Skin Cancer: The Melanin Report

May is skin cancer awareness month and it couldn’t come soon enough! Right now in Arizona, our weather has skipped spring and moved right into summer. In fact, we hit our first triple digit temperature (101F) over the weekend.

Due to COVID19, people have been seeking safe ways to maintain social distancing recommendations while keeping their bodies fit and the minds calm, and this means moving towards outdoor activities. People are hiking and spending time at the pool, which is amazing for the body and spirit, but also means increased exposure to the sun’s UV radiation.

Many people are aware about the need to reduce risk of sunburn and skin cancer by utilizing sunscreen, but there is an imbalance between sunscreen use in darker skinned people and fair skinned peopled. This data is concerning especially because skin cancer affects everybody. Yes, black people can also get skin cancer. Most people know that Bob Marley died from melanoma at the age of 36. He was diagnosed with acral lentiginous melanoma, which is seen on the palms of the hands, soles of the feet, mucous membranes, and nail beds. Bob Marley’s melanoma presented on under one of his toenails, and he initially dismissed it as a soccer injury.

So, because everyone is at risk, it’s important to understand what factors increase one’s risk. If you notice new or abnormal moles, say something. Everyone should discuss getting annual skin checks with a dermatologist, and perform self skin checks on yourself monthly. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Who are at higher risk?⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with fair skin⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with dysplastic nevi ⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with precancerous skin lesions known as actinic keratoses⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with pre-existing conditions and weakened immune systems ⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with poor nutrient intake⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with family history of skin cancer⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with lots of sun exposure (those who work / spend a lot of time outdoors)⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with history of severe sunburns or early age of first sunburn⠀⠀⠀⠀⠀⠀⠀⠀⠀
- People with radiation exposure ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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The 3 most common forms of skin cancer are: basal cell carcinoma, squamous cell carcinoma, and melanoma. Most skin cancers are treated by dermatologists, and as an oncologist, I come in to the picture when disease is wide spread or metastatic. The skin cancer I treat most often is Metastatic Melanoma.

Did you know that African Americans and Asian Americans with melanoma have a greater tendency than Caucasians to initially present with advanced disease at the time of diagnosis?

Although the rate of melanoma in African Americans is lower at ~1 in 100,000 (compared to ~22 in 100,000 in Caucasians), the survival rate in African Americans is lower at 77% compared to 91% for Caucasians.

Part of the reason for this is that brown and black people are not aware that they too are at risk, and do not recognize signs of disease. Although melanin provides some natural protection from UV radiation, it does not mean immunity.

Another reason is that people in healthcare have a lower index of suspicion for skin cancer in brown and black people and the educational data has often focused on showing what these cancers look like agains fair skin (though this is changing).

Children, especially non-Caucasian children, are an incredibly vulnerable population and are at increased risk of developing melanoma compared to adults counterparts.

Other skin cancers:

Basal cell carcinoma most frequently occurs in Hispanics, Chinese, Japanese, and Caucasians.
The most common skin cancer in African Americans and Asian Indians? Squamous Cell Carcinoma

Spring and summer means more outdoor activities, including swimming so be vigilant about protecting yourself and your children, including by applying and re-applying sunscreen.

Source: SEER Cancer Statistics Review