A new multicenter prospective study on the relationship between cancer and sleep-disordered breathing has shown that severe obstructive sleep apnea (OSA), if left untreated, may be linked to more aggressive malignant cutaneous melanoma. Sleep-disordered breathing is in reference to frequent starts and stops in breathing throughout the night. This study was presented at the 2016 ATS International Conference and included researchers from 24 different teaching hospitals that were part of the Spanish Sleep and Breathing Network.
Lead author of the study, Miguel Angel Martinez-Garcia, MD, PhD, stated that this study is the first that is specifically designed to analyze the relationship between a certain type of cancer and sleep apnea. He notes that even though additional research is necessary, this particular study shows that individuals who were part of the study had a poorer prognosis for their melanoma, highlighting the importance of identifying, diagnosing, and treating sleep apnea as soon as possible. Dr. Martinez-Garcia is part of the Hospital Universitario y Politecnico La Fe in Valencia, Spain.
There were 412 patients involved in this study, with an average age of 55.8 years. Each had a confirmed diagnosis of cutaneous malignant melanoma. There were equal numbers of men and women in the study group. Dr. Martinez-Garcia and the other researchers gathered various data points that indicated the prognosis for each patient. This included the Clark and Breslow indices, which determines the melanoma stage.
All participants had a sleep study performed, and those who were treated in the past with CPAP were excluded. CPAP is the primary treatment option for people with sleep apnea.
Scientists discovered that those with the most aggressive cancer were more likely to have a higher rate and severity of OSA. This finding and relationship between the cancer and OSA was true regardless of gender, age, BMI, sun exposure, skin type, or other melanoma risk factors.
It has already been established that there is a relationship between heart disease and sleep apnea, as well as motor vehicle accidents, Dr. Martinez-Garcia stated. This study, however, showed that there was also a relationship between cancer and sleep apnea. While this is a very important finding for people who currently suffer from sleep apnea, Martinez-Garcia states, it is vital that they do not infer this to mean they will develop cancer as a result of sleep apnea.
Melanoma was the focus of this study for a variety of reasons. Specifically, cutaneous melanoma is easily measured and observed. Well-validated measures are used to determine its aggressiveness, including the Clark and Breslow indices. Researchers who were part of the study group published, in addition to the findings of this study, a melanoma growth rate index. Finally, previous animal studies gave a foundation for the relationship link between sleep apnea and melanoma.
Dr. Martinez-Garcia noted that these findings implicate many factors for both physicians and patients. A medical professional should be sought if snoring and frequent nighttime awakenings with daytime sleepiness are a problem, especially if there are other risk factors for cancer, or if cancer is already present. Dermatologists, cancer surgeons, and oncologists especially need to be asking patients if OSA symptoms are a problem, and then work fast to refer them for a sleep study.
The researchers plan further research into this relationship and topic. The next study will be to watch these patients over time and look for important variables like relapse, treatment resistance, development of other cancers or a second melanoma, metastasis (spread, especially to sentinel lymph nodes), and mortality. Further, Dr. Martinez-Garcia is planning to do a multinational/multicenter study of people with other types of cancer in order to examine how long-term use of CPAP therapy may be affecting them.
Author: Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.