Melanoma and Pregnancy: What Every Woman Needs to Know About the Risks, Prognosis

Researchers estimate that nearly one-third of cases of melanoma, the most serious form of skin cancer, are diagnosed in women during their childbearing years. Since many women now are delaying pregnancy until their 30s or 40s, coupled with the fact that melanoma is the most common form of cancer for young adults 25-29 years old, more women could be faced with developing melanoma before or during pregnancy.

At the recent 67th Annual Meeting of the American Academy of Dermatology, dermatologist Marcia S. Driscoll, MD, FAAD, clinical associate professor of dermatology at the University of Maryland School of Medicine in Baltimore, presented evidence concerning the prognosis for women who become pregnant after surviving melanoma and for those who develop melanoma during pregnancy.

“Over the years, there has been ongoing controversy concerning the effect of hormones on melanoma,” said Dr. Driscoll. “Some researchers speculated that melanomas may grow rapidly and spread due to the hormones associated with pregnancy. While we know that hormones may impact other types of cancer, such as breast and ovarian cancer, a review of the research on pregnancy and melanoma shows there is no evidence that pregnancy has an adverse influence either on the prognosis of melanoma or the risk of developing melanoma.”

Prognosis Important when Considering Pregnancy after Melanoma

Dr. Driscoll explained that the best direct evidence of the prognosis for the woman who becomes pregnant after being diagnosed with melanoma is based on three small case-controlled studies. Reviewed collectively, these studies compared the prognosis of 530 women who became pregnant after being diagnosed with melanoma to 2,340 control subjects who completed their pregnancies prior to their diagnosis of melanoma.

“These studies found no significant difference between the prognoses of these two groups of women, indicating that hormones did not have a negative effect on melanoma,” said Dr. Driscoll. “Having researched this topic for 15 years, I personally have not found a solid link between hormones and melanoma.”

In counseling women who survived melanoma about future pregnancies, Dr. Driscoll said the most important factor to consider is a woman’s prognosis, which is based upon her stage of the disease. Stage of disease for melanoma is based on three variables – tumor thickness, presence or absence of ulceration, and whether the melanoma has spread to the lymph nodes or other organs. For example, if a tumor is less than 1 mm in depth (which is considered a “thin” melanoma, or in an early stage of the disease), no ulceration is present in the tumor (meaning the top layer of the skin when examined under the microscope is intact), and the melanoma is contained and has not spread, then the patient has what dermatologists consider a very good prognosis for surviving melanoma.