Melanoma: What You Need to Know

By Jane Farrell

Although skin cancer isn’t of as much concern to people as better known and more serious cancers such as those of the breast and colon, it can be very serious – especially in its most dangerous form, melanoma. Here, from the American Academy of Dermatology, is what you need to know about the illness that will cause an estimated 9,940 deaths in 2015.

The AAD experts say that melanoma is highly curable when it is detected earlier, but it can be much more serious if it spreads to the lymph nodes and internal organs.

Like other kinds of skin cancer, the illness is caused by exposure to natural and artificial ultraviolet light, according to the AAD. Other risk factors include age – people over 65 are more vulnerable because of all the UV exposure they’ve received during their lives. (Men of over 50 also have a higher risk.) If you’ve had five or more blistering sunburns between age 15 and 20, that increases your melanoma risk by 80 percent.

Tanning-bed use, a family history and a previous history of any type of skin cancer or cancer in general raises the risk, as does having immune deficiencies.

And the illness can strike anyone. There’s a mistaken impression that people of color cannot get melanoma, but that is not true. Possibly because of this belief, the AAD says, melanoma is often not detected in people of color until a late stage.

The AAD urges people to pay close attention to moles. Most people have moles (also known as nevi), the AAD says. Atypical moles are unusual moles that are generally larger than normal moles, vary in color, often have irregular borders and may occur in far greater number than regular moles. Atypical moles occur most often on the upper back, torso, lower legs, head and neck, the association says.

But they emphasize that atypical moles are not limited to any specific body area — they may occur anywhere. The presence of atypical moles is an important risk factor for melanoma developing in a mole or on apparently normal skin. People who have 50 or more moles are especially at risk for melanoma.

Recognition of changes in the skin is the best way to detect early melanoma. They most frequently appear on the upper back, torso, lower legs, head and neck.12,20 In females 15-29 years old, the torso/trunk is the most common location for developing melanoma, which may be due to high-risk tanning behaviors.12,20 If you have a changing mole, a new mole, or a mole that is different, make an appointment to see a board-certified dermatologist.

If you notice a mole on your skin, the AAD says, you should follow the ABCDE rule, which outlines the warning signs of melanoma:

Asymmetry: One half does not match the other half.

Border irregularity: The edges are ragged, notched or blurred.

Color: The pigmentation is not uniform. Different shades of tan, brown or black are often present. Dashes of red, white, and blue can add to the mottled appearance.

Diameter: While melanomas are usually greater than 6mm in diameter when diagnosed, they can be smaller.

Evolving: A mole or skin lesion that looks different from the rest or is changing in size, shape or color.

If you notice a mole different from others, or that changes, itches or bleeds, even if it is smaller than 6mm, you should make an appointment to see a board-certified dermatologist as soon as possible.

In its earliest stages, melanoma is easily curable. The average five-year survival rate for people whose illness is caught before it spreads to lymph nodes is 98 percent. Five-year survival rates for regional (lymph nodes) and distant (other organs/lymph nodes) stage melanomas are 63 percent and 16 percent, respectively, the AAD says

Early detection is essential. Dermatologists recommend a regular self-examination of the skin to detect changes in its appearance. Additionally, patients with risk factors should have a complete skin examination by a board-certified dermatologist annually. Anyone with a changing, suspicious or unusual mole or blemish should be examined as soon as possible. Individuals with a history of melanoma should have a full-body exam at least annually and perform monthly self-exams for new and changing moles.21

You can help prevent melanoma, the AAD says, by watching your sun exposure. Specifically, the experts advise:

Seeking shade when appropriate; the sun’s rays are strongest between 10 a.m. and 2 p.m.  If your shadow is shorter than you are, seek shade, the AAD says.

Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.

Generously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30. “Broad-spectrum” means that the product provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.

Use extra caution near water, snow and sand, because they reflect the sun’s damaging rays.

Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you’ve been in the sun, the AAD says, you may wish to use a sunless self-tanning product, but you should continue to use sunscreen with it.

For more information on skin issues, visit www.aad.org, the website of the American Academy of Dermatology.