What do we hear about melanoma of the ear?
“Not a lot,” says Mayo Clinic’s Matthew Carlson, M.D., an ear, nose and throat doctor (otorhinolaryngologist) and ear surgeon in Rochester, Minnesota. That’s why he partnered with colleagues from the Department of Otorhinolaryngology and the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery to find out more.
In a recent report in the American Journal of Otolaryngology, he and study author Nicholas Deep, M.D., an otolaryngology resident at Mayo Clinic in Phoenix, Arizona, describe some of unique characteristics that their team discovered, and why it matters.
“There is anecdotal evidence to support that melanoma of the ear behaves differently than that of other sites on the head and neck, or the rest of the body,” says Dr. Carlson. “This, of course, may have implications for treatment.”
Using the National Institutes of Health Surveillance, Epidemiology, and End Results (SEER) cancer registries, the team hoped to find out how frequently primary melanoma of the external ear is diagnosed, identify common treatment options, and determine survival for this particular subpopulation of patients.
They identified 5,481 patients newly diagnosed with melanoma of the ear between 2004 and 2013.
“We found that the rate of diagnoses increased nearly 20 percent from 2004 to 2013,” says Dr. Deep. “And men were more than six times more likely to be diagnosed with melanoma of the ear than women.”
This difference, according to the paper, is historically “attributed to the fact that women traditionally have longer hair which serves a protective role.”
Sex did not appear to affect life expectancy, but there were several factors that independently predicted time to cancer-specific death. The researchers noted these as:
- Older age
- Increasing Breslow thickness (how deep the tumor extends into the skin)
- How far cancer has spread (called cancer stage)
- Presence of ulceration (looks like a sore in within the tumor)
- Cancer that has spread to the lymph nodes or other parts of the body.
“Our findings can help clinicians counsel patients regarding short and long term prognosis,” says Dr. Carlson. “The available data does not actually allow us to effectively determine whether a certain treatment provided a better outcome, but knowing what the majority of the community is using can also inform best practice.”
This type of continuous learning and sharing is part of Mayo Clinic’s culture and an essential component to providing the best possible care for patients. Dr. Carlson serves as a mentor for Dr. Deep as he builds his expertise in head and neck surgery – both in clinical care and research. This study is one of several they have completed together.
“Research is an important part of our surgical residency education,” says Dr. Deep. “With the rapidly expanding body of knowledge in medicine today, it is becoming increasingly important to be able to efficiently review and synthesize the current literature on a specific clinical question to help guide management.”
Other Mayo Clinic research team members are Amy Glasgow, senior health services analyst; Elizabeth Habermann, Ph.D., Robert D. and Patricia E. Kern Scientific Director for Surgical Outcomes; and Jan Kasperbauer, M.D., chair, Division of Head and Neck Surgery.