Today, I will write some scientific facts about melanoma. My reference will be uptodate dot com.
Melanoma is the third most common cancer causing brain metastases in the United States, after cancers of the lung and breast , which appears to reflect the relative propensity of melanoma to metastasize to the central nervous system (CNS) . Brain metastases are responsible for 20 to 54 percent of deaths in patients with melanoma , and among those with documented brain metastases, these lesions contribute to death in up to 95 percent of cases .
Although all patients with melanoma are at risk for metastasis to the brain, certain characteristics that are associated with increased risk of systemic metastases also correlate with the subsequent development of brain metastasis. These factors include :
- male gender
- Melanomas arising on mucosal surfaces or the skin of the trunk, head, or neck
- Wide, thick, deeply invasive, or ulcerated primary lesions
- Acral lentiginous or nodular lesions on histologic examination
- Involvement of more than three regional lymph nodes, either at diagnosis or relapse
- Visceral metastasis at the time of diagnosis, especially if the visceral metastasis is disseminated to more than one organ
When you look at the risks for metastasis, Sen. McCain’s melanoma history is worrisome. He is male, his previous melanomas arose from head and neck area. As far as I am concerned, I don’t know what histologic type his melanoma was. Most probably you won’t find it on the released medical records. By the way, acral lentiginous and nodular lesions are histologic types of melanoma which will be seen on microscopy. As you have seen the extensive surgical scar on Sen. McCain’s face, the surgeons removed the lymph nodes in that are to prevent metastasis.
One more thing you should know about this notorious cancer is its prognosis.
PROGNOSIS — Melanoma patients with brain metastases have a poor prognosis. In two series totaling almost 1400 patients, the median survival was four months, and one year survival rates were 9 and 19 percent, respectively .
This shows how serious it could get if it metastasize to brain. Given the known recurrence of melanoma, no body knows what is going to happen to Sen. McCain.
For further reading: http://www.uptodate.com/patients/content/topic.do?topicKey=skin_can/2547
