Melanoma Compromises Quality of Life, especially in Later Stages Interview with:

Eugene R. Semenov, MD, MA Washington University School of Medicine

Dr. Semenov

Eugene R. Semenov, MD, MA
Washington University School of Medicine What is the background for this study?

Response: Melanoma is an aggressive type of skin cancer which has traditionally carried a poor prognosis. Over the past decade, many new therapies have become available that have improved long-term survival rates in patients with metastatic melanoma. However, these drugs have been associated with serious side effects, such as pancreatitis and hepatitis. Our goal was to study how melanoma diagnosis, disease stage, and treatment status impact patient quality of life (QoL). What are the main findings?

Response: We surveyed 87 melanoma patients and learned that quality of life among melanoma patients was considerably lower than that of age- and gender-matched general population. Specifically, QoL among melanoma patients was comparable to that of patients with other forms of cancer including breast, lung, and colon cancer. Moreover, as we predicted, patients with metastatic melanoma had worse quality of life than patients whose melanoma was localized to the skin, with the majority of this difference attributed to the use of systemic therapies in patients with metastatic disease. However, the magnitude of the QoL decrease associated with systemic therapy was small enough that it was deemed unlikely to be noticeable to patients. What should readers take away from your report?

Response: Like other cancers, melanoma has the potential to reduce equality of life, especially at advanced stages. Fortunately, modern systemic therapies that have been effective against melanoma do not appear to further reduce quality of life to a clinically perceptible extent. These findings may be useful when counseling melanoma patients regarding the risks and benefits of treatment. What recommendations do you have for future research as a result of this work? 

Response: In addition to traditional chemotherapy, there are two classes of systemic therapy used to treat metastatic melanoma: immunotherapy and targeted therapy. There is currently little evidence as to which of these classes is associated with better QoL outcomes. Our results suggest that targeted therapy is associated with a greater reduction in QoL, while patients receiving immunotherapy may have similar QoL to patients not receiving any systemic therapy at all. However, the number of patients in each therapeutic subgroup was too small to draw definitive conclusions. In the future, a larger multi-institutional study may elucidate differences in QoL outcomes between different medication classes and even individual drugs. 

The authors have no conflicts of interest to disclose.


J Am Acad Dermatol. 2018 Jun 12. pii: S0190-9622(18)32068-1. doi: 10.1016/j.jaad.2018.06.007. [Epub ahead of print]

Health-related quality of life in patients with malignant melanoma by stage and treatment status.Rosenberg AR1, Weston SJ2, Deshields T3, Fields RC4, Linette GP5, Cornelius LA1, Semenov YR6.


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