The American Cancer Society statistics for 2018 state that over 200,000 people will be newly diagnosed with melanoma. Melanoma is one of the most dangerous types of skin cancer and occurs most often when ultraviolet radiation from the sun or tanning beds or genetic mutations allow the skin cells to multiply and grow rapidly forming malignant tumors. Melanoma begins in pigment-making cells in the basal cell layer of the epidermis. They often resemble moles, but most are often black or brown. In some cases, the coloring of the mole has been skin-colored, pink, purple, white, blue or red. Melanoma has been linked to the over-occurrence of sunburns and not practicing safety when outdoors.
Of the over 200,000 people estimated to be diagnosed with melanoma this year alone, over 90,000 of those cases will be noninvasive, and just over 110,000 will be invasive; which means the growth of cells is penetrating the epidermis and into the second layer of skin. If melanoma is caught and treatment is sought early, the outcomes are much better as melanoma can be cured. If ignored or not caught in time, melanoma can spread elsewhere in the body, where it becomes much harder and more complex to treat. Of those diagnosed this year, just over 9,000 will lose their battle with this form of cancer and of those, sixty percent will be men.
Self-checks, Signs, and Symptoms of Melanoma
Performing self-checks year-round is an important aspect of skin health that not many people remember to regularly do. Even if you have spent the entire summer avoiding the sun, wearing long sleeves or sunscreens, there is always a chance that you could still have melanoma. A self-check requires a mirror or another person, focus and time. Simple disrobe and look at all of your skin in a mirror. Take note of any new moles or freckles and any skin changes, discoloration, marks, bumps or lumps that might be present. Simply finding a new growth does not necessarily mean that you have cancer. Simply monitor your skin and let your doctor know of your findings at your yearly check-up.
While most moles and skin marks are non-cancerous, many have the potential to be and knowing how to spot them could save your life. An easy way to remember how to monitor your skin and moles is to remember the ‘ABCDE Melanoma’ checking rule.
The ABCDEs of Melanoma
Asymmetry happens when two sides of one object are not even and would not “line up” if you cut it in half and folded it on itself. If you have a mole or skin mark that is changing with asymmetrical edges, or edges that do not look the same, you should count this as a warning and let your doctor know.
The Border of the mole tells much about it and if it is cancerous. A smooth border with even edges usually signifies a benign growth. The edges of early melanoma growth are usually jagged and uneven, with notched edges.
Color plays an important role in mole identification as well. Benign moles are most often one color, usually one shade of brown. Having any variety of colors tells that this could be a cancerous growth and should be investigated and checked out further. Remember, melanoma can be a variety of color, so do not go off of color alone.
The size and Diameter of the mole is also important. Moles that are benign tend to be on the smaller size. Malignant melanomas are normally the size of a pencil eraser or larger.
Watch for signs of the mole or skin mark Evolving or changing. Moles are typically the same shape and size forever unless they have abnormal cell growth. If you notice your mole is growing, changing color, or the border lines are different, take note and report this to your medical care team upon your next visit.
Types of Melanoma
With this type of skin cancer, there are four main types. All melanomas can continue to grow until they are removed or treated. Some types are noninvasive and turn to being invasive, and others begin that way.
Lentigo Maligna Melanoma remains close to the top layer of the skin and appears as a mottled tan or brown discoloration. This type is often found in the elderly and those who have had repeated sun exposure for years. In Hawaii, this is the most common form of skin cancer (ACS).
Superficial Spreading Melanoma is the more common type and makes up for over seventy percent of all diagnoses. This type grows along the top layer of the skin and manifests frequently in younger patients. This type has the potential to become much more serious without treatment. The first signs of this are usually slightly raised and discolored patches of the skin that have irregular borders and form. Pay attention to all moles and skin tags as many begin this way.
Nodular Melanoma is invasive upon first diagnosis. This malignancy is recognized and diagnosed immediately upon visual and cell biopsy. These are usually black but can be any color previously mentioned. These occur most often in elderly men on their scalp, and on the trunk, legs, and arms of those diagnosed. Ten to fifteen percent of melanoma diagnosis are this very invasive type. If you notice any moles that resemble this description, do not wait to alert your doctor.
Acral Lentiginous Melanoma is a superficial spreading cancer that has the potential to penetrate deeper into the tissues and body. It is different from the others, as this appears as a brown or dark discoloration under the nails of the fingers or toes, on the soles of the feet, or on the palms of the hands. This type of cancer can be found on any human of any race but tends to be one that is diagnosed in those with darker skin tones and is most common in African American and Asian cultures. This is the least common form of skin cancer for Caucasian humans.
Treatment for Melanoma
For the most part, treatment of melanoma cancers are pretty cut and dry. First, removal of the tumor and excising any margins begins the process of riding the body of this cancer. This surgical removal is called a resection. Resections are very common for many types of cancers and are quite quick and safe procedures most often done in an outpatient setting.
For basal cell and squamous cell carcinomas, Mohs Micrographic Surgery is done. In this procedure, layer by layer of the growth is removed and immediately scanned to check for cancer cells. The process is repeated layer by layer until the scans show no sign of cancer cells. This type of surgery eliminates the guesswork and wondering if all of the cancer was removed. Your doctor and medical care team will be able to address your concerns about this treatment. Do not hesitate to ask.
Risks for Getting Melanoma
Everyone is at risk for melanoma, regardless of how many precautions you take. There are things that can be avoided or changed to lessen the risk. Sun exposure is always at the top of the list. Avoiding sunburn, wearing protective clothing, wearing hats when going outdoors, and wearing sunscreen can all help lessen the direct risk from sun exposure. Those who are fair skinned should pay careful attention to avoid serious burns from ultraviolet rays from the sun or from a source of the fake sun like the tanning bed.
Having a family history of cancers or skin cancer can also heighten your risk, or if you are immunocompromised or struggle with chronic health conditions. Your doctor will go over the risk factors with you and determine if there are other changes you could make to further lessen your risk.
Here are the prevention guidelines recognized by almost all doctors in the United States of America.
-Don’t get sunburned.
-Avoid tanning and never use UV tanning beds.
-Seek the shade between the hours of 10 am and 4 pm.
-Cover up with clothing, including a broad-rimmed hat and UV blocking sunglasses.
-Apple 1 ounce or two tablespoons of waterproof sunscreen to your entire body thirty minutes before going outside. Reapply every TWO HOURS or after swimming or sweating.
-Use a broad-spectrum UVA/UVB sunscreen with an SPF of 30 or higher every day and every time you are outside. For those outside for longer periods, use a waterproof variety.
-Examine your skin every month, and schedule yearly check-ups with a Dermatologist.
-Keep newborns out of the direct sun. Sunscreen is safe for babies over six months old.
If you have moles or skin marks that are changing or are causing you worry, simply make a note to mention to your doctor at your next check-up. If you find yourself having multiple symptoms of melanoma, do not hesitate to contact your medical care team to help you find the proper course of action for your needs.