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Dementia is on a broad scale and can impair life but this shouldn’t influence how we view, or treat people.
Skin cancer is a prevalent form of cancer and dementia is all too common, around 1 in 5 of our population over 80 are likely to suffer from this to a degree. Understanding whether the two hold any link would relate to a fair proportion of people.
The relationship has been fairly well researched, although results are variable. One US study did show a substantially decreased risk of Alzheimer’s (one form of dementia) in those who previously had non-melanoma skin cancer.
Other studies have echoed the basic tenet of reduced levels for people with various forms of dementia but not to the same extent. Research has also found links the other way round, with dementia sufferers a little less likely to develop skin cancer.
We can safely say that any thoughts on one disease causing the other can be set aside but how significant are the findings.
The Medical Hypothesis
A long term study followeing patients over 65 for up to 25 years analysed both skin cancer and dementia in depth. They again saw reductions in each direction but not to an extent they considered significant. They did still suggest:
“The fact that Alzheimer’s disease, but not vascular dementia was inversely associated with cancer reinforces the idea that the process of neurodegeneration may be inversely related to
proliferative disorders.”
We all have a combination of cells which may be dying, or multiplying. If natural cell division gets out of control, we call that cancer, when sections of brain cells die, we call this Alzheimer’s disease.
The idea is that a balance exists between cell division and cell death. An increased risk of cancer driven cell division over cell death could decrease the risk of Alzheimer’s. To a lesser extent, triggers from dementia could reduce cell multiplication and cancer.
Interesting thoughts but how much direct value do they hold. We know that one disease is not a risk factor for the other and wish to avoid both.
A Patient Centred Approach
Further research on the neurologic and biologic mechanisms which underpin any relationship could help with treatment for one, or both conditions. In that sense worthwhile but not a reason to vary current treatment.
Skin Care Network wholeheartedly believe that nobody should be discriminated against when seeking skin cancer diagnosis, or treatment. With skin cancer often affecting older people, of course there can be co-morbidities, including dementia.
If a patient has late stage dementia, this may bring a greater clinical challenge to decide on treatment which is in the patient’s best interest. The effect a tumour, or tumours is having on a patient should still be the primary concern.
The relationship between dementia and skin cancer remains a little opaque and other factors could be influencing research results.
There might be a lower awareness of skin cancers in people with undiagnosed, early cognitive impairment. Behaviour varies when people have dementia, or skin cancer, do we truly understand whether this is part of the pattern seen.
Further research will be valuable but looking at a possible relationship with dementia should not influence skin cancer treatment. Neither should we focus on a changed likelihood of skin cancer, when diagnosis and early treatment remain important for all of us.