What is Melanoma?

Melanoma is the most serious type of skin cancer. It begins in skin cells called melanocytes. Melanocytes are the cells that make melanin, which gives skin its color. Melanin also protects the deeper layers of the skin from the sun’s harmful ultraviolet (UV) rays. When people spend time in the sunlight, the melanocytes make more melanin and cause the skin to tan. This also happens when skin is exposed to other forms of ultraviolet light (such as in a tanning booth). If the skin receives too much ultraviolet light, the melanocytes may begin to grow abnormally and become cancerous. This condition is called melanoma.

The Risk Factors for Melanoma

People of any age and any race can get melanoma, but some people are at higher risk. The more risk factors you have, the more likely you will get a melanoma. Risk factors for melanoma are:

Being a white male over the age of fifty
Although people of any race and age can get melanoma, people in this demographic are at particularly high risk for getting and dying of melanoma.  In this group, melanomas are most common on the back.  However, pay particular attention to moles on the scalp, since melanomas on the scalp have a higher mortality rate than elsewhere, because they are usually diagnosed when they are thicker and deeper.

Having other family members who have had a melanoma
Melanomas often run in families.  The more family members you have with melanoma, the higher your risk.  Some of the genes that occur in people with familial melanoma have been identified and can be tested for, but many patients who have family members with melanoma have no gene problem that can be tested for.

Having atypical (dysplastic) nevi
Atypical or dysplastic moles/nevi are a common genetic condition. People with atypical nevi usually have several or many large moles with more than one color.  The moles may start in childhood and increase in size and number through adolescence and early adulthood.  If you have atypical moles and have family members with melanoma you are at especially high risk for melanoma and should be followed regularly by a health care professional such as a dermatologist who has special expertise in following people with atypical moles.  Also, get your family members checked.

Being born with a mole or moles
Being born with a mole called a nevomelanocytic congenital nevus or having neurocutaneous melanosis puts a person at increased risk for developing melanoma.  Bigger moles pose a greater risk than smaller ones.  Deciding if and when these moles should be biopsied and/or removed involves complex medical decisions.  Parents should discuss these concerns with their Pediatrician and consider seeing a Pediatric Dermatologist or other Dermatologist who has special expertise in evaluating children with these lesions.

Ultraviolet light exposure
Sunlight is important to all living beings.  Sun helps plants to grow and helps our bones to grow stronger. However, sunlight is also carcinogenic to human skin.  There are three types of ultraviolet (UV) light: UVA, UVB, and UVC.  UVC rays, which are the most harmful, are blocked by our ozone layer.  Exposure to both UVB rays, which cause sunburns, and UVA rays, which cause tanning, increases your chance of getting skin cancer.  The more you tan and burn, the greater your chances of getting skin cancer.

Tips Courtesy of the Melanoma Foundation of NE

The Truth About Tanning

Glenna was a tanner – whether at the beach or in a tanning bed – she was always tanning.  Once she learned what tanning can do to your body (and your life) she worked as long and hard as she could to try to discourage her peers from following that path.  These are things she would have wanted you to know:

Tanning Fact #1:
The increased risk of melanoma associated with early tanning bed use is 59% for people whose first exposure to artificial UV rays in a tanning bed occurred before age 35 years and that risk increased with the number of tanning bed sessions per year.

Tanning Fact #2:
It is not safe to tan in the sun or in a tanning booth.

Tanning Fact #3:
The more you tan and the younger you start tanning, the more likely it is that you will get melanoma.

Tanning Fact #4:
Using a tanning bed for 20 minutes is equivalent to spending one to three hours a day at the beach with no sun protection at all.

Tanning Fact #5:
Tanning beds put out three to six times the amount of radiation given off by the sun.

Tanning Fact #6:
For most people, 5-10 minutes of unprotected sun 2-3 times a week is enough to help your skin make Vitamin D, which is essential for your health. Getting more sun won’t increase your Vitamin D level, but it will increase your risk of skin cancer. Vitamin D also comes from orange juice, milk, fish, and supplements.

Facts Courtesy of the Melanoma Foundation of NE

Detection & Screening

Detection & Screening

Monthly and Yearly Skin Exams

Anyone can get melanoma. And melanoma is aggressive, so early detection is critical. By performing a thorough self-skin examination each month and visiting a dermatologist each year for a professional examination, you will be one step ahead in catching melanoma early. Each month during your self skin exam, check your entire body thoroughly for any moles or discoloration that look new or different. Be sure to check less obvious areas as well, such as your scalp. The MRF provides a detailed guide on how to perform a self skin examination. At your yearly professional skin exam, your dermatologist will thoroughly check for suspicious moles or lesions on your entire body, including your scalp, fingers, toes and nail beds. Some dermatology practices may keep a photographic record of certain moles to track any changes between appointments. You may also want to visit the American Academy of Dermatology website to find free skin checks in your area.

What if a suspicious lesion is found?

If you notice a new or suspicious lesion on your body, notify your dermatologist right away. The evolution of a lesion is proven to be the most important determining factor in diagnosing a melanoma.

Tips Courtesy of the Melanoma Research Foundation

Know Your Moles

A mole or freckle that changes can be the first sign of skin cancer. People with a few larger moles or many moles are at increased risk.
Remember the ABCs of changing moles they may be the first signs of melanoma:

a_mole
A. ASYMMETRY

One half of the mole is unlike the other half.

b_mole
B. BORDER

The border of the mole is irregular, scalloped, or poorly defined.

c_mole
C. COLOR

The mole is varied from area to another. There may be shades of tan and brown and black and sometimes even white, red or blue.

d_mole
D. DIAMETER

The diameter of the mole is larger than 6 mm (as a rule), which is the same diameter of a pencil eraser.

E. EVOLVING

Ordinary moles do not change over time. A mole that changes in size, shape, color, or texture is a warning sign as is a mole that tingles, itches, burns, bleeds, oozes, or feels strange. Another warning sign for melanoma is a sore that does not heal. ANY changes to ANY moles in ANY way should be evaluated by a doctor immediately!

Tips Courtesy of the Melanoma Foundation of NE

Tips on Making a Dermatology Appointment

• Use your primary care doctor or nurse practitioner to advocate for an urgent problem. They have well established specialist contacts and a quick phone call from them can almost always find a appointment within the week.

• Call the specialist’s office in the early morning (ie 9-10am) to ask if there have been any cancellations for that day. Be flexible. It may mean leaving work early or arriving late.

• Realize that more than 90% of the time, the emergency skin lesion is not life threatening and reassurance is all that is needed.

• Educate yourself with reliable, patient friendly web sites such as the Skin Cancer Foundation (www.skincancer.org) or the American Academy of • Dermatology (www.aad.org) regarding the signs and symptoms of worrisome lesions.

• Discuss problems with access with your dermatologist directly. Leaving a concerned message will result in a return phone call and some telephone triage.

• If you are a high risk patient and don’t have a dermatologist, be proactive and undergo a yearly screening.

• Perform a monthly total skin examination in a full length, well lit mirror to familiarize yourself with your baseline skin examination and lesions.

Tips Courtesy of the Melanoma Foundation of NE

Sun Safety

Know the 5 simple steps to prevent and detect skin cancers. Find out how to keep yourself, and your family safe in the sun – its easy!

• Avoid unprotected exposure to sunlight, seek shade, and never indoor tan.

• Wear sun protective clothing, including a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses year-round.

• Apply recommended amounts of broad-spectrum sunscreen with a sunburn protection factor (SPF) greater than or equal to 30 to all exposed skin and reapply every two hours, or as needed.

• Routinely examine your whole body for changes in your skin and report concerns to a parent or healthcare provider.

• Educate your family and community about the need to be SunAWARE.

To learn more, visit SunAWARE.org

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