Summer 2005
Summer weather is here, and it's tempting to get out in the sun to enjoy the outdoors. Unfortunately, increased time outdoors is associated with a deadly skin cancer called melanoma.
Over 50,000 new cases of melanoma are found every year in the U.S, and more than 7,000 Americans die of this disease each year - and the numbers are rising. But melanoma can be cured if detected and treated early.
What is melanoma? Melanoma is a highly malignant skin cancer. It usually starts in a benign mole or pigmented spot on the skin. The skin lesion typically is dark in color but may have areas of red, blue or tan associated with the brown or black areas. It can be level with the skin surface in its early stages or raised up into a nodule as it grows. Melanomas often have a notched or irregular border. Sometimes they bleed, ooze or itch.
Melanomas occur most often on the back in males and on the legs in females, but can occur anywhere, including the palms of your hands, soles of your feet, your scalp - even under your fingernail. A melanoma is usually confined to the skin lesion at first, but once it becomes cancerous it can spread to organs distant from its initial location. The characteristics of a melanoma can be summarized as:
- A for Asymmetry: One side of the lesion is not a mirror image of the other.
- B for Border irregularity: The edge is notched or scalloped.
- C for Color variation: The lesion is not one solid color.
- D for Diameter: The lesion is larger than a pencil eraser.
Who is at risk? Most people who develop melanoma have light skin, but melanoma can strike anyone. Risk factors include:
- fair skin; light hair; blue, green or gray eyes
- tendency to sunburn easily
- history of one or more blistering sunburns as a child
- history of a lot of exposure to the sun, even if the exposure ended when you became an adult
- previous personal history of melanoma
- family history of melanoma
- compromised immune system
How can you prevent melanoma? The most effective preventive measure is avoiding sun exposure between 11:00 a.m. and 3:00 p.m., when ultraviolet radiation levels are highest. Tanning salons are dangerous as well. In Australia, which has the world's highest incidence of skin cancer, every child is taught to "Slip! Slop! Slap!" to protect their skin:
- Slip on a long-sleeved shirt (and other sensible clothing).
- Slop on some sun block (SPF 30, reapplied every two hours).
- Slap on a broad-brimmed hat that will protect your neck (and remember sunglasses, too).
Early detection of melanoma is critical to successful treatment. Look at your skin periodically to get familiar with your moles and birthmarks. If you notice an odd-looking skin lesion, especially a mole with one or more of the "ABCD" characteristics, contact your doctor as soon as possible. Melanoma can be cured if detected and treated early.
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David N. Tornberg, M.D., is Deputy Assistant Secretary of Defense for Clinical and Program Policy and Chief Medical Officer for TRICARE Management Activity.
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Melanoma: A Closer Look
How dangerous is melanoma? In the U.S. Caucasian population, one in 90 individuals will develop a melanoma in their lifetime, and the cancer will cause more than 7,500 deaths this year. It is the second leading cause of cancer in males age 30 to 49.
If a person has black or brown skin, is there still a risk of melanoma? The risk is much less for individuals with black or brown skin. However, if a melanoma does occur, it is usually on the soles or toes of the feet and easily missed by that individual. Bob Marley's melanoma was discovered on his feet before it spread and eventually took his life.
Where does one look for melanoma? It is most common on the skin of the back, above the waist. Special attention also should be given to the back of the legs between the knees and ankles, and the scalp. These areas are not easy to examine alone. It is essential to have regular physician screenings. The watchfulness of family and friends also is important.
What can be done to help prevent melanoma? The key is to avoid sun (ultraviolet) exposure. If your skin is exposed, use sunscreen with a Sun Protection Factor (SPF) rating of 15 or greater. Apply sunscreen often (at least every hour) as it will wear off, especially in youngsters. Waterproof sunscreen needs to be absorbed into the skin for 10 minutes before going in the water. However, it will still wear off from salt water or the sand on the beach.