More Americans develop skin cancer than any other type of cancer.

Melonoma

More Americans develop skin cancer than any other type of cancer. In its common forms, skin cancer is highly curable. But melanoma, though it accounts for only about 3% of skin cancer cases, causes by far the most skin cancer deaths. The reason is that melanoma is very aggressive. If not detected at an early, superficial stage, it can spread rapidly to the rest of the body.

How common is melanoma?

The incidence of melanoma is on the rise. This year there will be an estimated 60,000 new cases in the U.S., and more than 8,000 Americans will die from it. Melanoma tends to affect the relatively young and the middle-aged. Half of all victims are younger than 57. Men are 50% more likely to develop melanoma than women.

How it starts

Melanoma develops in cells called melanocytes. These cells produce melanin, which gives skin and other body tissues their color. For the most part, melanocytes are in the skin, although melanoctyes—and melanoma—also occur in the eye, among other tissues.

Melanoma can develop anywhere on the skin, but it’s most likely to occur on the trunk in men, the legs in women, and the upper back in both. Melanoma often begins as a new pigmented spot on a sun-exposed area of skin. Or it may develop from a mole (also called a nevus). Moles may be present from birth or they may develop as we get older.

Not all melanomas look alike. Some are raised brown patches with spots of various colors (white, black, blue, or red). They sometimes crust and bleed. Others are irregular flat brown patches with black spots. Another presentation is a firm gray or black lump. Any pigmented patch that has changed recently or looks “ugly” is suspicious and should be checked by a doctor.

Risk factors

The single most important environmental environmental risk factor for melanoma is a person’s exposure to sunlight, especially ultraviolet rays. Periodic bouts of intense sun exposure increase the risk more than does the total amount of time spent in the sun. Having a history of sunburns during childhood carries the highest risk. Also, living in southern regions (nearer the equator), where the sun is more intense, increases a person’s risk.

Light-skinned people have a higher incidence of melanoma. So do individuals with red hair, freckles, or very sun-sensitive skin—all traits associated with a certain genetic variation.

Having a lot of moles (50 to 100) contributes to melanoma risk, but the greatest danger comes from so-called atypical moles. They may be larger than normal, are frequently multicolored, and usually have an irregular shape and border (see box). Having atypical moles is an inherited trait and may explain why melanoma can strike a number of people in the same family. A family history of melanoma, especially involving a parent, child, sister or brother, also raises your risk.

Playing it safe

Sun-safe habits are critical to reduce the risk of melanoma. The main goal is to minimize exposure to the sun’s ultraviolet rays. That means you should

• avoid midday sun
• wear broad-brimmed hats and clothes that cover most skin
• apply SPF-15 or higher sunscreen (although experts caution that using sunscreen shouldn’t tempt you to spend extra time in the sun).

Avoiding sunburn during childhood is particularly important. The UV light in tanning salons should be avoided at any age. In addition to these preventive measures, screening is key to detecting melanoma at an early and still curable stage. Most effective is a regular head-to-toe skin examination, done by the individual as well as by a doctor. This is especially important for people
with any of the risk factors described above, as well as for men 50 and older.

The ABCDEs of moles

?Here’s an easy-to-remember guide to spotting suspicious moles.

• A for asymmetry: a mole that doesn’t look the same on both sides
• B for border: a mole with edges that are blurry or jagged
• C for color: a mole that has multiple colors
• D for diameter: a mole larger than 1/4 inch in diameter (about the size of a pencil eraser)
• E forevolving:amolethat has changed color, shape, size, or thickness.

From the Mayo Clinic Proceedings and Cancer