Protecting Your Skin: What Every Patient Needs to Know About Melanoma

If recognized early, even the deadliest skin cancer can be treated and cured. Pharmacists can help patients spot the warning signs.

Melanoma is the most serious form of skin cancer. Approximately 75% of all skin cancer deaths are due to melanomas. Melanomas may appear suddenly. They are most frequently found on the areas of the face, neck, arms, upper back, and legs, but can occur anywhere on the body. If recognized early and treated properly, melanomas can be cured. If left untreated, melanomas in later stages can spread to other organs and lead to death.

What Causes Melanoma?

Melanoma begins in the melanocytes, which are the cells that produce melanin. Melanin is the pigment that gives color to the skin, hair, and eyes. The majority of melanomas appear black or brown, but they can also appear to be skin-colored, pink, red, purple, blue, or white.

The exact cause of melanoma is not clear, but excessive exposure to ultraviolet (UV) rays from sunlight, tanning beds, or tanning lamps may increase your risk of developing melanoma. A family history of melanoma also increases your risk.

What Are the Risk Factors For Melanoma?

The risk for developing a melanoma is related to a person’s exposure to the sun or UV radiation without protection. The risk is greater among individuals with fair skin complexions, blue or green eyes, and red or blond hair.

• Risk factors that may increase an individual’s risk for developing a melanoma include:
• Living in areas close to the equator or at high altitudes
• Long-term exposure to UV rays because of a job or other activities
• One or more episodes of blistering sunburn during childhood
• Using tanning beds or lamp devices
• Having fair or freckled skin
• Spending lots of time outdoors without the use of sun protection
• Having a family history of melanoma
• Being exposed to chemicals that can cause cancer, such as arsenic, coal tar, and creosote
• Having multiple moles, the presence of certain types of moles, or multiple birthmarks
• Having a weakened immune system as a result of certain medical conditions (AIDS, certain cancers, organ transplant) or the use of certain medications used to treat certain medical conditions (such as rheumatoid arthritis)

Melanoma Warning Signs

According to the National Cancer Institute, the first sign of melanoma is often a change in the shape, size, color, or texture of an existing mole. Melanoma may also appear as a new mole or change in skin. Many skin care experts recommend the ABCDE method to help people look for and detect possible melanomas:

A is for Asymmetry: Do different halves of the skin lesion look the same?

B is for Borders: Do the borders of the lesion appear irregular, shaggy, or ill formed? The borders of an early melanoma tend to be uneven and the edges seem scalloped or notched.

C is for Color: Does the color appear different throughout the mole or lesion? Having a variety of colors is another warning sign of a melanoma.

D is for Diameter: Melanomas usually are larger than the size of the eraser on a pencil (1/4 inch or 6 mm), but they may sometimes be smaller when first recognized.

E is for Evolving: Look for any change that occurs in the size, shape, color, or elevation and note any new symptom, such as bleeding, itching, or crusting/scaling.

Diagnosing and Treating Melanoma

If you see any changes in the color, texture, size, or appearance of your skin or a mole, you should immediately contact your primary health care provider to have your skin examined. You may be referred to a dermatologist. Your health care provider will look at the appearance of the area and may order a biopsy to confirm the diagnosis. The biopsy may involve removing a small part of the affected area or the entire growth.

Once a melanoma has been confirmed, your doctor may also order CT (computed tomography) scans or other types of x-ray tests to determine if the cancer has spread.

The stage and location of the melanoma and your overall health will determine which type of treatment plan your doctor will recommend. If detected early, sometimes the removal of the affected area and surrounding tissues is all that is needed.

If the cancer has spread, patients may require surgery, chemotherapy, and radiation. Your doctor will discuss the treatment options with you, depending upon the severity of the cancer.

Prevention of Melanoma

To identify melanomas early, the American Cancer Society recommends professional skin examinations every year for people older than 40 years. People between the ages of 20 and 40 years should get a skin examination every 3 years.

Routine self-examination is also recommended. You should examine your skin at least once a month and contact your primary health care provider if you find any unusual changes in any moles or areas of skin.

Other steps that you can use to prevent or reduce your chances of melanomas include:

• Always avoid excessive exposure to the sun, especially between the peak hours of 10 am and 4 pm.
• Avoid using tanning beds or lamp devices.
• Always wear sunglasses to protect your eyes, because melanoma can occur in the pigmented area of the eyes.
• Always apply sunscreen 15 to 30 minutes before going outdoors to protect skin, and wear hats and protective clothing to protect against UV rays. Reapply sunscreen every 2 hours, especially if sweating.
• Routinely examine your skin for changes in moles.
• Always consult your doctor if you recognize any changes in your skin or a mole.

For more information on melanomas, please visit the following Web sites:

National Cancer Institute: www.cancer.gov

American Academy of Dermatology: www.aad.org

The Skin Cancer Foundation: www.skincancer.org

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.