Samuel Broder: Preventing Skin Cancer

What is important to know about malignant melanoma and skin cancer screening?

Samuel Broder: It's important to follow a program of prevention, screening, and early detection.

The term malignant melanoma and melanoma describe the most serious form of skin cancer, whose frequency is rising due to increasing sun exposures, especially when intermittent high-dose exposures (sunburns) come into play. Melanomas originate in melanocytes, which are specialized skin cells that make a protective brown pigment (melanin) to shield the skin against the harmful effects of the sun. Melanomas may arise in a mole (nevus). Individuals with a special skin condition called dysplastic nevi are at increased risk, as are people with a very large number (more than 50) of 'ordinary' moles.

However, a melanoma can also arise in the skin outside of a mole, and indeed, on occasion beyond the skin layers altogether, including the eye, the mouth, and so forth. While melanomas can arise anywhere on the skin, the face and neck are common sites. Men may have a greater tendency to form melanomas on the trunk compared with women, in whom the legs are perhaps more frequent sites. A previous diagnosis of a skin cancer, including the more common basal and squamous carcinoma, increases the risk of a second case in the future. Family history is another risk factor.

The frequency of melanoma is generally highest in fair-skinned individuals, particularly those with blond or red hair who freckle and sunburn easily. Severe, blistering sunburns significantly increase risk. In the United States, the risk is markedly lower in African-Americans compared with whites but, likely, no group is totally immune. Melanomas in people of color, including Blacks and Asians, may occur in regions not readily exposed to the sun, including the sole of the foot.

A melanoma of the skin generally can be cured by appropriate surgical excision if caught early, when it is still microscopically thin and before it has had a chance to invade too deeply into the layers of skin below. If the melanoma exhibits deep invasion under the microscope, or if it spreads to other sites, the situation becomes very serious.

Protection from the sun's harmful rays is essential to the prevention of skin melanoma, as it is for the prevention of the two other forms of skin cancer, basal cell and squamous cell carcinomas. Protecting the skin should begin in childhood, when it is most effective, but prevention is a virtue whenever it begins.

Here are some additional practical tips from the National Cancer Institute and the American Cancer Society: Avoid exposure to the midday sun, and if you go outside, wear long sleeves, long pants, and a broad hat. Recall that UV rays can penetrate windshields and windows—-and don't forget that UV rays can be reflected by water, sand, snow, and ice. Wear wrap-around sunglasses with UV-absorbing lenses. The lens-label should state a UV-blocking capacity of at least 99 percent relative to both UV type A and UV type B rays. Use "broad spectrum" sunscreens with an appropriate Sun Protection Factor (SPF). An SPF of 30 or higher affords the most protection against sunburn.

Health Advice Disclaimer: The information provided on this website is for the general information of the reader and to help patients become better informed to consult with their own physician. It does not constitute a doctor-patient relationship, and it is not a substitute for professional medical advice. You should not use the information on this website for diagnosing or treating… Read more >>