When spring gives way to summer and warm weather draws more people outside, skin cancer might just be a distant concern. But experts say it’s important to take the risk seriously.
Ultraviolet rays from the sun are a leading risk factor for skin cancer, which will affect one in five Americans during their lifetime. This includes melanoma, one of the deadliest types. About 100,000 people are diagnosed with melanoma each year in the United States, and about 8,000 die from it each year, according to the American Cancer Society.
Fortunately, there are simple ways to reduce your risk and catch possible cases as early as possible, when they are most curable. Therapies approved over the past 15 years have also transformed melanoma treatment, extending and improving patients’ lives, even in advanced cases.
Here’s what you need to know about melanoma, its treatments and how to protect yourself from it.
What is melanoma?
Melanoma is a cancer that usually starts in skin cells called melanocytes that make skin pigment. Compared to more common skin cancers that start in squamous or basal cells, melanoma is more likely to spread to other parts of the body.
“It really has some very aggressive behavior and biology behind it,” said Dr. Michael Davies, chairman of the department of melanoma medical oncology at the University of Texas MD Anderson Cancer Center.
Most melanomas appear as flat or slightly raised, dark-colored spots on skin that has been frequently exposed to ultraviolet light, such as the scalp and face, arms, back, and legs (although they can appear on areas that have never been exposed to the sun). , Also). In a smaller number of cases, the growth may appear as a dark-colored or red bump and extend into the skin, which may make it harder to detect.
A less common form, lentigo maligna melanoma, primarily affects older people who have had significant exposure to the sun and often appears as abnormally shaped tan or brown spots on the head or neck. An even rarer type, called acral lentiginous melanoma, occurs on the hands and feet (especially the soles, palms, fingers, toes, or nail beds) and accounts for more than half of all melanoma cases. in people who are not white. (Musician Bob Marley died from this type of melanoma, which was first misidentified as a bruise.)
Melanoma can also occur in the eyes or in the mucous membranes, such as inside the nose or throat, but these cases are rare.
Who is at risk? And can melanoma be prevented?
Melanoma is thought to be caused by a mixture of genetic and environmental factors. One of the main dangers is exposure to ultraviolet rays, particularly from the sun and from indoor tanning. A history of severe, burning sunburns may increase your risk; just like living near the equator or at high altitude, where the sun’s rays are more intense.
The best way to reduce your risks is to avoid unnecessary exposure to UV rays. The sun’s rays are strongest between 10 a.m. and 4 p.m., so limit your time outside during these hours. Wear protective clothing and glasses and regularly apply sunscreen of at least SPF 30.
Dr. Shanthi Sivendran, a medical oncologist and senior vice president of the American Cancer Society, also warned against the use of tanning lamps and beds, which significantly increase the risk of melanoma. According to the Skin Cancer Foundation, twenty states and the District of Columbia have banned minors from using tanning beds, in part because of this concern. But six states (Alaska, Colorado, Iowa, Montana, New Mexico and South Dakota) do not prevent them from doing so.
People with lighter skin are more vulnerable to damage from UV rays. But Dr. Sivendran said that doesn’t mean people with darker skin shouldn’t also stay vigilant. “You can get melanoma no matter what color your skin is,” she said.
It’s also important to know if melanoma runs in your family, which can increase your risk. And people with weakened immune systems are also more likely to develop melanoma. While about half of cases occur in people aged 66 and older, younger people can also develop melanoma.
How to detect melanoma?
It is vital to spot melanoma early because almost all cases that have not spread to other parts of the body are curable. However, once the disease reaches the lymph nodes or more distant organs, five-year survival rates decrease significantly.
There are no standard guidelines for skin cancer screening, but clinicians can examine your skin for abnormalities during annual exams. Dr. Kelly Nelson, a dermatologist at MD Anderson Cancer Center, also recommended that patients conduct their own head-to-toe self-exams regularly.
To recognize changes in your skin, it helps to know it, Dr. Nelson said. “People who are more aware of the appearance of the skin on their backs are less likely to die from melanoma than those who have no idea.”
“It’s a delicate balance between having a certain level of skin awareness, but also not worrying that every mole on your body is a ticking time bomb,” she added.
To distinguish melanomas from ordinary moles or irritations, dermatologists suggest looking for “ABCDEs”: spots that have an asymmetrical shape, a notched or scalloped border, an unusual color pattern, a diameter greater than six millimeters, or a stain that has evolved over time. time.
In practice, however, Dr. Anderson said patients often have difficulty making these distinctions. She recommended watching out for “ugly ducklings,” that is, anomalies that stand out for whatever reason.
How is melanoma treated?
For cancers that have not spread, a doctor will likely cut off the growth as well as a margin of surrounding skin. They may also perform a biopsy of nearby lymph nodes to assess the risk of cancer spreading and help the doctor decide if further treatment is needed.
Although melanoma is more likely to be fatal if it affects distant parts of the body, major advances in treatment have improved the outlook, even for those who did not catch their cancer early.
These include treatments that harness the immune system to fight tumors and targeted therapies that directly attack cancer cells.
Other innovations are on the way. In February, the Food and Drug Administration approved the first cancer treatment using tumor-infiltrating lymphocytes, known as TIL therapy, for use against melanomas that have not responded to other treatments. And scientists are also testing a vaccine tailored to the specific genetic makeup of a patient’s cancer in a late-stage clinical trial.
News Source : www.nytimes.com
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