Screening for second malignancies in mycosis fungoides: non-Hodgkin lymphoma, Hodgkin lymphoma, lung cancer, bladder cancer and melanoma

A. Goyal, D. O’Leary, K. Goyal, N. Rubin, M. Janakiram

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with mycosis fungoides (MF) are at increased risk of developing non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), lung cancer, bladder cancer and melanoma. The characteristics of patients developing these malignancies have not been specifically delineated. In addition, there are no established guidelines for screening MF patients for second malignancies. Materials/Methods: We identified 742 patients with MF who developed second malignancies in the Surveillance Epidemiology and End Result-18 database. Results: The majority of second malignancy patients were white and male, mean age 55–67 years at diagnosis of MF, and mean age 61–72 years at diagnosis of second malignancy. The majority of patients diagnosed with second malignancies had early stage MF. MF patients with NHL, lung cancer, and bladder cancer tended to be diagnosed at earlier stages of the second malignancy than patients without MF and demonstrated better 5-year overall survival. There was no improvement in stage at diagnosis or survival for MF patients who were diagnosed with melanoma compared to patients without MF. Conclusions: Improvements in survival in MF/NHL, MF/lung cancer and MF/bladder cancer patients may reflect differences in disease biology secondary to having MF or the importance of increased contact with the healthcare system. MF/melanoma data suggest that patients require regular pigmented-lesion-focused skin examinations. Tools for screening include regular lymph node examinations, pigmented-lesion-focused examinations and detailed review of systems questions. Smoking cessation counseling is key intervention in this population, as is ensuring that all age- and sex-specific cancer screenings are up-to-date (e.g. lung cancer screening, mammography, and colonoscopy). The utility of regular imaging for second malignancy screening and lab testing such as routine urinalysis requires additional study and expert consensus.

Original languageEnglish (US)
Pages (from-to)1821-1829
Number of pages9
JournalJournal of the European Academy of Dermatology and Venereology
Volume35
Issue number9
DOIs
StatePublished - Sep 2021

Bibliographical note

Funding Information:
Statistical analysis was supported by NIH grant P30 CA77598 and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. This work was supported in part by T32 HL007062.

Publisher Copyright:
© 2021 European Academy of Dermatology and Venereology

PubMed: MeSH publication types

  • Journal Article

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