December 5, 2017
A study has found that Queenslanders who regularly take statins to lower their cholesterol have less chance of developing an ulcerated melanoma, which has a significantly lower survival rate than regular melanoma.
Researchers from QIMR Berghofer Medical Research Institute found that while taking cholesterol-lowering statins reduced the chances of melanomas becoming ulcerated, conditions like diabetes made it more likely.
Dr Lena von Schuckmann from QIMR Berghofer’s Cancer and Population Studies group said ulceration was a feature of rapidly growing melanomas and associated with a poorer prognosis.
Dr von Schuckmann said the study, which was published in the Journal of Investigative Dermatology, built on existing research that inflammation in the body caused by smoking, obesity, high blood pressure, diabetes and heart disease may also be associated with melanomas becoming ulcerated.
“This new research is quite exciting because it tells us there are potentially modifiable factors associated with developing an ulcerated melanoma, like preventing diabetes with a healthy lifestyle,” she said.
“This information may help clinicians to give their patients better advice about what they can do to prevent what is a very serious – even deadly – form of melanoma.”
The study also looked at the impact of anti-inflammatory medications on the cancer’s development.
Dr von Schuckmann said this was because a common feature of ulcerated melanomas was high levels of inflammation around and within the tumour site.
She said anti-inflammatory medications assessed in the study included cholesterol-lowering statins; nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen; and corticosteroids, which can be used to treat a range of chronic conditions.
“We found that people who used statins regularly – at least three times a week for a minimum of three months – were significantly less likely to be diagnosed with an ulcerated melanoma compared to non-users, even after making adjustments for age and sex,” she said.
“It is possible that statins modify inflammatory mechanisms in the body that cause melanomas to become ulcerated but further studies are needed to confirm that statins can prevent the onset of melanoma ulceration, particularly before these medications can be used therapeutically.
“It’s also important that any future studies assess the impact of other factors like dosage and the duration of medication use, as well.”
Dr von Schuckmann said the study found diabetics were more than twice as likely to be diagnosed with an ulcerated melanoma as non-diabetics.
“We already know that diabetes causes inflammation in the body and is associated with higher rates of other cancers, such as in the liver, breast and colon,” she said.
“Further research is now required to confirm whether there is a causative association between diabetes and ulcerated melanoma.
“If diabetes is confirmed to cause melanoma ulceration, diabetic patients who are at high risk of melanoma may require more frequent skin checks, because early detection would be especially important for this group of patients.”
Dr von Schuckmann said the study recruited 787 people with newly-diagnosed, localised melanoma at Queensland hospitals and private practice clinics between 2010 and 2014.
Of those, 194 patients had ulcerated melanomas and were more likely to be male, aged 65 or over, and have worked outdoors.
Patients were asked to outline their medical history and medication use, and information about the melanoma was collected from pathology reports.
Dr von Schuckmann said from the 787 patients, a smaller subgroup of 338 patients who had melanomas with relatively low proliferation and growth rate, were studied to determine the impact of diabetes on melanoma ulceration.
Dr von Schuckmann’s work was made possible with both a scholarship and grant from the National Health and Medical Research Council.
The study was done in collaboration with researchers from the University of Queensland, Queensland University of Technology and the University of Manchester in the United Kingdom.