Sunscreen Check Does Malignant Melanoma
The
short answer is not necessarily. Two reasons why:
1.
People slather it on and then bake in the sun twice as long they should.
2.
Some sunscreens are not broad-spectrum. In other words they protect against UVB
rays but not UVA rays, which may also cause skin cancer - including malignant
melanoma, which can be deadly.
Last
year the FDA issued new sunscreen guidelines for manufacturers.
- In order to claim that a sunscreen protects against skin cancer, it must be at least SPF-15 and must protect against UVB and UVA. If the claim can't be made, a warning must be added to the label: "This product has not been shown to prevent skin cancer or premature skin aging."
- No sunscreen is really waterproof so only the term water-resistant can be used and only if studies prove that the product retains its value after being exposed to water.
- The term sun block can no longer be used, because no sunscreen can completely block the sun.
Even
if you choose the right kind of sunscreen, you also have to use common sense.
Here are some recommendations from the American Board of Family Medicine:
How
to use sunscreen
- Don't put on sunscreen and then stay in the sun so long you get sunburn.
- If your skin starts to get red or feel uncomfortable, don't just reapply sunscreen, cover up or get in the shade.
- Wear protective clothing, a hat, and sunglasses along with sunscreen.
The
goal isn't to avoid getting any sun exposure at all - in fact sunlight is an
important source of Vitamin D. The recommendation is that we get from five to
30 minutes of sun exposure between 10 am and 3 pm at least twice a week to our
face, arms, or back. What you want to avoid is sunburn because sunburns
increase your risk of developing malignant melanoma.
Did
you know malignant melanoma is now the most common skin cancer among people 25 to
29 years old? The Mayo Clinic just published research that showed the
incidence of malignant melanoma has increased more than six fold in the past 40
years. Multiple studies have shown a strong connection between sunburns during
childhood and adolescence and malignant melanoma.
Dr.
Frederick Aronson, a cancer specialist at Maine Center for Cancer Medicine in
Scarborough, Maine says, "Most of the ultraviolet radiation that causes
melanoma is delivered to the individual at risk before age 20. There are
migration studies that show if you grow up in a high sun region and move to a
lower sun region in your 20s, your melanoma risk is as if you lived in the high
sun region all your life and vice versa. If you live in a low sun region and
move to a high sun region in your 20s your melanoma risk remains relatively
low."
The
National Cancer Institute lists a number of melanoma risk factors we should be
aware of:
Malignant
melanoma risk factors related to sunlight
- Fair-skinned with blue or green eyes, or red or blond hair
- Live in a sunny climate or at a high altitude
- High exposure to strong sunlight
- Have had one or more blistering sunburns during childhood
- Use tanning beds
Non-sunlight
related risk factors
- Close relatives with a history of melanoma
- Come in contact with cancer-causing chemicals such as arsenic, coal tar, and creosote
- Certain types of moles (atypical dysplastic) or multiple birthmarks
- Weakened immune system due to disease or medication
Mike
Cushman was diagnosed with advanced malignant melanoma in 2010. He has a story
to share about the importance of catching it early. "I had a suspicious
mole on the back of my head under my hair," he recently described to me.
"My daughter spotted it and suggested my doctor check it out. The biopsy
came back benign. Late July I felt a lump in that same area. In early August it
was removed for biopsy and came back malignant melanoma. I cannot trace the
melanoma to my family. I seem to be the only one. As a child growing up in the
50s and 60s I probably had my share of sunburns."
Surgery
is the most effective treatment for malignant melanoma. Depending on a variety
of factors, chemotherapy, radiation therapy, and immunotherapy are also used to
treat melanoma. Each comes with some serious side effects. Several promising
new treatments are now being studied in clinical trials, including a targeted
therapy that has offered a great deal of hope to Mike. The treatment targets a
mutated gene found in about half the people diagnosed with metastatic malignant
melanoma.
"I
am on a GlaxoSmithKline Phase 1 Clinical Trial BRF113220. It is a combination
of a Brave and MEK protein inhibitor. It is a targeted therapy. I have a Brave
mutation in the cancer cells, which allowed me to be a candidate for a trial. I
am doing very well. I have been on this treatment for 15 months. My CT-Scans
continue to show stable tumor size and no new tumors. That is always good
news."
Dr.
Aronson says targeted therapies are hopefully, "the future of cancer
treatment in the universe, where we don't rely on the immune system to fight
the cancer, but we identify a mutation in the cancer cell that is driving the
cancer cell to proliferate and survive and cause trouble in your body. We
specifically design in the laboratory a small molecule that can target that
particular mutant process and cripple it. Because it's specific to the tumor
cell the side effects from the treatment are much less."
The
new approach to treating cancer holds a great deal of promise, but the real
keys to treating malignant melanoma are preventing it in the first place and
learning how to identify it as early as possible. The first signs are often
changes in an existing mole, but it can also show up as a new mole.
Signs
of melanoma in a mole
- Asymmetrical shape - one half doesn't match the other
- Borders are irregular - ragged or blurry edges or pigment that spreads into surrounding skin
- Color is not even - usually shades of brown, black, and tan, but sometimes whitish gray, red, pink or blue
- Diameter - usually bigger than a pea, but can start tiny and get bigger
- Evolving appearance - a change that happens in just weeks or months.
Mike
says at his age he chooses not to dwell on sunburns he got when he was younger.
"I cannot go back and undo the past. What I would have done differently is
talk to my doctor about follow up care with a dermatologist. I am very thankful
that my daughter brought to my attention the suspicious mole on the back of my
head. My two daughters now have a family history of melanoma and they see a
dermatologist at regular intervals. Believe me, I ask them if they have been
going to their appointments."
If
you've been meaning to get screened for any suspicious moles or are worried
about one in particular, Mike recommends that you make an appointment right now
to have it checked out. And if you're told that it's nothing, but you're not
convinced, get a second opinion.
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