With the arrival of May, our minds begin to turn to outdoor activities, summer travel and emerging after a long winter indoors. As May also marks Melanoma Awareness Month, it is a fitting time to increase our understanding of this potentially deadly form of skin cancer, which can improve detection and save lives.
Melanoma is one of the most common cancer types found in young adults ages 15-29. Despite incredible medical advances, melanoma remains one of the few cancers with incidence rates on the rise. This year alone, approximately eight thousand Canadians will be diagnosed with melanoma.
Melanoma can affect men and women of all ages and races. One of the most significant risk factors for melanoma is exposure to UV radiation from the sun, or artificially from tanning beds. Even one severe sunburn prior to the age of 20 increases an individual’s risk of developing melanoma later in life, and early exposure to tanning beds can increase the chance of developing melanoma by up to 75%. As such, preventative measures for melanoma should start young; we must raise our children with an understanding of the importance of sun protection and the danger of tanning beds.
Prevention is a true cornerstone of melanoma, but there are many myths when it comes to sun protection. My patients are often surprised when I tell them that there is no such thing as a safe tan, and that, ideally, their skin should not change colour at all on vacation or in the summer time. In addition, it is best to get your vitamin D by taking a supplement and eating a diet rich in vitamin D food sources, and not to rely on unprotected sun exposure or tanning beds. During summer months and on vacation, we must protect ourselves in a variety of different ways, applying a broad-spectrum sunscreen of SPF 30 or higher, and remembering to re–apply every two hours or after significant activity. In addition, it helps to seek shade when possible and wear hats and UV protective clothing. If you’ve ever come back from vacation with a burn or deep tan wondering “I don’t understand how this happened, I wore SPF 30 the entire time” it is likely that you applied sunscreen too infrequently, or in insufficient quantities, and then spent much of the day in direct sun without being mindful of seeking shade.
Because survival rates are very high when melanoma is detected early, knowing what to look for on your skin during regular self-checks can make the difference between life and death. You should take the opportunity to self-check your skin often, making note of any new or changing spots.
Melanoma typically presents itself as a brown spot on the skin, and can either occur from changes in an existing mole, or as a new mole that was not there previously. When determining whether a brown spot on the skin is potentially dangerous, it can be helpful to use the ‘ABCDE Rule’:
A – Asymmetry: Is the spot irregularly shaped (not round or oval)?
B – Border: Does the spot have borders that are uneven, notched, blurred or difficult to follow?
C – Colour: Is the spot very dark in colour compared to your other spots, or does it have multiple colours within it?
D – Diameter: Is the spot larger than 0.6 cm (around the same size as a pencil eraser)
E – Evolution: Is the spot growing or changing over time?
If you answered yes to any of the above questions, it is important that you have your spot examined by a physician, who can properly assess and remove it to be sent for biopsy, if needed.
Summertime can be a wonderful time of year for relaxation and outdoor activities, and with just a little bit of extra thought and planning, it is possible to enjoy a sun-safe summer holiday.
A board-certified dermatologist in both Canada and the United States, Dr. Jennifer Salsberg has authored a number of research articles published in peer-reviewed journals and been quoted in a variety of magazines, newspapers and online publications. She is an Assistant Professor at the University of Toronto and on staff at Women’s College Hospital in Toronto, where she takes an active role in medical education.