There will be an estimated 55,000 new cases and nearly 8000 people will die this year in the United States of malignant melanoma, the most deadly form of skin cancer. People in the US can expect to have a 1:71 lifetime risk of getting melanoma. When melanoma is caught early, the expected 10 year survival is well over 90%. However, the 10 year survival for stage IV melanoma is less than 10%. Although Melanoma has the highest mortality among skin cancers, basal cell and squamous cell carcinomas can cause significant problems for patients. There are nearly 1.3 million new cases of these two types of skin cancer each year in the United States. Although fewer people die each year of squamous cell and basal cell carcinomas than do of melanoma, many recur several times requiring significant amounts of surgery that leave them scarred and with other health problems. In rare instances, these basal cell and squamous cell carcinomas can also be fatal.
The most important risk factor for all types of skin cancer is the exposure to UV radiation. The major source of UV exposure is sunlight. By far, the best way to avoid skin damage/cancer is to limit exposure to the sun. It is a myth that tanning decreases the risk of long term skin damage. In fact, tanning greatly increases the cumulative effects of UV exposure. Avoiding sun damage can best be accomplished by wearing clothing that covers as much exposed skin as possible. This includes wearing hats with wide brims. People should also apply a high quality sun block several times a day that includes protection against both UVA and UVB. Some good ingredients to look for are parsol 1789 (avobenzone), oxybenzone, zinc oxide or titanium dioxide. Some general rules of thumb are that you should put it on 15-20 minutes before going out into the sun, use at least SPF15 and most sun blocks need to be reapplied at least every 3 hours. If you are sweating excessively, as most of us do when marching around a football field in the middle of the summer, it needs to be applied even more often.
The incidence of melanoma is increasing in nearly every caucasian population in the world. Although historically low, it is also increasing in other populations such as Hispanics and the Japanese. While people with fair skin and hair are at the greatest risk for melanoma, people with dark skin also need to be wary of excessive sun exposure. In fact, Bob Marley died at only 36 years old of a melanoma that was initially on his toe and spread to his brain and lungs.
Although prevention is the best way to avoid problems with skin cancer, early detection is the key to decreasing mortality. Examine your skin and remember your ABC’s. If you notice anything that is Asymmetric in shape, has irregular Borders, has unusual Coloring, or has a large Diameter (bigger than a pencil eraser) on your skin, you should show it to your doctor.
Protect your skin and have a great summer. I can’t wait to see the shows in Madison.
David Curley
MD PhD Student, University of Vermont College of Medicine
Thesis project: Conditional Mouse Models of Malignant Melanoma
Former member, Boston Crusaders