As days get longer and warmer, people are flocking outdoors for recreation, yard work, and gardening. The sun’s rays feel great, but leaving your skin unprotected could lead to an unwelcome diagnosis.
Skin cancer is by far the most common cancer in the United States. In fact, more skin cancers are diagnosed in the US each year than all other cancers combined. About one percent of skin cancers will be melanoma, the most serious form. Melanoma is far less common, but this year an estimated 5,150 New Yorkers will learn they have the disease.
Before you head outdoors, here are four things the American Cancer Society wants you to know about melanoma.
Who is at risk?
While skin cancer is the most common cancer type, melanoma is far less common. Some risk factors for melanoma you should be aware of include:
Gender: In the United States, men have a higher rate of melanoma than women, although this varies by age. Before age 50, the risk is higher for women; after age 50, the risk is higher in men.
Age: The risk of melanoma increases as people age. The average age of diagnosis in people is 63; but it’s not uncommon to see cases in people under 30, especially women.
Race: Melanoma is more than 20 times more common in whites than in African Americans. Overall, the lifetime risk is about 1 in 30 for whites, 1 in 172 for Hispanics, and 1 in 1,000 for blacks. Whites with fair skin that freckles or burns easily are at especially high risk.
Immune system suppression: People with weakened immune systems have an increased risk of developing melanoma. For example, people who get organ transplants are usually given medicines that weaken their immune system to help prevent them from rejecting the new organ. This increases their risk of melanoma. People infected with HIV, the virus that causes AIDS, often have weakened immune systems and are also at increased risk for melanoma.
UV light exposure: Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. Sunlight is the main source of UV rays. Tanning beds and sun lamps are also sources of UV rays. While UV rays make up only a very small portion of the sun’s rays, they are the main cause of the damaging effects of the sun on the skin.
Moles: A mole is a non-cancerous pigmented tumor. Babies are not usually born with moles; they often begin to appear in children and young adults. Most moles will never cause any problems, but someone who has many moles is more likely to develop melanoma.
Family history: Your risk of melanoma is higher if one or more of your first-degree relatives (parents, brothers, sisters, or children) has had melanoma. Around 10% of all people with melanoma have a family history of the disease.
Having a risk factor, or even multiple risk factors does not mean you will get melanoma. Still, it’s important to know the risk factors because there may be things you can do to lower your risk.
What are the signs or symptoms?
The most important warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape, or color. Another important sign is a spot that looks different from all the other spots on your skin. If you have one of these warning signs, have your skin checked by a doctor.
The ABCDE rule is another guide to the usual signs of melanoma. Be on the lookout and tell your doctor about spots that have any of the following features:
A is for Asymmetry: One half of a mole or birthmark does not match the other.
B is for Border: The edges are irregular, ragged, notched, or blurred.
C is for Color: The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), although melanomas can sometimes be smaller than this.
E is for Evolving: The mole is changing in size, shape, or color.
Some melanomas don’t fit these rules. It’s important to tell your doctor about any changes or new spots on the skin, or growths that look different from the rest of your moles.
Other warning signs are a sore that doesn’t heal; spread of pigment from the border of a spot into surrounding skin; redness or a new swelling beyond the border of the mole; change in sensation, such as itchiness, tenderness, or pain; change in the surface of a mole – scaliness, oozing, bleeding, or the appearance of a lump or bump.
Be sure to show your doctor any areas that concern you and ask your doctor to look at areas that may be hard for you to see. It’s sometimes hard to tell the difference between melanoma and an ordinary mole, even for doctors, so it’s important to show your doctor any mole that you are unsure of.
Is melanoma treatable?
When they occur, most skin cancers can be treated successfully if detected early – even melanoma, the most serious type of skin cancer.
Can it be prevented?
Most skin cancers could be prevented by limiting unprotected exposure to the sun. In addition to seeking shade, the American Cancer Society recommends the Slip! Slop! Slap! Wrap!® method of prevention – slip on a shirt, slop on a broad-spectrum sunscreen of at least SPF 30, slap on a hat, and wrap on sunglasses before any exposure to the sun.
If you or a family member is facing melanoma or other skin cancer, the American Cancer Society can help you learn about treatment options and possible side effects and point you to information and services to help you in your cancer journey. Visit cancer.org/skincancer or call 1-800-227-2345.
Some thoughts on my experience with Acral-lentiginous melanoma
By Vikki Moran
According to The National Cancer Institute, “Acral-lentiginous melanoma represents approximately 8% of all melanomas and is the most common melanoma in dark-skinned people. Acral-lentiginous melanomas represent up to 70% of melanomas in blacks and up to 46% in Asians. This type can occur on the palms, soles, and nail beds (subungual). Like nodular melanoma, acral-lentiginous melanoma is extremely aggressive, with rapid progression from the horizontal to the vertical growth phase.”
As a Caucasian woman whose ancestry does not reflect either African American or Asian traces, I am here to tell you that you cannot let your guard down concerning this deadly form of melanoma. I was first diagnosed six years ago, and then again this past September. I have had two surgeries, with the latest being a partial amputation of my big toe. A team of specialists at the Mayo Clinic feel that this may occur more times during my life because of the type of relentless cancer that Acral-lentiginous melanoma is.
I have written about my battle with melanoma for Capital Region Living Magazine in the March 2012 article aptly titled, Just wear darker nail polish. I encourage you to read it if you have not already.
What can you do:
1. Don’t be swayed against caution concerning chance or percentages. I am living proof that everyone can get this cancer.
2. Take off that dark polish and opt for lighter shades of nude polishes. If you go from polish to polish, take a break and check those nails carefully for lines and moles. Mine started as a vertical line.
3. Get answers if you see something abnormal on your nails. It took me years to get answers. Many doctors told me that I didn’t have cause for worry and that I only had a pigmentation issue. I finally found a wonderful doctor who took one look and said to get a biopsy quickly. I will never know if an earlier diagnosis would have changed my eventual outcome, but I do know that if this cancer were more understood and recognized, I would be healthier for sure. You have to be your own advocate.
4. Wear sunscreen all over, including your nails. My oncologist is not sure that this disease is caused by the sun, as other melanomas are, but there just isn’t enough data yet to dispute the caution, so be safe.
5. Look over your children’s nails as they typically don’t speak up or are unaware of such things. Be their eyes and advocate.
6. Listen to Bob Marley’s music. I know that sounds like odd advice and certainly not something the medical community is going to tell you, but know this…had there been more awareness of Acral-lentiginous melanoma, he may still be alive and performing today instead of having succumbed to the disease at such a young age.