Patients Find Most Melanomas -- But Doctors Find Them Earlier
By Jim Morelli
WebMD Medical News
November 16, 1999 (Atlanta) -- Patients may do a good job of finding melanomas on their own, but a recent study finds that doctors more often detect the dangerous skin tumors at an earlier stage, when treatment may be most effective.
As reported in the Journal of the American Medical Association, the researchers questioned 102 patients who were diagnosed with primary cutaneous melanoma -- that is, a tumor confined to the skin. Fifty-five percent of the patients reported that they were the first to notice the tumor, vs. 24% who said their doctor found it. The remaining tumors were detected by spouses or others.
But the researchers found that the doctor-detected tumors tended to be thinner -- an extremely important factor when dealing with melanoma. "In patients who have no evidence of tumor spread elsewhere in their body, the most important prognostic factor is tumor thickness," Susan Koch, MD, tells WebMD. In other words, the thinner the tumor, the better the patient will likely fare in terms of survival. Koch is one of the study researchers and a professor of dermatology at Oregon Health Sciences University, Portland, Ore.
The special expertise of doctors at detecting melanomas is the reason the researchers recommend that all doctors routinely check patients? skin -- even if that?s not the reason the patients came into the office in the first place. "There are a number of cases where melanomas were found incidentally when patients were seeing a clinician for something totally unrelated," says Julie R. Lange, MD, an assistant professor of surgery at Johns Hopkins School of Medicine in Baltimore who was contacted for commentary on the study. "We?d like to encourage that kind of general surveillance."
The study finds that doctors were especially important in detecting tumors on the back and buttocks -- places patients have trouble seeing -- and far more likely to have speedy biopsies done. In fact, just 16% of patient-found tumors were biopsied within a month, compared with 83% of those found by doctors.