, Liu’s team investigated the
    growth rate of melanoma in 404 patients with invasive melanoma. Patients had
    their skin examined, and data about the moles were collected. In addition,
    patients were interviewed as soon as possible after
    diagnosis.

    Patients and their families were asked to
    recall when they first noticed a spot on their skin from which the melanoma
    later developed, and when they noticed the mole had changed or become
    suspicious.

    The researchers collected data on
    demographics, skin cancer risk factors, the characteristics of the tumor and who
    first detected the cancer — the patient, a family member or friend, or a
    physician.

    Using this information and the thickness of
    the tumor when it was removed, Liu’s group was able to estimate its rate of
    growth.

    The researchers found that about one-third
    of all the melanomas grew less than 0.1 millimeters per month, another one-third
    grew between 0.1 millimeter and 0.49 millimeters per month, and one-third grew
    0.5 millimeters or more per month.

    Rapid tumor growth was associated with
    tumor thickness, ulceration (formation of a break or sore on the skin),
    amelanosis (lack of pigment in the tumor), regular borders, elevation and
    symptoms.

    Moreover, faster-growing melanomas were
    more often found in people 70 and older, in men, and in those with fewer moles
    and freckles, the researchers reported.

    Factors not associated with the rate of
    growth were the number of atypical moles or age spots or liver spots; a history
    of sun damage or blistering sunburns; skin type; eye color; family or personal
    history of melanoma; and current or childhood sun
    exposure.

    “Rapidly growing melanomas no longer fit
    the classical description of melanomas,” Liu said. “We need to promote the
    awareness of this less common but more aggressive form of melanomas among the
    health professionals and the general public.”

    But Liu cautioned that “any rapidly growing
    skin lesion, regardless of its morphology and perceived risk factors for
    melanoma, deserves prompt medical assessment.”

    The study findings are published in the
    December issue of the Archives of Dermatology.

    One expert noted that most cancers have
    rapidly growing forms.

    “This is not a surprising finding,” said
    Dr. Vijay Trisal, an assistant professor of surgical oncology at the City of
    Hope Cancer Center, in Duarte, Calif. “You can extrapolate these findings to any
    tumors in the body.”

    Tumors that are fast-growing are more
    aggressive, and can divide faster and invade vessels and organs more quickly,
    Trisal said.

    Trisal added, however, that asking patients
    about the growth of their melanoma is not an accurate basis for estimating the
    speed of the cancer’s growth. “It is very subjective,” he said. “It also depends
    on where the lesion is. If it’s on the back, it might not be noticed for a long
    time.”

    “Tumors that grow fast are particularly
    worrisome, especially if you have no chemotherapy for them,” Trisal said. “For
    melanoma, we have no chemotherapy, and the faster they grow, the worse they are,
    because that means that the tumor has the ability to get into the blood vessels
    and lymph nodes faster.”

    People should get medical attention as soon
    as they notice a melanoma, Trisal said.

    “You can’t just sit there and
    watch a melanoma grow and say, ‘Fine, it hasn’t grown in two months, so it is
    not that aggressive,’ because you want to get on top of it sooner,” Trisal
    added.