Untreated Sleep Apnea Linked to Aggressive Melanoma

Issues with sleep can lead poor prognosis for skin cancer.

A new study found an association in the increased aggressiveness of malignant cutaneous melanoma and untreated severe obstructive sleep apnea (OSA).

Researchers from 24 teaching hospitals as part of the Spanish Sleep and Breathing Network were involved in the study, which was presented at the ATS 2016 International Conference.

There were 412 patients with an average age of 55.8-years-old involved in the study, and the number of men and women were almost equal.

Researchers examined the amount of factors that indicated a patient’s prognosis, including the Clark Breslow indices.

“This is the first large prospective multicenter study that was specifically constructed to look at the relationship between sleep apnea and a specific cancer,” said lead author Miguel Ángel Martinez-Garcia, MD, PhD.

Patients previously treated with CPAP treatment to improve breathing during sleep were excluded from the study. Each patient underwent a sleep study, and the results revealed that patients diagnosed with the most aggressive forms of cancers had a high prevalence and severity of OSA.

This association remained independent of gender, age, BMI, skin type, skin exposure, and other risks for melanoma.

“The relationship between sleep apnea and heart disease, as well as with automotive accidents, is already well established,” Martinez-Garcia said. “Based on our study, it seems a relationship between sleep apnea and cancer may also exist. It is very important, however, that people with sleep apnea do not infer that they will necessarily develop cancer.”

Researchers believe that those with sleeping issues seek out a specialist to determine if they have OSA, especially if they have other cancer risk factors.

“Our findings have implications for both patients and physicians,” Martinez-Garcia said. “People who snore, frequently wake up at night or have daytime sleepiness should see a sleep specialist, especially if they have other risk factors for cancer or already have cancer. Physicians -- especially dermatologists, cancer surgeons and medical oncologists -- should ask their patients about potential sleep apnea symptoms, and refer them for a sleep study if they have these symptoms.”

The researchers plan future studies to examine the patients over time to analyze other important variables, including relapse, mortality, treatment resistance, development of a second melanoma or other cancers, and metastasis.

Additionally, a multicenter, multinational study of melanoma patients or patients with other types of cancer will be conducted to examine the effect of long-term CPAP therapy for those diagnosed with sleep apnea.

“While more research is needed, this study shows that patients in the study had markers of poor prognosis for their melanoma,” Martinez-Garcia said. “It also highlights the importance of diagnosing and treating sleep apnea.”