The warmth of summer has a deadly secret. It’s during these hot days that you’re at higher risk of developing melanoma – the most aggressive form of skin cancer – which can come back to haunt you later in life.
You don’t have to look far to see melanoma at work. Former U.S. President Jimmy Carter made headlines last year when he announced his advanced melanoma was in remission. That’s significant because advanced skin cancer is often lethal, as Carter’s was, and it could have been the end of him. But new melanoma drugs appear to have saved his life.
Melanoma is the most aggressive form of skin cancer, but it’s not without irony. Skin cancer is largely preventable, and you can often spot melanoma before it gets out of control. In this article we’ll discuss melanoma risk factors, along with developments in health news and review some basic prevention tips that may help you side-step this aggressive form of skin cancer in the first place.
Skin cancers are abnormal cell changes in the outer layers of skin. They are the most commonly diagnosed cancers in the world and account for 75% of all cancer diagnoses.
Skin cancer comes in two forms:
Melanoma – The deadliest form of skin cancer. Melanoma can start in heavily pigmented skin, like a mole or birthmark, though it can begin in normal skin as well. It typically starts on the extremities, back or chest, though it may appear on other areas, like the palms, soles of the feet, in the mouth, vagina and even the eyes.
Melanoma tends to spread faster than other skin cancers and kills about 10,000 Americans each year. At present it is incurable if it spreads to other areas – although new drugs may change that in the future.
Non-Melanomas – These are more common and typically less-threatening, although you shouldn’t ignore them either. Non-melanomas are either basal cell carcinoma or squamous cell carcinoma. They progress slower than melanoma and are usually treatable.
Incidents of skin cancer are rising, despite the fact it can usually be prevented by limiting exposure to UV radiation.
Skin cancer is about three times more common in men than women, and risk appears to increase with age. Most patients are diagnosed with melanoma between 45 and 54 – although that range is getting younger by the year.
You’re more likely to get skin cancer if you’ve had it before or have it in your family. Geography and race factor in too; fair-skinned people who migrate to hot climates like Australia tend to have higher rates of melanoma.
All malignant skin tumors eventually become visible on the skin’s surface. This makes skin cancer the only cancer that is almost always detectable in its early stages – spot it early and you have a higher chance of survival.
Watch your skin for unusual changes to spot signs of melanoma. You’re looking for strange-looking moles, sores, lumps, blemishes, and more importantly, changes to how they look and feel.
Consider that a normal mole is usually an evenly colored black, brown or tan hue. They can be flat or raised, and typically less than 6mm (1/4 inch) in diameter. Moles usually appear as a child or in young adulthood. That’s why it’s important to review new moles later in life with your doctor.
The ABCDE rule can help you spot signs of melanoma. These are:
Asymmetry – When one half of a mole does not match the other.
Border – Irregularities in the border, like if they’re ragged, notched or blurred.
Color – Look for different shades of color in the mole, like different shades of black or brown. It may also be a completely different color, like pink, red, white or blue.
Diameter – Be wary if the mole is bigger than 6mm across. That’s about the size of a pencil eraser, though they can be smaller as well.
Evolving – Watch for changes in your moles. These can include size, shape and color.
You may also want to look for melanoma symptoms that don’t fit these criteria. That may be a sore that doesn’t heal or spread of pigment beyond a mole into the surrounding skin. Redness or swelling beyond the mole also warrants a closer look, along with itchiness or pain, or if the mole becomes infected, oozes or bleeds.
So why is melanoma in the news lately? Several reasons, not the least of which being that it’s summer, when you’ve got higher exposure to melanoma-caused UV rays. Just as notably, however, are that new drugs like Keytruda are in the works and appear to boost survival odds for advanced cases, which until now meant certain death.
Keytruda was the melanoma drug that saved Jimmy Carter’s life, and it’s one of four new drugs approved for the disease in the last four years.
These new approvals come after decades of stagnancy in melanoma drug approval. Until now, patients diagnosed with advanced melanoma fared poorly. It’s safe to say Carter would be dead if his melanoma had appeared just five years ago; Stage 4 cancer means it’s spread to other parts of the body, like the brain (which it had in Carter’s case).
That makes these new developments all the more encouraging in our fight against skin cancer – particularly melanoma – and hints that further, even more promising treatments for melanoma in the not-so-distant future.
Of course, there’s a catch.
The new drugs are prohibitively expensive. Keytruda by itself would set you back roughly $12,500 per month. Some of the other drugs in development can approach the $1 million mark annually, and may need to be taken with other drugs as well.
You’d have to cough up that money indefinitely – and they don’t appear to work for everyone. Nor do we know even how long the effects will last, or even if they boost survival rates for melanoma patients in general.
And there’s always the chance they may have side effects, or patients may become resistant to them.
Still, it’s a step in the right direction. Melanoma is the most aggressive and threatening of skin cancers. New cases are growing at an alarming rate, particularly in sunny climates like Australia and the southern United States. If it means hope in the fight against a common global killer of men and women, that’s a good thing.
Keep an eye on Keytruda, and the development of new melanoma drugs in the next five years.
With all this being said, you’re better off not going this route in the first place. You’ve heard the basics, like using sunscreen and to wear a cap and long-sleeved clothes. But did you know that coffee may help you ward off some of the more nefarious effects of UV damage, and that you can even get skin cancer where the sun don’t shine (literally)?
You may reduce your chance of melanoma with the following guidelines:
Consider Seeing a Dermatologist – Your family doctor is likely a GP. That’s fine – but he’s likely not a dermatologist, the latter of which specializes in human skin. Researchers from Emory University School of Medicine found that 2,000 melanoma patients with growths diagnosed by a dermatologist were in earlier stages – and more likely to survive – compared to those discovered by another kind of physician.
Don’t Ignore Basal Cell Cancers – It’s true that basal cancers are more common than melanoma and usually easy to remove. But that’s not always the case – five to ten percent of basal cell cancers are resistant to treatment and can spread to bone and cartilage. Basal cell carcinoma can even disfigure your face.
Studies Suggest Coffee May Fight Skin Cancer – Skin cancer ain’t all doom and gloom. For proof of this, consider that researchers found a daily cup of caffeinated Joe lowered chance of a non-melanoma skin cancer by 5% – and a 30% lower risk if that coffee was 20 ounces.
Use a Broad Spectrum Sunscreen – SPF just means a sunscreen offers protection against UVB rays. But that doesn’t tell the whole story because at present it doesn’t mean the product will protect you from UVA, which penetrates deep into and can damage your skin. Solution? Always buy a product that says “Broad Spectrum”, and look for ingredients avobenzone (Parsol 1789) and ecamsule (Mexoryl SX), or use zinc oxide or titanium oxide.
Use this in addition to long-sleeve clothing.
Avoid Tanning Beds – Your tanning salon habit doesn’t help you avoid melanoma. You’re 2.5 times more likely to have squamous cell cancer and 1.5 times at higher risk of basal cell carcinoma with indoor tanning. The bad news is you’re at higher risk of melanoma too, if you went at it before age 35, even if you’ve given up the habit. That’s why you’ll want to do monthly self-exams for melanoma and consider seeing a dermatologist each year.
The bottom line with melanoma is to be vigilant. You’re still at risk if you live in northern states like North Dakota – perhaps even higher – because you likely won’t burn as much here, and therefore not feel the need to slather up, even though you’re exposed to melanoma-causing UV rays regardless of where you live.
If the sun’s out, you’re exposed.
Also, you’re not off the hook if you’re dark-skinned. While it’s true that melanoma is less common in Hispanics and African-Americans than Caucasians, it’s also more likely to be fatal in the first two.
Watch your moles and inspect yourself monthly. And also keep in mind that tattoos may look nifty, but they also tend to cover up developing melanoma, so resist the urge to get totally inked up. Try not to tattoo a mole.
Finally, remember that melanoma doesn’t always play by the rules. It’s completely possible you’ll get skin cancer regardless of the tips we mentioned above, or it could develop in your personal areas. Melanoma may not even follow the ABCDE guidelines we talked about, and could develop from a mole smaller than 6mm, or from a color you might not suspect.
The safest play with melanoma is to check your skin each month, and see a dermatologist yearly. Watch your moles, and report anything that looks odd to your physician.