Melanoma and Parkinson’s

Melanoma screening

Multiple studies have found living with Parkinson’s corresponds with an overall decreased risk of cancer, but these same studies also claim that people living with Parkinson’s tend to have an increased risk of melanoma.

Sun exposure is the most common environmental influence on developing melanoma. When living with Parkinson’s, it’s a smart practice to decrease exposure to the sun. You can do this by wearing protective clothing: pants, long sleeved shirts, and hats. Given that temperature regulation issues are common in Parkinson’s, this may not always be comfortable, so wear sunscreen on exposed skin at all times of the year when spending extended time in the sun.

A BRIEF OVERVIEW OF MELANOMA

Melanoma is a type of skin cancer. It starts in the melanocytes: the cells that determine skin color. While extensive exposure to UV light from the sun is the a key risk factor for developing melanoma, other factors also elevate your risk of developing melanoma. These include having lighter pigmented skin, having many freckles or moles, and having a history of skin cancer in your family.

There are multiple types of melanoma. The most common is superficial spreading melanoma, which accounts for approximately 70% of melanoma diagnoses. The next most common is nodular melanoma, which is more aggressive. Nodular melanoma accounts for approximately 20% of melanoma diagnoses.

Less common forms of melanoma include Lentigo maligna melanoma and acral melanoma. Lentigo maligna melanoma tends to occur in older individuals. Acral melanoma occurs in areas with limited sun exposure—palms of the hand or soles of the foot—and comprises a large portion of diagnoses in people with darker skin tones.

Melanoma is treatable, but survival rates involve multiple factors. Visit the American Cancer Society for more information on melanoma survival.

HOW TO IDENTIFY MELANOMA

Melanoma can sometimes be visually identified, but some melanomas are difficult to detect this way—including nodular melanoma. For this reason, have regular checks with a knowledgeable care provider. Expedite appointments if you feel unusual bumps or lumps beneath your skin or if you notice discoloration of your skin that changes shape or gets larger.

WHAT IS KNOWN ABOUT MELANOMA AND PARKINSON’S?

In a 2021 meta-analysis that included 17 million people, Zhang et al. found “Parkinson’s was significantly associated with a 75% higher risk of melanoma.” In a 2010 study involving 2,106 people, Bertoni et al. estimated the overall prevalence of melanoma among people living with Parkinson’s to be 1.1%.

Shortly after levodopa’s introduction as a treatment for Parkinson’s, some case studies reported an association between levodopa use and melanoma. Because of this, you may still hear that levodopa use increases risk of melanoma. However, in 2006, a Danish research team conducted a study of over 8,000 people and found that the association between Parkinson’s and melanoma increased before a person began levodopa therapy. Other studies have since corroborated this finding, and at present, it is not widely believed that levodopa increases risk of melanoma.

ADDITIONAL CONNECTIONS

The exact reason for the relationship between melanoma and Parkinson’s is unknown, but there are numerous intriguing overlaps between Parkinson’s and melanoma. Examples from a 2018 report from researchers from Cornell Medicine include:

  • Brain imagery of people with Parkinson’s and of people with melanoma show “extended” substantia nigra. This is a part of the brain significantly affected by Parkinson’s, and is rich in a type of melanin. Melanocytes—the skin cells affected in melanoma—produce melanin. Neuromelanin and melanin may be the fundamental linkage between Parkinson’s and melanoma.
  • Melanin is created by oxidation of tyrosine, an amino acid. Tyrosine is necessary for production of dopamine, epinephrine, and norepinephrine. These neurotransmitters are generally found in lower levels in people with Parkinson’s. Tyrosine may be another link between melanoma and Parkinson’s.
  • There are multiple genetic connections between Parkinson’s and melanoma. While there are not clear causal relationships between these genes, Parkinson’s, and melanoma, the relationships are suggestive. Some of the genes connecting these conditions relate to alpha-synuclein–which is associated with Parkinson’s neurodegeneration–and others relate to LRRK2.
  • Alpha-synuclein is common in melanoma cells, despite that the cells expressing high levels of alpha-synuclein typically produce little melanin.

BE PROACTIVE, BUT DON’T LET STATISTICS GET YOU DOWN

Associations between Parkinson’s and other health conditions—including those relative to melanoma—describe patterns in groups of people. There are other factors involved, however, and the fact that people with Parkinson’s are more likely to develop melanoma does not mean that you will be diagnosed with melanoma.

Nevertheless, these associations are worth bearing in mind as you make lifestyle choices. Choices you can make to decrease your risk of melanoma include the following:

  • Protect your skin from frequent or prolonged sun exposure.
  • Regularly visit a dermatologist.
  • Avoid use of tanning beds. The sun is not the only source of dangerous UV light.

Another important thing to keep in mind is that exposure to sunlight is important for vitamin D levels, which can be lower in people with Parkinson’s. Vitamin D helps with mood and cognition. It can also decrease risk of fractures.

A simple blood test can evaluate your vitamin D levels. If your levels are low, consider increasing sun exposure in the early morning and evening, when the sunlight is less intense. Alternatively, talk with your care team about vitamin D supplementation.

With these simple steps, you can reduce your risk of melanoma and the complications of navigating an additional challenging diagnosis while living with Parkinson’s.

ADDITIONAL RESOURCES

Biological and Clinical Implications of Comorbities in Parkinson’s

Understanding the Connections Between Parkinson’s and Melanoma: UCLA Health

Highlighting the Link Between Parkinson’s and Malignant Melanoma: A Case Report and Literature Review

Malignant Melanoma and Levodopa in Parkinson’s: Causality of Coincidence?

Melanoma, Parkinson’s, and Levodopa: Causal or Spurious Link?

The Association Between Parkinson’s and Melanoma

Malignant Melanoma in Early Parkinson’s: The DATATOP Trial

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