5 Melanoma Myths

Many see developing skin cancer as “no big deal,” compared with other forms of cancer, but for the 73,870 Americans who will be told this year they have melanoma, they quickly learn preventing skin cancer is a “very big deal.”

“While other forms of cancer are seeing declines over recent years, we’re seeing the incidence of skin cancer rise,” said Coren Menendez, M.D., a Baptist Health Medical Group physician with Baptist Health Primary Care. “That may be due to increased awareness among patients and doctors of what to look for and greater access to primary care, but the key to proper treatment is seeking medical attention when something looks new or unusual.”

This is especially true in South Florida, where we face greater sun exposure due to year-round outdoor activities, such as lying out on the beach, swimming, golfing, playing tennis and watching sports outside. Over a period of time, that exposure – especially if left unchecked and unprotected – can lead to skin cancer and melanoma.

Dr. Menendez stresses early intervention to her patients, but recognizes that many myths about skin cancer still exist.

Myth #1: ‘People don’t die from skin cancer.’

“Tell that to the nearly 10,000 people the American Cancer Society estimates will die this year from melanoma,” said Judith Crowell, M.D., a dermatologist in Kendall. “Melanoma, if not diagnosed and treated early, can spread to other parts of the body and be fatal.”

Conversely, Dr. Crowell says that melanomas that are diagnosed early, before they reach 1 millimeter in thickness, have a 95-percent-cure rate.

She advises people to pay attention to the ABCDEs of skin cancer.

• Asymmetry – Is the mole unusually shaped?
• Border – Does the mole have an irregular border?
• Color – Is the mole more than one color?
• Diameter – Is the mole larger than the size of a standard eraser on the end of a pencil?
• Evolution – Has the mole changed, especially over one to two months?

“Skin cancer is easier to detect than other types of cancer, because we can see it,” she said. “So we should pay attention to our skin.”

And while melanoma is the deadliest form of skin cancer, basal cell and squamous cell skin cancers should not be ignored. “These can be locally invasive and lead to disfigurement,” Dr. Crowell said. “Squamous cell carcinoma has been known to spread to other areas of the body as well.”

Myth #2: ‘Only old people have to worry about skin cancer.’

Not true, says Dr. Crowell.

“We’re still trying to map out the pathways that lead to someone getting melanoma,” she said. “We know that exposure to ultraviolet rays is a trigger and that explains why older people with long-term exposure to the sun are at risk, but we’re also seeing more and more young people with melanoma.”

In fact, the American Association of Dermatology reports that melanoma is the most common cancer among people 25 to 29 years old. The Skin Cancer Foundation attributes 6 percent of cancer cases in teens 15 to 19 years old to melanoma.

“The melanoma we see in this population can’t be definitively traced back to sun exposure,” Dr. Crowell said. “To try to explain these cases, we look at family history and noticeable traits that have been linked to a higher risk of skin cancer – fair skin, blonde or red hair color, light-colored eyes, freckles or a high number of moles.”

Dr. Menendez says she pays special attention to her patients with these traits and educates them about the importance of wearing sunscreen, hats and sunglasses to protect their skin and watching their skin for changes. She also refers these patients to a dermatologist for regular full-body exams.

Myth #3: ‘I tan to prevent the sunburn that leads to melanoma.’

“Tanning is the body’s reaction to injury caused by UV rays and it equals skin damage,” Dr. Crowell said. “When the skin is exposed to the sun’s harmful rays, it thickens to try to protect itself from further injury.”

She also warns that in addition to leading to melanoma and other skin cancer, tanning also leads to deep wrinkles and premature aging.

And for those who think that tanning beds are safer than the sun because you’re in them for a short time, consider this statistic from Dr. Crowell: Tanning increases the risk of skin cancer or melanoma by 75 percent.

That has led the International Agency for Research on Cancer to place tanning beds on its list of the most dangerous cancer-causing substances, along with plutonium and cigarettes.

Research points to tanning bed use as significantly increasing a person’s risk for developing melanoma, especially with repeated use.

“I start talking to my patients about the dangers of tanning beds when they are 13 or 14,” Dr. Menendez said. “That way, when they are old enough to go to a tanning salon, they will understand the risks and hopefully decide against lying in one to get a tan.”

Myth #4: ‘Darker-skinned people don’t get melanoma.’

“While the incidence of Hispanics and African Americans getting melanoma is lower compared with Caucasian populations, darker-skinned people are not immune to melanoma,” Dr. Menendez said.

She strongly cautions against this denial of danger, because melanoma in these ethnic populations tends to be caught later, when it has spread to other parts of the body. The American Cancer Society reports that the 5-year survival rate for African Americans with a melanoma diagnosis is 75 percent, versus the 93 percent survival rate in Caucasians.

“I tell my darker-skinned patients to by even more vigilant about their skin,” Dr. Menendez said. “Moles can be hidden or ignored, leading to a later diagnosis, when the cancer may have already spread.”

Myth #5: ‘I read recently that melanoma has been cured.’

Researchers at the Huntsman Cancer Institute in Salt Lake City reported last month they saw success treating melanoma with modified herpes viruses. When researchers injected the virus into the skin where melanoma was, they say the virus attacked the cancer cells, eliminating them.

Dr. Crowell says this research is indeed useful, but advises not to write melanoma off just yet. “This treatment may interfere with the growth of melanomas, but we don’t yet know if the cancer will return somewhere else and if this treatment works on melanoma that has spread,” she said.

Both she and Dr. Menendez say prevention and awareness are the best defenses in the fight against melanoma. When discovered early, the cancer can be surgically removed from the skin and has a 95- percent-cure rate, according to the American Cancer Society.

“We, as doctors, rely on our patients, who see their skin every day, to point out changes to us,” Dr. Crowell said. “We will likely catch something suspicious when we examine you in our office, but when our patients catch the changes themselves, the cancer is usually at an earlier, more curable stage.”

See Related Stories:

Tanning Salons Sued for Alleged False Safety Claims 
The Risks of Tanning 
Skin Cancer Does Not Discriminate 
Melanoma: Learn Your ABCDs

Tags: Baptist Health Primary Care, Coren Menendez M.D., Judith Crowell M.D., melanoma