A report published in JAMA Dermatology shows that the rates of melanoma, the deadliest of skin cancers, is on the rise despite the 2014 Surgeon General’s call for prevention.

According to the report, one out of every 58 of us during our lifetime will be diagnosed with melanoma in situ (an early stage before it spreads) up from 1 in 78 in 2009, and one out of every 54 of us will be diagnosed with it after it begins to spreads (invasive ) up from 1 in 58 in 2009. The lifetime risk of being diagnosed with either invasive melanoma or in situ melanoma is estimated to be 1 in 28. Deaths from melanoma have also risen about 1.5% since 2009.

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For a summary of this report see: https://medlineplus.gov/news/fullstory_162673.html

For the complete report see: http://jamanetwork.com/journals/jamadermatology/fullarticle/2593033

 

Use this news

Yes, it’s January, and even though it’s not beach weather, we still need to protect ourselves from skin cancer, especially melanoma.

Of all the cancers, skin cancer is the most common cancer in the U.S. Over 5 million people are diagnosed with one or more of three types, squamous cell, basal cell and melanoma, each year. Combined, these three skin cancers cause about 13,600 deaths a year out of the millions of people diagnosed. But of these, more than 10,000 deaths are from melanoma even though it accounts for less than 1% of all skin cancers.

Melanoma develops in the melanocytes, the cells in our skin that produce melanin, the stuff that gives our its color. Basal cell cancer develops in the cells in the bottom layer of the skin, squamous cell cancer forms in the upper or outer layers of the skin.

Basal and squamous cell cancers rarely metastasize or spread to other parts of the body. Rather, they stay in one spot and get bigger. Melanoma, on the other hand, spreads quickly to other parts of the body, which is why finding it early is so important.

Given that skin cancer is related to ultraviolet radiation, the key to prevention is avoiding tanning beds and minimizing sun exposure. While we’re all aware of the need for sun protection in the summer, we need it in winter, too.

Winter sports put us in higher altitudes which increases the levels of UV we’re exposed to from the sun. According to the Skin Cancer Foundation, for every 1000 feet above sea level, our UV exposure increases 4 to 5 percent. At an altitude of about 9, 500 feet, UV radiation can be 35 to 45 percent more intense than at sea level. To put this in perspective, Denver is 5160 feet above sea level, Taos Ski Valley in New Mexico is 9300, Mt Everest is 29,000 feet above sea level. The highest point in New Jersey, High Point, is 1800 feet above sea level.

In addition, there is the issue of snow. Snow reflects up to 80 percent of the UV light from the sun, which means the same rays hit us twice, increasing our UV exposure and risk of skin damage.

In addition to sun exposure, other risk factors for melanoma include:

Family history
Age (usually occurs in older people)
Having numerous moles – more than 50.
Tendency toward sunburns
Difficulty tanning
Naturally light hair (blonde or red)
Light eyes (blue or green)
History of sunburns (UV exposure is cumulative, so our lifetime exposure adds up)
Weak immune system (from organ transplant, medical treatments or disease such as HIV/AIDS)

To reduce your UV radiation exposure when outdoors during the winter months:

  • Use a sunscreen with an SPF of at least 30
    • Apply sunscreen 30 minutes before engaging in outdoor activities (skiing, snow boarding, etc.)
    • Remember that about 80% of UV rays penetrate clouds, so sunscreen protection is needed even on cloudy days.
    • Apply enough sunscreen – about a teaspoon to your face, making sure to apply it to your ears, under your chin, neck, around your eyes.
    • Apply SPF 15 or higher lip balm and bring it with you.
    • Reapply sunscreen every 2 hours as wind, snow and sweat wear it away, just as water does in the summer.
  • Cover up as much skin as possible
    • Wear a hat. It will protect your scalp and keep you warm.
    • Wear a ski mask to cover as much facial skin as possible
    • Wear wrap around sunglasses with a UV rating of 99% to protect your eyes, eyelids and the skin around your eyes.
  • Be mindful of the time
    • If possible, avoid being outdoors between 10 a.m. – 4 p.m.
    • Take periodic activity breaks to go indoors. Reapply sunscreen at this time.
      (Skin Cancer Foundation, 2010)

Even when we do everything we can to reduce the chances of melanoma, there is no guarantee that it won’t develop. A mole that meets any of the following ABCDE characteristics needs to be evaluated by a health care provider, preferably a dermatologist, ASAP!

  • Asymmetry: Both halves of the mole don’t look the same.
  • Border: The edges are jagged, irregular, not smooth, or blurry.
  • Color: The color is not the same throughout. It may have shades of brown or black, or
                 pink, red, white, or blue patches.
  • Diameter: The mole is bigger than the size of a pencil eraser, although sometime
                       melanomas are smaller than this.
  • Evolving: The mole is in the process of changing size, shape, or color.
    (American Cancer Society, 2016

Other things to check your moles for are:

Changes in the surface of a mole - Itchiness, scaling, bleeding, oozing, or a lump
Pain or tenderness.
Redness or swelling near the mole.
Pigment/coloration near the mole, but not attached to it.

Keep in mind that while most skin cancers occur in areas exposed to the sun, sometimes they develop in areas that are rarely in the sun, like the soles of the feet, palms of the hands or under the nailbed.

 

For more information:

American Cancer Society

Melanoma Skin Cancer
http://www.cancer.org/acs/groups/cid/documents/webcontent/003120-pdf.pdf

2016 Cancer Facts and Figures- http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-047079.pdf

Basal and squamous cell cancer
http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell

Skin Cancer Picture Gallery
http://www.cancer.org/cancer/skincancer/galleries/skin-cancer-images

 

National Cancer Institute
Tool to recognize ABCDE https://analysistools.nci.nih.gov/nevustool/