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    High-Risk Melanomas Often on Head or Neck

    Rate of cell growth may be a key to diagnosis and treatment, an expert says


    But before mitotic rate can be used as a predictor of the aggressiveness of melanomas, the results from this study will have to be duplicated, Day said.

    Another expert, Dr. Homere Al Moutran, of Staten Island University Hospital in New York City, agreed. "Mitotic rate, even though not universally evaluated for melanoma, has been shown to be a significant prognostic indicator in skin cancer," he said.

    The American Academy of Dermatology says inclusion of mitotic rate in skin cancer reports is an option, he noted. "This study shows a possible particular behavior for mitotically active melanoma, but more studies are needed to define whether mitotic rates should become a standard independent factor in these tumors," Al Moutran said.

    For the study published online Aug. 20 in JAMA Dermatology, a research team led by Dr. Sarah Shen, from Alfred Hospital in Victoria, looked at the mitotic rates of melanomas in more than 1,400 patients.

    The investigators found that melanomas with higher mitotic rates were more likely to occur on the head and neck, grow faster and appear without color.

    These cancers were more likely to occur in men 70 and older and in people with a history of sun damage, called solar keratosis -- rough, raised areas on skin that's been exposed to the sun for long periods.

    A history of blistering sunburns and a family history of melanoma, however, were associated with cancers having lower mitotic rates, the researchers said.

    New treatments are improving survival of people with advanced melanoma, Day said. "There are now some genetic-based treatments and some immune-based treatments," she said.

    "This has taken what was a death sentence and made it into a chronic illness. People are now living four and five years when they would have died in six months," Day explained.

    What's sad, she added, is that skin cancer is largely preventable. "A lot of cancers you can't do anything about, but skin cancers are up to 80 percent preventable by just adjusting behavior," she said.

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