May is Skin Cancer Awareness Month and a good time to examine your body for potential problem spots. Among the most common skin cancers – which include melanoma, basal cell carcinoma and squamous cell carcinoma – melanoma is the most serious and potentially deadly. It must be treated and surgically removed for survival.
The good news is that if diagnosed and removed while in its early stages, melanoma is almost 100 percent curable. Unfortunately, once it spreads it is difficult to treat and is frequently deadly.
“Prevention, early detection and surgical treatment still offer the best chance for survival of melanoma,” said Dr. Gary Goldenberg, a New York-based board-certified dermatologist and dermatopathologist.
The symptoms of melanoma are varied as it has a myriad of possible appearances – ranging from an irregularly colored lesion to an unremarkable beige spot. In general, a pigmented spot that is changing should be considered a potential melanoma and must be evaluated by a dermatologist.
Within the category of melanoma, there are four basic types.
– 1. Superficial spreading melanoma is the most common and accounts for about 70 percent of all cases. It is detected by its irregular borders and color. This type of melanoma may be seen anywhere on the body, but is most frequently found on the trunk or backs of men, and on the legs and backs of women.
– 2. Lentigo maligna is usually seen in fair skinned people with considerable sun damage. Typically, these large brown or black patches are on the face and ears. These tend to grow slowly and remain superficial for long periods of time.
– 3. Acral lentiginous melanoma occurs on the hands, feet or nails. They are difficult to diagnose and may require a nail biopsy, so there is often a delay in finding them. This type is the most common melanoma in African-American and Asians and the least common among Caucasians.
– 4. Nodular melanoma is invasive at an early stage and usually begins as a black, blue or pink bump. This aggressive type of melanoma accounts for 10 to 15 percent of cases.
Treatment of melanoma is surgical, and while the recommended margins have changed over time, the basic approach has not. Development of a melanoma vaccine continues to be an active area of melanoma research. “Among the several vaccines currently in trials, OncoVEX is a product that’s currently in Phase III trials and appears promising,” Dr. Goldenberg said.
But even more exciting is the recent FDA approval of ipilimumab, a new drug for treatment of advanced cases.
“Ipilimumab is a new biologic for melanoma that has been shown to prolong survival in advanced disease,” explained Dr. Goldenberg. “It functions by blocking CTLA-4, which is a regulator of the immune system. The survival was longer for patients on ipilimumab than those that received a tumor vaccine.”
Best case scenario is to prevent the occurrence of melanoma in the first base. In this regard, the sun truly is the enemy. “Prevention includes sun protective measures, such as sun avoidance, sunscreen and sun-protective clothing. It is recommended to use SPF 50 sunscreen, with UVA and UVB protection,” Dr. Goldenberg stressed.
Anyone who has more than 100 moles is at greater risk for melanoma, according to the Skin Cancer Foundation, and must know their body and moles well to detect any changes. Full body checks by a dermatologist are also a necessity for those at risk. “Total body skin checks are advised, especially for those with a history of blistering sunburn, long-term sun exposure, history of dyspastic/abnormal moles and patients with a high number of moles/freckles.
So, in honor of Skin Cancer Awareness month, pull out that hat and spread on that sunscreen. If you fall into a high risk category, make an appointment to visit a dermatologist today.