Gene Mutations Raise Melanoma Risk
June 13, 2003 02:03:47 PM PDT , HealthDay
By Janice Billingsley
HealthDay Reporter
(HealthDay is the new name for HealthScoutNews.)
FRIDAY, June 13 (HealthDayNews) -- People who are genetically prone
to melanoma are also much likelier to have a second gene mutation
that leaves them susceptible to sun exposure.
Swedish scientists say the discovery of this genetic double whammy
could help health professionals identify those at high risk for
the cancer.
"The genetic mutation is not very common, but it is very important
to inform these individuals who carry this mutation, and then to
give them support and counseling to let them know what the research
means and how to protect themselves," says study author Dr.
Johan Hansson, director of the melanoma unit at Stockholm's Karolinska
Hospital.
The results appear in a recent issue of the Journal of the National
Cancer Institute.
The genetic mutation of a tumor-suppressing gene called CDKN2A
occurs in approximately 20 percent of the 10 percent of melanoma
cases where there is a family history of the disease, Hansson says.
There are, however, different types of mutations of the same CDKN2A
gene, the study adds, and here researchers looked at only one type.
Melanoma affects about 54,000 Americans annually, according to
the American Cancer Society, and while it accounts for only 4 percent
of skin cancers, it causes 79 percent of deaths from skin cancer.
For the study, researchers looked at 35 melanoma patients -- 25
with a family history of the disease who carried the mutation of
the CDKN2A gene, and 10 with no hereditary association with melanoma.
They compared the presence between the two groups of a mutation
called NRAS proto-oncogene, which is related to sun exposure and
is known to be associated with melanoma.
They found that while only 10 percent of those with no family history
of the disease had NRAS mutations, 95 percent of those with the
genetic mutation of the CDKN2A gene also had the NRAS mutations.
"We were surprised because the results were so striking,"
Hansson says. Of the group with the mutation of the CDKN2A gene,
20 out of 21 of those patients with a primary melanoma, which means
the site where the cancer was first found, also had the NRAS mutations,
compared with only one of the 10 patients with primary melanomas
who had no genetic mutation.
A further important finding, Hansson says, is that all but one
of the melanomas in the first group were found on sun-exposed parts
of the body, suggesting there was an association between ultraviolet
light exposure and activation of the NRAS mutations. The other primary
melanoma, which means the site where the cancer started, was on
the sole of the foot.
"This is certainly an important area to watch. People have
been looking for these genes for a long time. Epidemiology studies
have shown that one of the most important risks for melanoma is
a family history of the disease," says Dr. Vincent DeLeo, an
associate professor of clinical dermatology at Columbia University
in New York City.
He adds, however, that there could be other gene mutations besides
the one looked at in this study that are also associated with NSRA
mutations.
The authors acknowledge their study examined mainly those with
a specific genetic mutation for the CDKN2A, and that further work
is needed to compare the NSRA mutations among patients belonging
to families with other CDKN2A mutations as well as those with normal
CDKN2A genes