Rare Type of Skin Cancer More Likely to Recur

Acral melanoma survival rates were half those of patients with other melanomas

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The skin cancer melanoma comes in a variety of forms. One rare form of this cancer, called acral melanoma, may do something that other melanomas don't do.

Researchers found that acral melanoma often recurs in the same spot or near the site where it originally developed.

These researchers concluded that surgery to remove acral melanomas may need to take out a wider chunk of tissue than surgery for other melanomas of similar sizes. 

"Check your skin regularly for any abnormal changes."

This study was led by Jennifer Stein, MD, of the Perlmutter Cancer Canter of NYU Langone Medical Center.

Only 1 to 2 percent of melanomas are acral lentiginous melanoma — a form of melanoma that is not caused by sun exposure. While its exact cause is not known, acral melanoma often appears on the palms, soles, under the nails or in the mucous membranes. It often develops in people with darker skin. It's almost twice as likely to recur as other similar types of cancers, the researchers found, and it can be deadly.

In their study, Dr. Stein and team looked at the rate of recurrence of acral melanoma skin abnormalities compared to other types of melanoma.

These researchers enrolled 244 patients from their center and followed them from 2002 to 2012. Of the 244 patients, 61 had acral cancer. Each patient with acral cancer was compared to three others with different melanomas who were of similar age, gender and ethnic origin and who had similar cancer severity.

Compared to other melanomas, acral melanoma was 49 percent more likely to recur in the same spot. Acral melanoma also was 30 percent more likely to reappear close to the original location, but in another part of the body, the researchers learned.

The acral tumors, which can be less than 2 millimeters in diameter or thickness, can also be aggressive and penetrate into the body even though they may appear flat.

Although all of the patients in this study were treated according to standard surgical guidelines of the National Comprehensive Cancer Network, patients with other types of melanomas fared better than those with acral melanoma.

Over the 10 years of the study, survival rates of those with acral melanoma were half those of patients with non-acral melanomas, the researchers reported.

Dr. Stein cautioned that doctors seeing these cancers need to be concerned. “Physicians and their patients need to recognize acral melanomas as a potentially dangerous, aggressive, and recurring form of skin cancer, especially in minorities with dark skin,” she said in a press release. "Our study results document that people with acral melanomas are more likely to have recurrences in the skin surrounding their original malignancy."

Dr. Stein added that while there should be discussion to widen the removal area of these types of cancers, the skin in the areas of the hands and feet are particularly sensitive.

Brian Lawenda, MD, National Director of Integrative Oncology and Cancer Survivorship at 21st Century Oncology and founder of Integrative Oncology-Essentials, thinks this study is fascinating. It “highlights a clinical suspicion that most doctors who treat skin cancers already suspected, that melanomas located on the hands, feet and on mucous membranes are potentially more aggressive and are associated with worse clinical outcomes,” Dr. Lawenda told dailyRx News.

"Although this study doesn’t give us clues to the reasons why, I think the main take home point for patients and healthcare providers should be that melanomas can occur almost anywhere on the body and to be diligent in checking for skin cancer even in some of the less common locations such as on the heads, feet and oral cavity," he said.

This research is being presented on May 31 at the annual meeting of the American Society of Clinical Oncology in Chicago. The research has not yet been peer-reviewed.

Funding for the study was provided by the National Cancer Institute.

Review Date: 
May 30, 2014
Last Updated:
June 2, 2014