Its summer and that means more time outside and more sun exposure - which can increase your risk of melanoma and other skin cancers
According to the American Cancer Society, more than 100,000 people in the U.S. are diagnosed with melanoma each year. In Colorado, there are an estimated 2,000 new cases of melanoma each year. Our state has one of the highest death rates of melanoma due to our higher elevation and the fact that many Coloradans love the outdoors.
What can you do to protect yourself? We talked with CU Medicine surgeon, Dr. Camille Stewart, who’s the Surgical Director of the Melanoma Program at the University of Colorado.
What is melanoma?
Melanoma is a type of cancer that begins in cells called melanocytes, “Melanocytes live in the epidermis of your skin and produce melanin, that’s the pigment in our skin,” explained CU Medicine surgeon, Dr. Camille Stewart.
Melanoma is associated with sun exposure and often arises on visible areas of skin, but it can also develop in other sites. Because most melanoma cancer cells produce melanin, the tumors are often brown or black. However, some melanomas stop producing melanin and can appear tan, pink, or even white.
Although melanoma accounts for only about 1% of all skin cancer diagnoses, it is responsible for the majority of skin cancer deaths because of its ability to spread to other parts of the body.
When detected and treated early, however, melanoma is often curable. The estimated five-year survival rate for patients who get treatment for early-stage melanoma is 99%.
Signs of melanoma:
Melanoma typically presents as a new, irregular or changing mole or lesion. Most are non-cancerous (benign), but a mole or lesion that changes in size, shape, or color may be a sign of melanoma skin cancer, “Other important characteristics include if a lesion bleeds or if it won’t heal after it’s injured,” added Dr. Stewart.
Experts recommend that people examine their skin once a month to identify potential skin cancers, taking note of any new moles and checking existing moles or lesions for changes.
Dr. Stewart shared the "ABCDE rule” — to assess whether a mole might be cancerous:
A is for Asymmetry: If someone were to draw a line down the middle of the mole, would the two halves match? If not, it could be a sign of melanoma.
B is for Border: Are the edges of the mole uneven, irregular, jagged, scalloped, notched, or blurry? Does the color spread past the border of the mole into the area of skin around the mole? These are potential indicators for melanoma.
C is for Color: Is the mole a single, consistent color throughout? If not, it could be cancerous. Melanomas are often varying shades of tan, brown, black, blue, grey, red, pink, or white.
D is for Diameter: Is the mole larger than 6 mm across (about the size of a pencil eraser)? Large moles are more likely to develop into melanoma.
E is for Evolving: Has the mole changed color, size, shape, elevation, or texture? Any change or new symptom (such as bleeding, oozing, itching, burning, or crusting) may be a melanoma symptom.
Patients should make an appointment with their primary care provider or dermatologist if they find a mole that fits the above criteria and get a professional skin exam at least once a year. Click/tap here to find a CU Medicine location near you.
Signs of non-melanoma skin cancer:
- Skin cancer looks like an abnormal area of skin and can be:
- Red and swollen
- Bleeding or look like an open sore
- Thick or crusty
- Any new bump, or spot that bleeds easily, itches or does not seem to be healing
Reduce your risk of melanoma and other skin cancers
You can reduce your risk of melanoma and other types of skin cancer if you wear sunscreen daily and reapply often, avoid the sun during the middle of the day (10 a.m. – 2 p.m.), avoid tanning beds, and wear protective clothing – such as a wide-brimmed hat, long sleeved shirt, and/or long pants. Clothing labeled UPF (Ultraviolet Protection Factor) is recommended if you will be outdoors for long periods of time.
CU Medicine Dermatology also recommends that you do monthly skin checks to become familiar with your skin and can look for signs of skin cancer. Take note of any moles, freckles, and other marks on your body. Look for any changes in them from month to month, including shape, size, color, or symptoms such as bleeding or itching.
To perform a skin check:
- In front of a full-length mirror, look at the front of your body making sure to examine the front of your neck, chest (including under breasts), legs, and genitals.
- With your arms raised, look at both sides of your body making sure to look at your underarms.
- With your elbows bent, look at the front and back of your arms as well as your elbows, hands, fingers, areas between your fingers, and fingernails.
- Look at the tops and bottoms of your feet, the areas between your toes, and toenails.
- With your back to the mirror and holding a hand mirror, look at the back of your body, including the back of your neck, shoulders, legs, and buttocks.
- Using a hand mirror, look at your scalp and face.
Factors that may increase your risk of melanoma and other skin cancers include:
Fair skin. Having less pigment (melanin) in your skin means you have less protection from damaging UV radiation. If you have blond or red hair, light-colored eyes, and freckle or sunburn easily, you're more likely to develop melanoma than is someone with a darker complexion.
A history of sunburn. One or more severe, blistering sunburns can increase your risk of melanoma.
Excessive ultraviolet (UV) light exposure. Exposure to UV radiation, which comes from the sun and from tanning lights and beds, can increase the risk of skin cancer, including melanoma.
Living closer to the equator or at a higher elevation. People living closer to the earth's equator, where the sun's rays are more direct, experience higher amounts of UV radiation than do those living farther north or south. In addition, if you live at a high elevation, you're exposed to more UV radiation.
Having many moles or unusual moles. Having more than 50 ordinary moles on your body indicates an increased risk of melanoma. Also, having an unusual type of mole increases the risk of melanoma. Known medically as dysplastic nevi, these tend to be larger than normal moles and have irregular borders and a mixture of colors.
A family history of melanoma. If a close relative — such as a parent, child or sibling — has had melanoma, you have a greater chance of developing a melanoma, too.
Weakened immune system. People with weakened immune systems have an increased risk of melanoma and other skin cancers. Your immune system may be impaired if you take medicine to suppress the immune system, such as after an organ transplant, or if you have a disease that impairs the immune system, such as AIDS.
Treatment for melanoma
If melanoma is suspected, a biopsy is needed.
If a mole or lesion is cancerous treatment typically starts with surgery, “In general, melanoma is treated by surgically removing the tumor, along with a rim of normal skin and soft tissue to make sure it’s entirely removed,” explained Dr. Stewart, “In some patients their risk of cancer spread to lymph nodes is high enough that we also remove some lymph nodes. This is to test if those cancer cells are in those lymph nodes. If there’s cancer in them, then patients might be considered for other types of treatment,” she added.
One option for some patients being treated through CU Medicine are clinical trials, “Something that is invaluable about our group at the University of Colorado is the amount of clinical trials that are offered,” said Dr. Stewart.
Dr. Stewart said there are various circumstances where a clinical trial might be the right thing for a patient, “They may have exhausted all other treatment types or it might be that we’re trying to answer a clinical question, should we be doing things differently in the future?”
Whether or not a patient participates in a clinical trial is always their choice but if they do participate they become part of the knowledge doctors have moving forward.
Click/tap here to learn more about clinical trials for melanoma through the University of Colorado.
Click/tap here to learn more about Dr. Camille Stewart.
If you are concerned about your melanoma risk, click/tap here to book an appointment with CU Medicine Dermatology.