Monthly Article: May is Melanoma Month. Have you had your skin checked?
May 10, 2007
May is Melanoma Month and the first Monday of each May is Melanoma Monday. Hence, it is important to learn prevention methods of this deadly disease and recognize early signs of its development. Melanoma accounts for 3% of skin cancer and is the 6th most common form of cancer in the United States. It is projected that nearly 60,000 people will be diagnosed with melanoma in the United States this year and about 13% of people with melanoma will die from this disease. It is a disease more common in fair skin individuals, but has been found to be a more deadly disease in skin of color. However, with early detection, this disease can be cured.
What is Melanoma?
Melanoma occurs when special cells in the skin that produce skin color, named melanocytes, become deregulated and experience unrestricted growth. However, with melanoma, the cells are cancerous and if not detected early, can spread to other areas in the body such as the lymph nodes, lung, and breast. Once melanoma has spread from the skin, it is often difficult to treat.
Causes
What causes a melanocyte to become deregulated is not 100% clear. It is known that exposure to the sun’s ultraviolet radiation (UVR) plays a significant role in the deregulation in fair skin individuals. Melanocytes produce melanin which provides skin color. While the greater amount of melanin in skin of color offers protection from UVR, it does not completely prevent the damage of UVR to the skin. It has been found that UVR increases the overall risk for skin cancer in blacks. Hence, no one is safe from the harm of UVR.
Another risk factor for melanoma development is the number of moles you have and their location. Many melanomas arise from preexisting moles. Over 90% of African Americans have at least one mole with a minimum of one fifth occurring on the palms and soles. For African Americans, Native Americans, darker Latinos and Asians, melanomas occur more frequently on non-sun exposed areas of skin. This includes the nails, palms of hands, and soles of feet. Therefore, it is imperative that these areas in people of color are monitored for changes associated with melanoma. Although most melanomas are brown or black, some may be red, skin color, or white.
While melanoma is not as common in people of color, African Americans have a lower survival rate if they develop melanoma. This is thought to be due to the late diagnosis in these patients. Consequently, it is vital that people of color learn methods for prevention in order to decrease the number of deaths from melanoma.
Prevention
There are signs to monitor for melanoma called the ABCD’s of melanoma. These are changes you look for in a mole to determine if it could be melanoma.
- Asymmetry – Means one half of the mole is different from the other half.
- Border – The edges are irregular, blurred, jagged, or notched.
- Color – Unlike moles, melanomas can be multicolored.
- Diameter – Melanomas tend to grow to larger than 6mm, the size of a pencil eraser.
Not only is it key to evaluate your skin using the ABCD’s, sun protection is of equal importance. The following are things you can do to protect yourself while in the sun:
- Limit midday sun exposure between 10am and 4pm (UVR is highest at this time of day).
- Stay in the shade as much as possible.
- Wear clothes that comfortably cover as much of your body (the darker the color, the more protection from the sun it provides).
- Wear a wide brimmed hat.
- Use sunglasses with ultraviolet (UV) protection.
- Wear sunscreen. Use at least an SPF 15 for daily use (often found in moisturizers) or an SPF 30 if planning extended sun exposure.
Also, a yearly skin exam by your dermatologist is important as dermatologists are trained to evaluate skin for melanoma.
Treatment
Treatment can be curative in the early stages of melanoma. This involves surgical removal. However, if the melanoma has spread from the skin, further medical evaluation must occur. This may include, but is not limited to, a lymph node biopsy, computed tomography (CAT scan), and/ or magnetic resonance imaging (MRI). Depending upon results, chemotherapy, immunotherapy, or radiation therapy may be required for treatment in addition to surgical removal.
While many of the above recommendations for prevention can seem cumbersome, they can be life saving in prevention of a deadly disease. Melanoma can be cured, especially when diagnosed at an early stage. When in doubt of a suspicious mole, never hesitate to consult a dermatologist, as it can save your life.
By Pamela Summers, MD
References
1. American Cancer Society. http://www.cancer.org/docroot/CRI/CRI_2_1x.asp?dt=39. viewed 4/1/2007.
2. Gloster HM Jr, Neal K. Skin cancer in skin of color. J Am Acad Dermatol. 2006 Nov;55(5):741-60.
3. Gray-Schopfer V, Wellbrock C, Marais R. Melanoma biology and new targeted therapy. Nature. 2007 Feb 22;445(7130):851-7.
4. Pennello G, Devesa S, Gail M. Association of surface ultraviolet B radiation levels with melanoma and nonmelanoma skin cancer in United States blacks. Cancer Epidemiol Biomarkers Prev. 2000 Mar;9(3):291-7.
5. Hu S, Ma F, Collado-Mesa F, Kirsner RS. UV radiation, latitude, and melanoma in US Hispanics and blacks. Arch Dermatol. 2004 Jul;140(7):819-24.
6. Halder RM, Ara CJ. Skin cancer and photoaging in ethnic skin. Dermatol Clin. 2003 Oct;21(4):725-32.
7. Rahman Z, Taylor SC. Malignant melanoma in African Americans. Cutis. 2001 May;67(5):403-6.
8. Byrd KM, Wilson DC, Hoyler SS, Peck GL. Advanced presentation of melanoma in African Americans. J Am Acad Dermatol. 2004 Jan;50(1):21-4.
9. Ramirez R, Schneider J. Practical guide to sun protection. Surg Clin North Am. 2003 Feb;83(1):97-107.
10. American Academy of Dermatology. http://www.aad.org/public/Publications/pamphlets/MalignantMelanoma.htm. viewed 4/2/2007.
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