 |
 |
Levodopa and Melanoma 12 Jan 1999 Thanks, Kathrynne Holden, for your post of 10 Jan regarding levodopa (as in Sinemet) and melanoma (skin cancer). I was UNAWARE! First, I looked in my trusty PDR. Then, I downloaded all the "available" abstracts (battling W95 and my NEC "Printer From Hell" at every step). Some of the key articles Kathrynne cited are in journals that I shall see on Friday when I next visit the library, but here's the scoop thus far: Physicians Desk Reference p.874:SINEMET:CONTRAINDICATIONS: "Because levodopa may activate a malignant melanoma, SINEMET should not be used in patients with suspicious undiagnosed skin lesions or a history of melanoma." Sober A et al; JAMA 1978: "..of 1099 [melanoma pts]..only one had been taking levodopa. ...[it] must be playing an inconsequential role.." Bernstein et al; Arch Derm 1980: "Although the association between levodopa is tenuous, careful monitoring of pigmentary changes in patients receiving levodopa is advised." Rosin A, Braun M; Cutis 1984: "...data do not [show that levodopa] promotes development of malignant melanoma. However, patients...should be monitored..." Rampen F; J Neur N'surg Psych 1985: "...The capacity of levodopa to induce melanomas and its alleged adverse effect on the clinical course of the disease are questioned." Kochar A; Am J Med 1985: "...if malignancy is found, alternate therapies for treatment of parkinsonism should be considered." Weiner W et al; Neur 1993: "...only anecdotal evidence to support a link between levodopa and melanoma. In fact, levodopa has an antitumor effect on melanoma...evidence suggests that [Sinemet] can be used safely in patients with a history of melanoma." Pfutzner W, Przybilla B; J Am Acad Dermatol 1997: "The incidence of malignant melanoma is rising....literature does not provide evidence of [a link to levodopa]. Despite this, it is suggested that patients treated with levodopa, particularly those with history of malignant melanoma, be observed carefully..." CONCLUSION: The age of these references indicates that serious fears have pretty well been laid to rest. But as in all therapy, caution is advised. DON'T stop Sinemet without definite specific reason, such as unusual susceptibility or history of melanoma. Cheers, Joe -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013