Visible Melanoma Lesions Affect Patients' Physical, Emotional Quality of Life

A recent study highlighted the additional psychological effects that patients with locally advanced cutaneous melanoma go through, particularly because their lesions are a visible part of their everyday life.

“These patients who have locally advanced cutaneous melanoma have different manifestations of their disease than those who have internal or visceral metastases in that you can see them,” Jonathan S. Zager, M.D., senior member at the Moffitt Cancer Center, said in an interview with CURE. “So, it is important to take that in to consideration because they have a lot of psychological, physical and emotional aspects to their disease.”

However, despite these apparent quality of life implications, symptom management and subsequent impacts from these psychological effects are not well understood or evaluated.

The study, published in Melanoma Research, aimed to understand the daily experiences of patients with locally advanced cutaneous melanoma using qualitative phone interviews.

The researchers recruited 22 patients with stage 3B (36 percent), 3C (59 percent) or 4 (5 percent) cutaneous melanoma from two U.S. cancer centers and one from Australia. Patients were approximately 69.7 years old, and 64 percent were male.

The results are derived from a Provectus-sponsored study to understand the daily experiences of patients with locally advanced cutaneous melanoma, and how their experience impact their everyday life.

Patients reported emotional health/self-perception issues as the most common aspects to their disease, including worry, concern, embarrassment, self-consciousness, fear and thoughts of death. Limitations of lifestyle and activities were also identified in 28 percent of patients, including leisure and social activities, physical functioning, general functioning, and personal care.

“Here, there is not a day that goes by that [a patient with locally advanced cutaneous melanoma is] not reminded when it is visible and physical,” said Zager.

To cope with these issues, patients reported strategies consisted of modified clothing choices, increased use of pain and/or anti-inflammatory medications, and avoidance/protection from the sun.

Zager recommends for patients to be honest and in touch with their health care providers. “And hopefully they will provide and help with the emotional support that is needed: Get patients in touch with social workers and case managers who will be able to provide that emotional support,” he added. “Maybe get them involved with support groups and patient advocates to allow them to talk openly about it and maybe come up with a plan on how to deal with those manifestations of this unique pattern of disease.”

Additionally on the physician side of things, Zager hopes these results prompt researchers to find better therapies to help address psychological and emotional effects.

“This was more of a patient-reported outcomes study that pointed out the aspects of this disease, and that they are symptomatic, and it allow us to understand the role of the physician and helping patients through their treatment period and hopefully as time goes on we are going to continue to find better treatments for melanoma,” he said. “We have had a ton of advances in the therapeutic options for melanoma in the last decade, and still yet promising advances are on the horizon.”