What You Should Know About Melanoma

About 1.3 million Americans are diagnosed each year with skin cancer, the most common form of cancer.  Of these, about 47,700 people will be diagnosed with melanoma, the most serious form of skin cancer.  With careful inspection of the skin, most melanomas can be detected early and treated successfully.

There are three main types of skin cancer.  Most are either basal cell or squamous cell carcinomas which seldom become life-threatening.

Malignant melanoma is much less common.  If not detected early and treated promptly, it can be very dangerous.  This year, about 47,7000 people will be diagnosed with melanoma and about 7,700 will die from it.  Since 1973, the incidence has increased about 4% per year.

When diagnosed early, melanoma can be cured.  But if it is not found soon enough, it can be very difficult to treat.  It's therefore important to recognize any changes in your skin which could indicate melanoma, and to report them to your physician without delay.

What is Melanoma?
Melanoma is a cancer that begins in melanocytes--the skin cells that produce the skin coloring or protective pigment called melanin.  Melanin helps protect the deeper layers of the skin from the harmful effects of the sun.  When you're exposed to sunlight, the melanin in your skin increases and your skin darkens.  Melanoma consists of melanocytes which have been transformed into cancer cells that grow uncontrollably.  Melanoma cells usually still produce melanin, which is why these cancers may have mixed shades of tan, brown and black.

Unlike basal cell and squamous cell carcinomas of the skin which do not commonly spread to other parts of the body, melanoma can spread if not detected at an early stage.  Once colonies of melanoma cells reach vital internal organs and grow, they are much more difficult to treat, and are much less likely to be cured.

While melanoma may appear in the skin without warning, it may begin in or near a mole or other dark spot in the skin.  That is why it's important to know the color, size and location of the moles on your body, so you'll recognize any changes that might take place.

What Causes Melanoma?
Although, the most important known risk factor is unprotected exposure to the sun, melanoma may appear on skin that is not exposed to the sun.

Melanoma is also linked to certain types of moles.  Sometimes these are atypical moles that run in families.  These moles themselves may turn into melanomas or they may serve as markers which identify the individual at higher risk for melanoma developing elsewhere in the skin.

Who Is Likely to Get Melanoma?
Actually, no one is entirely free from the risk of melanoma. People who have the highest risk of melanoma have many moles, irregular moles, or large moles.  Those with blood relatives who have had melanoma or who have previously had melanoma themselves are also at high risk.

Other people who develop melanoma may have fair skin that burns and freckles easily and naturally red or blond hair.  They may have had sunburns as a child or as young adults, or other types of cancerous or precancerous spots on their skin at any age.  Although melanoma is less common among people with darker skin who seldom become sunburned, no one is immune to all of the damaging effects of the sun.

The risk is also higher in places where there is intense year-round sunshine.  As with most other cancers, the chance of developing melanoma increases as a person gets older.
It was once believed that dark brown or black skin was a guarantee against melanoma.  We now know that darker-skinned people can develop this cancer, especially on the hands, the soles of the feet, and under the nails.

Warning Signs
Almost everyone has moles, on the average about 25.  The vast majority of moles are perfectly harmless.  A change in a mole's appearance is a sign that you should see your physician.  However, a melanoma is more complicated than a mole.  Here's the simple ABCD rule to help you remember the important signs of melanoma and other skin cancers:

A. Asymmetry-One half of the spot does not match the other half.

B. Border irregularity-Normal moles are round or oval.  The borders of a melanoma may be uneven or notched.

C. Color-Common moles are usually one color throughout.  Melanomas may have several colors or an irregular pattern of colors.

D. Diameter-Common moles are generally less than 1/4 inch in diameter (the diameter of a pencil eraser).  Melanomas may be 1/8 to 1/4 inch, but are often larger.

Is There Any Way to Prevent Melanoma?
By avoiding exposure to intense sunlight, you can reduce your risks.  This is especially true for light-complexioned people and those with a tendency to develop many and/or atypical moles, or who are at increased risk for any reason.  Avoid direct sun exposure especially when the sun is high in the sky.

Wear protective clothing, sunglasses, and a hat.  Use a sunscreen that's rated SPF 15 or higher.  Remember, sunscreeen doesn't provide total protection from ultraviolet rays, although it does help.  Also, remember to re-apply the sunscreen after swimming or sweating.  Indoor sunlamps and tanning beds may be harmful.  Whether a tan is achieved by these artificial means or by natural sunlight, the ultraviolet dose adds to the total lifetime accumulation of UV and to the risk of skin cancer.