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Skin cancers, including deadly melanoma, on the increase

Just a brown spot on the skin, a little irregular and splotchy, smaller than a dime, but a melanoma that size can kill, said MUSC dermatologist Joel Cook, M.D.

“We’re seeing a very real increase in skin cancers, but the melanoma is by far the most dangerous because of its ability to widely metastasize.”

Cook said the spread of melanoma beyond that spot on the skin is doubly tragic considering that the cancer is surgically curable in its early stages.

Melanoma is the most rapidly increasing cancer; over 40,000 invasive melanomas will be diagnosed in the United States this year.

Light-skinned Caucasians are especially susceptible to skin cancers, including melanoma. The risk increases, among those who are freckled, sunburn easily and have a family history of skin cancer or melanoma.

These people should thoroughly examine their skin every month, looking for any discoloration larger than a pencil eraser, Cook said. He listed other things to look for: asymmetry (sides don’t match), irregular border, color variations, bleeding or other symptoms.

“Anything suspicious should be seen by a board-certified dermatologist,” Cook said.

Found early, a melanoma usually can be permanently cured with a minor outpatient surgical procedure. Melanomas that are missed can metastasize widely, as they spread the cancer throughout the body. Treatments are seldom successful for widely metastatic melanoma.

Because of the grave danger posed by melanoma and the seriousness of other skin cancers, MUSC dermatologists follow the American Academy of Dermatology recommendation to offer a complete skin screening to every patient seen at the clinic. They hope that frequent screenings, self examinations, and improved public education about the dangers of sun exposure will slow the recent increases in the incidence of skin cancer.

“Sun bathing is a tragedy,” Cook said. “It immediately puts a person at a higher risk for skin cancer. Simple lifestyle modification - avoiding midday sun, wearing SPF15 or higher sunscreens, photoprotective clothing, and self-skin examinations - can significantly lower your risk for melanoma or nonmelanoma skin cancers.

Dr. Joel Cook's recommendations:

• Stay out of the midday sun by avoiding outdoor activities between 10 a.m. and 2 p.m.
• Wear wide-brimmed hats and sunglasses
• Wear clothing that covers arms and legs, and remember that a standard T-shirt is the equivalent of a SPF8 or lower sunscreen.
• Use UVA and UVB protective sunscreen of SPF15 or higher; pay special attention to ears, corners of the eyes, and the upper lip.

“It is important to remember that wearing sunscreen is only a part of a program to protect your skin against skin cancer and premature aging,” Cook said.