Northern Westchester Hospital Chief of Dermatology Talks Skin Cancer and Melanoma

Posted on: July 31, 2014

Melanoma: The black sheep of the family

By Dr. Ross Levy

Of the three common types of skin cancer, melanoma is the most worrisome. This aggressive cancer is deadly when caught late. Skin cancer in general is on the rise: Fifty years ago, one in 2000 people developed a melanoma. Now it’s one in 35. By gaining a better understanding of melanoma and its causes, you remove some of the scare and can protect yourself.

The cancer starts in pigment cells in the skin. The cells can turn cancerous after excessive exposure to sunlight or spending too much time in tanning booths. About 85 to 90 percent of melanomas are caused by UV rays. Genetics can also play a role – having one parent with melanoma puts your risk at 30 percent; having two parents increases your risk to 80 percent.

Fair-skinned people are at highest risk; melanoma is rare in dark-skinned people. In men, the telltale moles are often found on the head, neck or between the shoulders and hips. Women often get melanomas on the trunk or lower legs. The danger is that, over time, melanomas can metastasize (spread or grow) releasing mutated cells that travel to other organs in the body, and that can be deadly.

The first step to protecting yourself is limiting your exposure to UV light. Cover up when you’re outside, wear sunscreen on any exposed skin, and stay out of tanning booths. The second step is to keep an eye on any moles you have. Look for moles that change and are a bit darker. A melanoma is the black sheep of the family. It’s the mole that looks really different than the others.

Size can also be an indication of a melanoma, but you don’t want to find it when it’s too big and may have had a chance to spread. If you’re worried about a mole, see your dermatologist. Considering there are about 80,000 new cases a year and about 9,000 deaths from melanoma, it’s critical that you catch it early.

According to the American Cancer Society, sun exposure is the most preventable risk factor for all skin cancers, including melanoma. For the best protection, select a sunscreen that can prevent sunburn, reduce your risk of getting skin cancer, and help prevent early signs of skin aging.

The “ABCDE” rule
This rule, according the National Cancer Institute, can be helpful in identifying the features of early melanoma.
•    Asymmetry. The shape of one half does not match the other half.
•    Border that is irregular. The edges are often ragged, notched, or blurred in outline. The pigment may spread into the surrounding skin.
•    Color that is uneven. Shades of black, brown, and tan may be present. Areas of white, gray, red, pink, or blue may also be seen.
•    Diameter. There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than 6 millimeters wide (about 1/4 inch wide).
•    Evolving. The mole has changed over the past few weeks or months.
Melanomas can vary greatly in how they look. Many show all of the ABCDE features. However, some may show only one or two of the ABCDE features.

Editor’s Note: Ross Levy, MD is Chief of Dermatology at Northern Westchester Hospital