Screening for second malignancies in mycosis fungoides: non‐Hodgkin lymphoma, Hodgkin lymphoma, lung cancer, bladder cancer and melanoma

Abstract

Patients with mycosis fungoides (MF) are at increased risk of developing non-Hodgkin lymphoma (NHL),Hodgkin lymphoma (HL), lung cancer, bladder cancer, and melanoma. There are no guidelines for screening MF patients for second malignancies. We identified 742 patients with MF and second malignancies in the Surveillance Epidemiology and End Result-18 database. The majority of second malignancy patients were white and male, mean ages 55-67 years at diagnosis of MF, and mean age of 61-72 years at diagnosis of second malignancy. MF/NHL, MF/lung cancer, and MF/bladder, cancer tended to be diagnosed at earlier stages of the second malignancy than patients with NHL, lung cancer, or bladder cancers alone and have improved survival. There was no improvement in stage at diagnosis or survival for MF/melanoma patients. Improvements in survival in MF/NHL, MF/lung cancer, and MF/bladder cancer patients may reflect underlying biology or the importance of increased contact with the healthcare system. MF/melanoma data suggests that patients require pigmented-lesion focused skin exams. Tools for screening include regular lymph node exams, pigmented-lesion focused exams, and detailed review of systems questions. With these simple interventions, we hope to identify second malignancies sooner and potentially avoid them.