From the Departments of Surgery, Oncology and Dermatology, Johns Hopkins Medical Institutions, Baltimore, MD
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Charles M. Balch, MD, FACS, Departments of Surgery, Oncology and Dermatology, Johns Hopkins Medical Institutions, 600 N Wolfe Street, Osler 624, Baltimore, MD 21287; e-mail: balchch{at}jhmi.edu
Overview: Cutaneous melanoma in older individuals has some notable features and treating advanced disease can be challenging. The number of melanoma cases in older individuals is expected to rise in the coming decades largely because of the aging of the population. Older white males have been identified as a population of particular concern because they represent the population at highest risk of death from melanoma. Older age is recognized as an independent adverse prognostic factor; whether this is principally related to differences in the inherent biology of the disease for older individuals or whether poor outcomes are related to declining host defense factors is unclear. Older patients, particularly those with stage III or IV disease, can be difficult to treat because they are more likely to have complications following major surgery and are often unable to tolerate aggressive systemic therapies. Early diagnosis is critical for the successful treatment of melanoma for this population.
