Aloha Laboratories, Inc.

Melanoma
Most people are aware that melanoma is a skin cancer that can spread earlier and more quickly than the other skin cancers. Our awareness in the public and in the medical community is increasing about how the sun causes skin damage. There are great sites on the internet with an incredible amount of information about all aspects of melanoma. In this article, I will narrow down that information and answer a few basic questions.

What is Melanoma?
Melanoma is a cancer in melanocytes, or pigment-producing cells, in the skin. There are other types of skin cancer that don't spread, but melanoma is the type that can spread to other areas of the body, or metastasize. It most frequently appears on the trunk in men and on the legs in women, but it can occur anywhere on the body.

Significance of Melanoma
Melanoma is the eighth most common cancer in the United States and causes 1-2% of all cancer deaths. The incidence of melanoma has been increasing faster than any other cancer over the past 20 years. The way to decrease your chance of developing melanoma is to recognize if you are at risk and take measures to decrease that risk or be more vigilant.

Melanoma Risk Factors
The following are risk factors from the highest to lowest risk. Also, the more risk factors you have, the higher your chances are of getting melanoma.

• A mole that is changing
• Atypical nevus syndrome
• Having a mole that is >15cm in diameter and has been present since birth
• White race
• A prior skin cancer
• A close family member with melanoma
• Using a tanning bed ten times a year or more before age 30
• More than 50 moles on your body
• Suppression of the immune system
• The tendency to burn and freckle instead of tan

Preventing Melanoma
The best prevention is to recognize any risk factors you may have and take steps to prevent sun damage. Use a sunscreen that has at least an SPF of 15 anytime you go out in the sun. If you have several risk factors you should probably use a sunscreen all the time with an SPF of 30. There are several moisturizers you can buy that already have sunscreen added to them.

Recognizing Suspicious Moles
The common rule of thumb is to apply the ABCD's.

• Asymmetry - Draw a line through the middle of the mole. If the halves don't match, the mole is asymmetric and more likely to be abnormal.
• Border - The borders of atypical moles are not well defined or can look scalloped with notches between the scallops.
• Color - An uneven color throughout the mole is more likely a sign of abnormality. This is especially true if all the other moles on your body are a uniform color. On the other hand, some people normally have moles that have different colors in them. The colors red, white, and blue may be patriotic, but they also are signs of abnormality.
• Diameter - Most melanomas spread horizontally before they start to spread vertically. Therefore look for moles that are enlarging in diameter greater than 6 mm or 1/4 inch. This is about the size of a pencil eraser.

Melanoma Treatment

If you are concerned about a mole, you should ask your provider about it. Treatment of melanoma starts with excision of the lesion also taking at least a 1 cm border of healthy tissue around it. The stage of the cancer is determined by how many millimeters thick the cancerous tissue is. To make sure the cancer hasn't spread to other areas of the body, a chest x-ray is taken and a lab test checking the liver is also done. Depending on several factors, sometimes lymph nodes in the area are removed and examined to see if they contain cancerous cells. If the cancer has spread to other areas of the body, the best treatment is to remove the cancerous tissue if possible. Sometimes, chemotherapy is used along with removal. Radiation therapy is generally not helpful. Finally, there are controversial treatments involving interferon and vaccines.

 This image below represent a microscopic image of malignant melanoma.  Please not the cells invading the epidermis and dermis, those in the epidermis are said to have Pagetoid spread.

 

 

The ABCDEs of Melanoma 

 

Skin cancer can develop anywhere on the skin. Ask someone for help when checking your skin, especially in hard to see places. If you notice a mole that is different from others, or that changes, itches or bleeds (even if it is small), you should see a dermatologist. 

 

 

 

A-Asymmetry = One half unlike the opposite half.

 

B-Border = Irregular, scalloped or poorly defined border.

 

C-Color = Varied from one area to another; shades of brown, tan, black, red, white and blue or any combination.

 

D-Diameter = Usually greater than six millimeter, but maybe be less than the size of a eraser.

 

E-Evolving = A mole than changes in size, shape or color over time. 

Here's how to Be Sun Smart

• Generously apply a water-resistant sunscreen with a Sun 

Protection Factor (SPF) of at least 15 that provides broad-spectrum 

protection from both ultraviolet A (UVA) and ultraviolet B (UVB) 

rays to all exposed skin. Re-apply every two hours, even on cloudy 

days, and after swimming or sweating. Look for the AAD SEAL 

OF RECOGNITION® on products that meet these criteria. 

 

• Wear protective clothing, such as a long-sleeved shirt, pants, 

a wide-brimmed hat and sunglasses, where possible. 

 

• Seek shade when appropriate, remembering that the sun's rays 

are strongest between 10 a.m. and 4 p.m. If your shadow is shorter 

than you are, seek shade. 

 

• Protect children from sun exposure by playing in the shade, 

wearing protective clothing and applying sunscreen. 

 

• Use extra caution near water, snow and sand as they reflect 

the damaging rays of the sun, which can increase your chance 

of sunburn. 

 

• Get vitamin D safely through a healthy diet that may include 

vitamin supplements. Don't seek the sun. 

 

• Avoid tanning beds. Ultraviolet light from the sun and tanning 

beds can cause skin cancer and wrinkling. If you want to look 

like you've been in the sun, consider using a sunless self-tanning 

product, but continue to use sunscreen with it. 

 

• Check your birthday suit on your birthday. If you notice 

anything changing, growing or bleeding on your skin, see a 

dermatologist. Skin cancer is very treatable when caught early.