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Surviving Melanoma May Take Different Toll on Women, Men

By Alan Mozes
HealthDay Reporter

MONDAY, Feb. 21 (HealthDay News) -- The experience of surviving a melanoma may weigh more heavily on the emotional lives of women than men, a new study suggests.

"In clinical practice, this observation may imply that women need additional care, including follow-up and possibly counseling to optimally cope with their melanoma," the authors, led by Dr. Cynthia Holterhues of the department of dermatology at Erasmus MC in Rotterdam, the Netherlands, noted in a news release.

In some respects, however, the study found that female melanoma survivors often took a more positive attitude compared to males.

For example, while female patients were more likely to say that melanoma and the side effects of treatment interfered with their quality of life, they were also more prone to say that the experience had left them wiser and more spiritual.

Women who beat a melanoma were also more likely than their male counterparts to go on to protect themselves and their families from harmful UV radiation, the study found.

"Men might be less aware of general measures of sun protection and need education about these measures after treatment," the authors noted.

The study is published in the February issue of the Archives of Dermatology.

According to the U.S. National Institutes of Health, melanoma is the most lethal of all skin cancers. However, the disease is curable if caught early enough, before it has spread to the lymph nodes and other tissues and organs.

According to the study authors, that means that 80 percent of melanoma patients face a "relatively good" prognosis. But there's one caveat: all melanoma survivors will face a lifetime risk for disease recurrence.

With that in mind, the research team decided to conduct a survey of more than 560 Dutch melanoma survivors to explore their behaviors, attitudes and overall quality of life.

The participants, 62 percent of whom were women, averaged 57 years of age and had been diagnosed with a melanoma between 1998 and 2007. The survey focused on each person's reaction to their illness up to 10 years after their diagnosis.

All patients were asked to complete both a health status questionnaire as well as an "impact of cancer" survey, to assess how their diagnosis affected them on all fronts: physical, mental, social, existential and medical.

About 70 percent of the melanoma patients had received an stage 1 (early-stage) diagnosis. About a third also struggled with an additional serious medical issue, such as high blood pressure or joint pain.

Overall, the authors found that melanoma survivors did not suffer from a worse health-related quality of life as compared with the general Dutch population. In fact, there was a non-significant trend suggesting that the cancer patients might be in generally better physical health, overall, than people without the skin cancer.

That said, among melanoma survivors women were found to have more serious reactions to the experience than men. Female patients were more likely to suffer from generally worse physical and mental health, the authors noted, and additional indications pointed towards their having a significantly poorer health-related quality of life overall.

Compared with men, women also appeared to experience more pain, numbness and/or itchiness as a side effect of treatment-related scarring.

However, women were also more likely to place an appropriate focus on sun exposure than did men. Women tended to worry more than men about how UV risk might affect them (66 percent vs. 45 percent, respectively) and their family (49 percent vs. 32 percent).

This was associated with women tending to vacation less often than men in sunny locales (67 percent vs. 56 percent), and to seek shade and/or use sunscreen more often (67 percent vs. 48 percent) and more times a day (64 percent vs. 25 percent).

Dr. Darrell. S. Rigel, past president of the American Academy of Dermatology and currently a clinical professor of dermatology at NYU Langone Medical Center in New York City, said the findings came as little surprise.

"You see differences even on the front end, when women are much more often than men to be the ones to uncover their melanoma," he noted. "Also, given the fact that melanoma is often a very young disease, with a mean age of 47, I can certainly see how the emotional implications for women would be greater in light of the fact that it often strikes when women have children, and would bring about obvious concerns for them about who's going to take care of their family if their disease returns."

"But on a positive note, I'd say that women are always the leaders when it comes to the health care of their family," Rigel added. "Not just for melanoma, but for everything. So, again, when it comes to prevention and subsequent behavioral changes that should clearly be taken to limit risk after treatment, women are just better, always, than men."

More information

There's more on melanoma at the U.S. National Cancer Institute.

SOURCES: Darrell. S. Rigel, M.D., F.A.A.D., clinical professor, dermatology, NYU Langone Medical Center, New York City, and past president, American Academy of Dermatology; Feb. 21, 2011, news release, American Medical Association; February 2011 Archives of Dermatology

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