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As spring turns to summer and warmer weather draws more people outdoors, skin cancer may become at least a distant concern. But experts say it’s important to take the risk seriously.
Ultraviolet rays from sunlight are a leading risk factor for skin cancer, affecting one in five Americans during their lifetime. This includes melanoma, one of the deadliest types. About 100,000 people in the United States are diagnosed with melanoma each year, and about 8,000 die from it each year, according to the American Cancer Society.
Luckily, there are simple ways to reduce your risk and catch potential cases early, while they are most treatable. Therapies approved over the past 15 years have also transformed the treatment of melanoma, extending and improving the lives of patients even in advanced stages of the disease.
Here’s what you need to know about melanoma, its treatment and how to protect yourself.
What is melanoma?
Melanoma is a cancer that usually begins in skin cells known as melanocytes, which produce skin pigment. Compared to more common skin cancers that start in squamous or basal cells, melanoma is more likely to spread to other parts of the body.
“It does have very aggressive behavior and biology,” said Dr. Michael Davis, chairman of melanoma medical oncology at the University of Texas MD Anderson Cancer Center.
Most melanomas appear as flat or slightly raised dark-colored patches on skin that is frequently exposed to ultraviolet light, such as the scalp and face, arms, back, and legs (although they can occur in areas that have never been exposed to the sun) . , too much). In fewer cases, the growth may appear as a dark or red bump and grow into the skin, which can make it difficult to detect.
A less common form, lentigo maligna melanoma, mainly affects older people who have had significant sun exposure and often appears as irregularly shaped brown or brown spots on the head or neck. An even rarer type, called acral lentiginous melanoma, occurs on the arms and legs (especially the soles, palms, fingers, toes, or nail beds) and accounts for more than half of melanoma cases in people of color. (Musician Bob Marley died from this type of melanoma, which was initially mistaken for a bruise.)
Melanoma can also occur in the eyes or on mucous membranes, such as inside the nose or throat, but these cases are rare.
Who is at risk? And can melanoma be prevented?
Melanoma is thought to be caused by a combination of genetic and environmental factors. One of the main dangers is exposure to ultraviolet radiation, including from the sun and tanning beds. A history of severe sunburn may increase the risk; as is life near the equator or at high altitudes where the sun’s rays are more intense.
The best way to reduce your risk is to avoid unnecessary UV exposure. The sun’s rays are strongest between 10am and 4pm, so limit your time outside during these hours. Wear protective clothing and glasses and regularly apply sunscreen with an SPF of at least 30.
Dr. Shanthi Sivendran, a medical oncologist and senior vice president of the American Cancer Society, also warns against using tanning lamps and beds, which significantly increase the risk of developing melanoma. Twenty states and the District of Columbia prohibit minors from using tanning beds, in part because of this concern, according to the Skin Cancer Foundation. But six states (Alaska, Colorado, Iowa, Montana, New Mexico and South Dakota) do not restrict them from doing so.
People with fair skin are more vulnerable to UV damage. But Dr Sivendran said this did not mean people with darker skin should not remain vigilant. “You can get melanoma no matter the color of your skin,” she said.
It’s also important to know if you have a family history of melanoma, which may increase your risk. People with weakened immune systems are also more likely to develop melanoma. Although about half of cases occur in people 66 years of age or older, younger people can also develop melanoma.
How to detect melanoma?
Catching melanoma early is vital because almost all cases that have not spread to other parts of the body are curable. However, once the disease reaches the lymph nodes or more distant organs, the five-year survival rate drops significantly.
There are no standard recommendations for skin cancer screening, but doctors may examine your skin for abnormalities during your annual exams. Dr. Kelly Nelson, a dermatologist at MD Anderson Cancer Center, also recommended that patients perform regular head-to-toe self-exams.
To recognize changes in your skin, it helps to become familiar with it, says Dr. Nelson. “People who know better what the skin on their back looks like are less likely to die from melanoma than people who have no idea at all.”
“It’s a fine line to walk between a certain degree of skin awareness and not worrying that every mole on your body is a ticking time bomb,” she added.
To differentiate melanoma from common moles or irritations, dermatologists suggest checking for “ABCDEs”: spots that have an asymmetrical shape, a jagged or scalloped border, an unusual color pattern, a diameter greater than six millimeters, or a spot that has developed over time.
In practice, however, Dr. Nelson says patients often find it difficult to make this distinction. She recommended paying attention to “ugly ducklings,” that is, abnormalities that stand out for some reason.
How is melanoma treated?
If the cancer has not spread, the doctor will likely cut out the tumor along with an edge of the surrounding skin. They may also biopsy nearby lymph nodes to assess the risk of cancer spreading and help the doctor decide whether further treatment is needed.
Although melanoma is more likely to be fatal if it reaches distant parts of the body, significant advances in treatment have improved the prognosis even for those who do not contract the cancer early.
These include treatments that use the immune system to fight tumors, as well as targeted therapies that directly attack cancer cells.
More innovations are on the way. In February, the Food and Drug Administration approved the first cancer treatment using tumor-infiltrating lymphocytes, known as TIL therapy, for use against melanoma that has not responded to other treatments. In late-stage clinical trials, scientists are also testing a vaccine tailored to the specific genetic makeup of a patient’s cancer.
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