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Epidemiology and treatment of melanoma in elderly patients

Nature Reviews Clinical Oncology volume 7, pages 148–152 (2010)Cite this article

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Abstract

The number of melanoma cases in the elderly (>65 years) will rise over the coming decades, making it an important public health problem. Elderly white men are the demographic group who are at highest risk of being diagnosed with melanoma and of dying from this cancer. Among patients with melanoma, older age is recognized as an independent poor prognostic factor, but it remains unclear whether this relationship is due to a change in the biology of the disease with increasing patient age, declining host defenses, or both. Most elderly patients can have surgery to control locoregional disease, but might not be candidates for intensive biologic therapies for advanced melanoma because of comorbidities and inability to tolerate the adverse side effects of these treatments. Early detection remains an important strategy for the management of melanoma. Further research is needed to determine why older melanoma patients have a worse prognosis than their younger counterparts, even when matched for all other clinical and pathological predictors of survival outcomes.

Key Points

  • The number of melanoma cases among the elderly (>65 years) is expected to increase owing to the aging population

  • Older men are at higher risk of developing melanoma, and once diagnosed, are at higher risk of dying from this cancer compared with other demographic groups

  • Older men often present with thicker lesions and a truncal location compared with older women, making self-detection less likely

  • Melanomas in elderly patients often have poor prognostic features compared with younger patients, including ulceration, elevated mitotic rate, and head and neck location

  • Older age is an independent, adverse prognostic factor even after taking all other factors into account

  • Older patients are less likely to receive standard surgery for melanoma, although they usually tolerate these surgeries well

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Authors and Affiliations

  1. Department of Surgery, Johns Hopkins Hospital, 600 North Wolfe Street, Carnegie 681, Baltimore, 21287, MD, USA

    Susan Tsai, Charles Balch & Julie Lange

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  1. Susan Tsai
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  2. Charles Balch
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  3. Julie Lange
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Correspondence to Charles Balch.

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The authors declare no competing financial interests.

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Tsai, S., Balch, C. & Lange, J. Epidemiology and treatment of melanoma in elderly patients. Nat Rev Clin Oncol 7, 148–152 (2010). https://doi.org/10.1038/nrclinonc.2010.1

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