With Skin Cancer Awareness Month in full swing, I thought this was the perfect opportunity to discuss the realities of melanoma — and why it’s crucial to catch this type of skin cancer as early as possible.
What is melanoma?
Melanoma is a type of cancerous growth that originates from a particular type of skin cell called the melanocyte. This cell is responsible for creating the pigment (aka color) of our skin, and is also the primary type of cell within our nevi, or what we commonly call moles. Melanomas, like most cancers, are caused by damage or alteration to our DNA. In the case of melanoma, this DNA damage causes melanocytes to change and become atypical. If these atypical cells divide and grow, it can lead to the appearance of malignant tumors. This DNA damage is most frequently caused by exposure to UV radiation, usually from the sun or tanning beds. Genetics also plays a big role, as does skin type (those with fair skin, light eyes and light hair have an increased risk), a weakened immune system, or a disposition of moles and freckles. Half the time, melanomas will develop within a pre-existing mole, and half the time they will develop on previously normal-appearing skin.
What is particularly devastating about melanoma is that it often takes people by complete surprise, at an age when the last thing they are thinking about is their mortality.
Melanoma is a cancer that tends to strike when people are in their “prime” — when they’re in their 20’s, 30’s, and 40’s, building their lives, careers, and families. There are many melanoma statistics, but the one I point to most frequently is that when melanoma is caught in Stage 1, the 10-year survival rate is 95%. Unfortunately, this number drops significantly (to 10%) if the cancer is found in stage 4.
What I want to share with you is that melanoma can be caught in its very early stages and is very treatable at this stage. It’s so important that you are diligent about checking your own skin because often, the patient can be the first person to bring a potential dangerous growth to their doctor’s attention.
So, now you’re probably asking “OK, well what do I look for?”
It’s important to understand that melanoma can come in all forms. Look at the images below. How many of these would you guess are melanoma?
I think many of you may be surprised to learn that all of the above are melanomas. Since melanoma can appear so subtly, and in so many forms, it can be hard to detect. Many times people come into my office thinking something is cancer but it’s not, and vice versa. Melanoma doesn’t always present the way that we think it might.
To minimize your chances for developing melanoma as much as you can, it’s crucial to stay out of the sun and use proper sun protection whenever possible. Getting a tan may look good temporarily, but it’s dangerous in the long term. But also remember that a melanoma can develop anywhere that you have melanocytes pigment cells, meaning melanoma can also occur on your body where the sun doesn’t often shine.
My other advice is to get your skin examined, and examine your own skin. You know your body best, and you probably have a gut instinct about something on your body that doesn’t look quite right. If you feel this way, bring it to the attention of your dermatologist who hopefully can allay your fears.
Skin checks are especially important if you have a personal history or a family history of melanoma. If you aren’t sure, ask your parents or grandparents about your family history — if anyone in your family has had a melanoma in the past, you’re more susceptible. Note that this is different than having a family history of the more common but much less life-threatening type of skin cancers, basal cell carcinomas (BCC’s) and squamous cell carcinomas (SCC’s). If you have a family history of BCC’s and SCC’s this does not directly increase your chances for melanoma. Those with a history should be getting their skin checked thoroughly at least once a year.
Dermatologists have created a simple, straightforward method of examining your moles or any unusual skin growths: When examining your body for abnormal growths, start with the ABCDEs of Moles:
Asymmetry: If a mole’s shape is uneven, i.e. if one side is bigger than another this makes it more suspicious.
Border: A normal mole has a solid, even border, but an abnormal growth is more likely to have an uneven, notched edge.
Color: If the mole is varying shades, not one solid color, this increases the suspicion that it’s melanoma.
Diameter: Any mole that’s larger than 6 mm should be watched more closely.
Evolution: After our late 20’s, we really don’t develop any new moles on our body. Generally speaking, our moles grow as we grow, but once we reach full size, they shouldn’t continue to grow or change. So, if a mole on your body is evolving, meaning it’s changing in shape, size, color, or consistency, it should be looked at.
See a mole or bump or spot on your skin that looks odd? Notice that a mole has a funny shape? Think something that has recently appeared on your skin may be suspicious? Trust your instinct and go to your dermatologist to get it checked out or to get a biopsy — most of the time, getting it removed and biopsied is not as big of a deal as you might think.
Ultimately, be vigilant about protecting yourself from the sun, checking your skin, taking responsibility for your health and being aware of what’s going on with your body. Don’t forget that when a melanoma is caught early, it’s almost always curable — it’s when they’re caught late, unfortunately, that they’re often incurable.