Summer is here. Protect yourself against melanoma

Melanoma is the fifth most common cancer in adults in the U.S., and accounts for about 5 percent of all U.S. adult cancer diagnoses, according to Kevin Moore, MD, a dermatologist and Mohs micrographic surgeon in Marstons Mills.

“A little more than 100,000 Americans are diagnosed with invasive melanoma annually, which is a big number,” he said.

Melanoma is a skin cancer that originates from cells called melanocytes which are cells that produce the pigment in our skin and give us our natural skin tone, according to Dr. Moore, who practices out of Contemporary Dermatology. The majority of melanomas are related to ultraviolet (UV) radiation naturally from the sun or artificially from a tanning bed, Dr. Moore said. However, there are some types that don’t have to do with exposure to the sun. One of them is acral lentiginous melanoma, which the famous reggae singer/songwriter Bob Marley died from in May 1981 at the age of 36. This is a rare form of melanoma that develops on the palms of the hands, soles of the feet or under the nails, and typically occurs in darker skinned individuals. A genetic condition, xeroderma pigmentosum (XP) carries an increased risk of developing melanoma, he noted.

Warning Signs

“We use the acronym ABCDE when we talk about the warning signs of melanoma,” said Dr. Moore.

A: Asymmetry: The mole looks asymmetrical, and one half of the mole does not look like the other half.

B: Border: The border of the mole is jagged or not smooth. It has an irregular shape to it.

C: Color: Moles are normally a solid color. The entire mole should be light brown, medium brown or dark brown. If it becomes multicolored, then we need to keep our eye on it.

D: Diameter: A mole should be less than 6 mm in size, which is the diameter of a number two pencil eraser. It is a red flag if the mole is larger than 6 mm.

E: Evolution: This is the most important warning sign. Anything that is changing or growing, bleeding, becomes itchy or starts to hurt, needs to be checked by a dermatologist.

Prevention

“Prevention revolves around limiting sun exposure or doing it safely with lotions or sprays containing SPF (sun protection factor) or clothing that contains UPF (ultraviolet protection factor),” said Dr. Moore.

Dr. Moore recommends the following for sunscreen use:

• Sunscreen with 30 or 50 SPF: SPF 30 blocks out 97 percent of UVB (ultraviolet B radiation), the type of radiation that causes sunburn and skin cancer. SPF 50 blocks 98 percent of UVB rays.
• There is also the added benefit of anti-aging, if you use a broad-spectrum sunscreen that will protect from UVB and UVA (ultraviolet A, which is a component of natural sunlight and artificial sources like tanning beds). This protection is called PA (protection grade of UVA). The PA on the label of the sunscreen is shown as PA+, PA++, PA+++ and PA++++. The more plus signs indicate a higher level of protection.
• Reapply sunscreen at least every two hours because it either gets washed off when you swim or by sweat.

Diagnosis and Treatment

Dr. Moore most commonly sees melanoma in men in their 50s and early 60s.

“The most common area for melanoma in men is on their backs and females on their legs,” said Dr. Moore. “I also see it on the head and neck. These are all areas we don’t check every day, so it’s important to have skin checks done by your spouse, your primary care physician or a dermatologist.”

If melanoma is diagnosed in the early stage and is superficial, the area can be removed under local anesthesia in the office, Dr. Moore said. Patients with deeper melanomas are referred to a surgical oncologist and sometimes require sentinel biopsies of the lymph nodes. If the melanoma is invasive, further treatment is required and can include immunotherapy, which has revolutionized the treatment of melanoma over the past two decades, he said.

“The most important thing for people to know is that early detection and early diagnosis are key,” said Dr. Moore. “The survival rate for stage I melanoma is 99 percent, whereas the survival rate for stage IV melanoma is 14 percent. That is a huge difference in survival. It is always better to seek out a dermatologist early if you have a question about a spot.”

The VNA of Cape Cod Public Health & Wellness team also offers skin cancer screening clinics to various town residents across Cape Cod. To learn more about events in your area, the team can be reached at 508-957-7423.