Melanoma (skin cancer)
Melanoma (also known as malignant melanoma) is the most serious type of skin cancer caused by sun exposure. It's serious because the cancer can spread to other organs in the body, so it needs prompt identification and treatment. You can take steps to prevent it, but also keep a watch for any moles or other skin marks that are new, changing or don't look like your other moles.
Melanoma is the 5th most common cancer in the US, with almost 100,000 new cases each year. The number of cases has doubled in the last 30 years, and it can occur at any age.
Doctor’s advice
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Am I at high risk?
Melanoma develops after exposure to the sun. While anyone can get it, certain factors increase your risk. This includes if you have pale skin and freckles, blue eyes and red or blonde hair, lots of moles, or skin that burns easily and rarely tans. You're at higher risk if a close family member (parent, child, or sibling) has had melanoma.
Spending significant amounts of time in the sun - either working outdoors, living in hot climates, or sunbathing - puts you at higher risk, along with extensive use of sunbeds. Melanoma can occur anywhere, but more commonly in areas exposed to the sun - men usually get them on their backs and women on their legs.
How can I protect myself?
It is advisable for everyone to wear strong sun protection and reapply it regularly. Look for SPF of 30 or higher, with both UVA and UVB protection, and labeled "broad spectrum". Reapply every two hours when outdoors, or after a shower or swim. UVA rays are present from dawn until dusk, no matter the season, so we should all be wearing sunscreen on exposed areas all year round. UVB is at its strongest during summertime from 11 am to 3 pm, and is responsible for sunburn (it's easy to remember: UVB for Burning, UVA for Ageing).
UVB rays cause burning and sunburn; even a slight pinkness is a warning sign your skin is traumatized. Both UVA and UVB carry a risk of melanoma.
Dermatologists advise that sunscreen is important but shouldn't be used as an excuse to stay out in the sun longer. You should avoid prolonged sun exposure where possible and wear clothes and hats to cover up.
When should I see my doctor?
If you have a large number of moles or the above risk factors, keep tabs (or ask your partner to for areas you can't see). Alternatively, you may prefer to book an appointment with your doctor. If any mole looks new or different to the other moles, or a new skin mark is itchy, bleeding or growing rapidly, see your doctor urgently.
Melanoma are often irregular in shape and have more than one color or a blue or black tinge so it is worth remembering the ‘ABCDE rule’ here when diagnosing a melanoma, as all these are signs of a possible skin malignancy:
- Asymmetry of a mole (not being a circle, or an oval)
- Border irregularity (instead of having a smooth outline)
- Color uneven (instead of the same color all over)
- Diameter bigger than 6 mm, and
- Evolving (a mole that is changing or getting bigger)
Your doctor will examine the concerning mole and other moles, listening to how it came about and any symptoms it causes, and they will take into account your individual risk factors.
If they are concerned, they will refer you urgently to a dermatologist who will assess your skin lesion and recommend treatment. This may involve minor surgery to cut the lesion out and examine the tissue under a microscope to see if it is a melanoma. If this turns out to be the case, you may have further examinations in case it has spread to lymph nodes or other areas, and you will be followed up regularly.
What's the outlook for melanoma?
Melanoma is the fifth most common cancer in the US, with the majority diagnosed in those under 50.
The outlook is good if melanoma is diagnosed and surgically removed. Once it's advanced, it may have had a chance to spread, and further treatment is needed. It does carry a risk of death, and cases have been increasing over the last decade, so we must be sun aware and take measures to protect ourselves.
There's a risk melanoma can return, so there will be follow-up at regular intervals for the dermatologist to perform full skin checks.
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