Melanoma-Silent but Deadly

By Velvie Bennett, RN, MSN, FNP-CJuly 15, 2014

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(Photo Credit: U.S. Army) VIEW ORIGINAL

Do you love having fun in the sun? If you do, it is essential you protect your skin from exposure to harmful sun rays known to cause skin cancer. Skin cancer is the most commonly diagnosed cancer in the United States, and melanoma is the deadliest skin cancer.

According to the National Cancer Institute, more than 68,000 Americans are diagnosed with melanoma each year and another 48,000 are diagnosed with an early form of the disease that involves only the top layer of skin. According to the Centers for Disease Control (CDC) melanoma causes about 8,000 deaths in the U.S. each year.

People with certain risk factors are more likely than others to develop skin cancer. Risk factors vary for the different types of skin cancer but here are some of the general risk factors listed by the CDC:

• Lighter natural skin color

• Family history or personal history of skin cancer

• Chronic sun exposure

• History of sunburns, especially early in life

• History of indoor tanning, especially before age 35

• Skin that freckles, burns, reddens easily or becomes painful in the sun

• Multiple moles (more than 60)

Sun exposure is the most modifiable risk for melanoma. Ultraviolet (UV) rays come from the sun or indoor tanning, such as using a tanning bed or booth, or sunlamp. When UV rays reach the skin's inner layer, the skin makes more melanin.

Melanin is the pigment that colors the skin. It moves towards the outer layers of the skin and becomes visible as a tan. A tan does not indicate healthy skin or good health. Tanned skin is a response to injury, because skin cells signal they have been hurt by UV rays by producing more pigment. Although everyone's skin can be damaged by UV exposure, people with sensitive skin and those who burn easily and tan very little are at the highest risk.

What are the signs of melanoma? Most melanomas have black or blue-black areas, but may appear as a new mole. It may be black, "ugly-looking" and abnormally shaped. The National Cancer Institute reminds us to think "ABCDE" to remember what to look for:

• Asymmetry- the shape of one half of the suspicious mole does not match the other half.

• Border- the edges are ragged, irregular or blurred.

• Color- the color is uneven and may include shades of black, brown and tan.

• Diameter- there has been a change in size, usually an increase.

• Evolving- the mole has changed over the past few weeks or months.

Surgery is the first treatment of all stages of melanoma. Prevention, however, is the best treatment. The National Institutes of Health (NIH) recommends to avoid/reduce exposure to direct sunlight, especially from 10 a.m. to 4 p.m., when the sun's rays are the strongest. Wear a wide-brimmed hat and clothing that protects the body from direct sunlight. Wear sunglasses that absorb UV radiation to protect the skin around the eyes.

Apply sunscreen lotions with a sun protection factor (SPF) of 30 or greater, reapply every two hours, and after swimming. It is important to use a broad-spectrum sunscreen lotion that filters both UVB and UVA radiation. Perform routine skin checks to monitor for changes in your skin. If you notice a mole that is changing or is concerning you, see your primary care provider for an evaluation.

There has been increased concern regarding Vitamin D deficiency in the news. Vitamin D is produced by the skin with UVB exposure. Some promoters of tanning have recommended tanning bed use to help produce Vitamin D. It is important to note that Vitamin D is produced with moderate exposure to UVB rays. Tanning lamps typically emit more UVA rays and fewer UVB rays. Vitamin D can be more safely obtained by eating a healthy diet and supplementation if needed. According to the CDC, indoor tanning is estimated to cause about 419,000 cases of skin cancer every year. For comparison, smoking is thought to cause about 226,000 cases of lung cancer every year.

Melanoma is the deadliest skin cancer, but early diagnosis gives the best chance for long-term survival. If you are interested in more information on melanoma, go to the NIH website and see the online booklet "What You Need To Know About™ Melanoma and Other Skin Cancers" to learn about melanoma symptoms, diagnosis, treatment, and questions to ask your doctor.

Related Links:

Official Website of U.S. Army Medical Command

National Cancer Institute

National Institutes of Health

Centers for Disease Control and Prevention