Practical Practitioner
By: Pamela Egan, FNP-C CDE
Melanoma is an aggressive and deadly form of skin cancer
Skin cancer from sun and tanning beds is claiming more and younger victims each year. Many who have been diagnosed with skin cancer wish that they had some training to look for skin cancer or to avoid those activities that increase its risk.
May is “Skin Cancer Awareness Month,” hoping to portray a message of skin protection and cancer detection.
Wearing sunscreen daily, limiting sun exposure, including tanning beds, and getting skin cancer screenings on a regular basis can prevent the skin cancer epidemic.
Melanoma is the most aggressive and deadliest form of skin cancer.
Many patients experience denial upon hearing that they have metastatic skin cancer – cancer that has spread to other regions of the body. They think it’s got to be a mistake.
Many younger people don’t understand why the dermatologist is so nervous when they explain a disease that sounds like a foreign language.
Younger women especially that partake in tanning beds think cancer is an old person’s disease and would never happen to them. Many are ignorant to the possibility of a skin cancer diagnosis.
The American Cancer Society and the American Academy of Dermatology know that many patients possess a cavalier attitude about skin cancer.
Skin cancer, with about one million cases a year, continues on a decades-long rise.
Dermatologists classify skin cancer into two groups, melanomas and non-melanomas. Most skin cancers, about 95 percent, are non-melanomas. They are localized and highly curable, although their removal can leave unsightly scarring.
The relatively low toll of non-melanoma skin cancers may explain why people ignore or do not detect the more deadly melanoma. In so doing, they miss early detection of a cancer that can quickly turn deadly. Melanoma skin cancers kill nearly 8,000 people a year.
Melanoma is not as rare as people believe; nearly 60,000 cases of melanoma will be diagnosed this year, with incidence rates increasing at about 4 percent a year.
When caught early, melanoma has a five-year survival rate of 96 percent. When detected after the disease has spread, the survival rate drops sharply, to 16 percent. It is mainly a disease of whites, but African-Americans and Hispanics and others with dark skin get it also.
The sun has most often been the culprit, with about 80% of melanomas believed to be caused by ultraviolet rays that change cellular DNA. Fair skinned people are much more vulnerable to the sun’s burning rays.
Particularly troubling to clinicians who treat skin cancer is the growing melanoma incidence in people younger than 30.
While dermatologists for years agonized mainly about the sun’s damaging rays, they now have a new worry in tanning beds.
Some studies suggest that teenagers and young adults believe that they are avoiding skin damage by getting an indoor tan, but that is not so.
The cellular damage from sunlight occurs because of its ultraviolet rays. Tanning bed lamps also emit UV rays.
Ten trips to the tanning bed doubles your risk of melanoma.
A bigger challenge may be that millions of people do not want to do anything at all to limit their sun exposure.
It takes time to change cultural attitudes about what is attractive. With continued messages about the harmful effects of the sun, practitioners are hopeful that it won’t be long until porcelain white skin rather than bronzed brown once again becomes attractive for Caucasians.
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