Melanoma, the Deadly Skin Cancer

Serving Chattanooga, Tennessee

eptember is both healthy aging and national skin cancer awareness month.  With these as a central theme, I can’t think of a subject more important than melanoma.  Melanoma is by far the most dangerous of skin cancers.  Unfortunately, over the past 35 years its incidence in the U.S. has doubled.  It accounts for 3% of all cancers and 1-2% of all cancer deaths in our country.  In terms of its increase, it is second only to lung cancer.

 Several individual and environmental factors may increase your risk of developing melanoma. There is an increased risk as we age.  Those of us with light pigmentation also suffer an increased risk. However, the greatest risk is repeated exposure to the sun.  Melanoma is more common in the hot areas of our country and world than the higher latitudes.  Its risk of occurrence increases in people who sunburn easily and have had frequent sunburns early in life. 

People whose family members have had melanoma may have an increased risk, and patients who have had a melanoma in the past have the greatest risk of developing another cancer in the future. Protection from the harmful rays of the sun is a must for all of us, but most particularly for anyone who fits into the described categories.  Sun blocks, sun proof clothing, hats, sunglasses, and avoidance of exposure during the most damaging hours (10am – 2pm) should become a matter of course.  Changing your sun worshipping behavior could save your life.

The survival statistics for melanoma which is localized at the time of diagnosis is 71-90% at 10 years.  Those with regional spread of the tumor have a 52% survival at best.  These numbers demonstrate increases in survival rates from the early 1960’s.  This may have to do with increased public awareness and skin cancer screening programs. Every spring, a group of dermatologists and plastic surgeons here in Chattanooga volunteer their time to perform a cost free skin cancer evaluation of the community at a local clinic. It is through efforts like this that information regarding this potential killer can spread.

Any pigmented lesion larger than 5 to 10 mm is more likely to be malignant than benign.  Benign pigmented lesions are typically small and orderly with even color and a sharply defined border and surface.  Malignant lesions are usually larger, have varying coloration, irregular borders, and surface undulation.  However, it is very difficult to say simply by looking at a suspicious lesion whether it is a melanoma or not.  To be sure, the entire lesion should be removed and sent for pathologic examination.  In addition to the above, I must say that physicians should have a high level of suspicion when patients present with pigmented lesions which have begun to change characteristics.

From what we know about melanoma today, the risk of dying from melanoma correlates significantly with the character of the lesion when it is removed.  Thin lesions have a much better survival rate than thick lesions.  Surgical excision remains the mainstay of treatment.  This is so because nothing else we have works particularly well.  That is to say that, in advanced stages, melanoma does not respond predictably to any of the typical treatments we currently have in cancer management.  Research continues to find management solutions and a cure.

           

The take home point is prevention.  Recognize your risk factors.  Protect yourself from the harmful rays of the sun. Have routine skin cancer check-ups by a dermatologist, and report any suspicious lesions to your physician.  Early detection is paramount in treatment of melanoma.