Skin Cancer May Foretell Cancers to Come

Margaret Karagas, associate director of the Center for Environmental Health Sciences at Dartmouth Medical School, said that this study could provide a model for future cancer research, noting that many discoveries about cancer that are applied to different types originated with skin cancer research.

"Skin cancer has been a useful model of carcinogen discovery," she said, listing radiation and arsenic among the cancer-causing agents that were initially discovered because they caused skin cancers.

"It's also important because in many parts of the world it appears to be one of the most rapidly increasing cancers," she said.

Alberg also noted that non-melanoma skin cancer may provide a better initial marker because any subsequent cancers are unlikely to be caused by the treatment.

"Non-melanoma skin cancer avoids [these problems] because it is locally treated, and so there aren't late effects of treatment like you might see with melanoma."

While he said the findings were interesting, Abdelmalek said he would be reluctant to use this information in his practice.

"The idea is fine to think about. You don't want to think of skin cancer as a separate issue that has nothing to do with the rest of the body," he said.

He noted that for many patients, however, there were other explanations for their cancers that the study did not adequately address. One problem he said he found was that patients' history of sun exposure was based on their own recall over 10 years after the study began.

"Relying on a patient's history to accurately report their sun exposure is a joke," he said. "You have no idea how many people will tell me they don't go out in the sun when they have a tan line glaring at me and their back is peeling from a recent sunburn."

He said that these warnings might not be helpful.

"The data can't really say which types of other malignancies are associated," he said. "So what do you tell people? 'You may get another cancer, but it's a crap shoot as to where?'"

While he sees promise in these findings for helping younger patients assess their future cancer risk, in older patients, he said, you have much more with which to gauge their chances of other cancers.

"They have other risk factors, not just that they've had a skin cancer," he said.

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