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The Catalyst

New directions in melanoma management

By Kimberly McGhee
Progress Notes

Test your skin cancer IQ

Which one of the following statements about skin cancer is true?

a. It is a disease primarily of the elderly.
b. It does not pose a serious health risk.
c. Melanoma, a type of skin cancer, is increasing in frequency more than any other cancer (except lung cancer in women).
d. Tanning beds are not a risk factor for skin cancer.


If you answered “c,” you are correct.

Melanoma, a potentially lethal form of skin cancer, is becoming more frequent, especially in the young. Adolescent boys are four times more likely and adolescent girls eight times more likely to be diagnosed with melanoma than were those of a similar age in the 1970s, likely due to tanning bed use.

Medical illustration by Sargent Illustrations And Design, LLC
Medical illustration by Sargent Illustrations And Design, LLC

Melanoma is the second leading type of invasive cancer diagnosed in people 15 to 29 years of age.

It can also be deadly. Of the almost 77,000 people who are expected to be diagnosed in 2013, one in eight will die of the disease. Although a family history of the disease, a fair complexion, a high number of moles, irregular or asymmetrical moles and a weakened immune system all increase the risk of developing melanoma, severe sunburns, especially at a young age, are thought to put one at the greatest risk.

That is why the increased use of tanning beds by young people has raised alarm. The International Agency for Research on Cancer recently reported a 75 percent increase in melanoma risk for those who used a tanning bed when aged less than 35. Yet more and more adolescent girls are choosing to visit tanning salons.

According to the American Academy of Dermatology, 32 percent of young women reported using a tanning bed within the past year, 25 percent of whom admitted to regular use. Another study reported that 66 percent of college students who had used tanning beds had been burned at some point, and many had suffered multiple burns.

Dr. Joel Cook, director of the Division of Dermatologic Surgery.
Dr. Joel Cook, director of the Division of Dermatologic Surgery.

On May 6, the United States Food and Drug Administration, alarmed at evidence linking tanning bed use in the young to an increased risk for melanoma, ordered that a warning label be affixed to all tanning beds and on promotional information for tanning salons — akin to the warning label that must be printed on cigarette packages — that will read “Attention: This sunlamp product should not be used on persons under the age of 18 years.” The FDA will also encourage all people using tanning beds to obtain regular cancer screening.

Joel Cook, M.D., director of the Division of Dermatologic Surgery at MUSC, strongly supports this action by the FDA because he has seen far too many young people die of melanoma that may have developed as a result of tanning bed use.

Although all tanning bed use increases risk, the most dangerous practices identified by the FDA are failing to wear the goggles provided (exposure to UV light can cause eye injury), failing to follow the manufacturer-recommended exposure times for your skin type and starting with long exposures (close to the maximum) that can lead to burning.

Dermatologists also recommend that everyone use skin-protective clothing and sunscreen while in the sun.
If melanoma is caught early, the survival rate is higher than 90 percent.

Dr. Ramsay Camp, director of the Jenny Sullivan Sanford Melanoma & Skin Cancer Program at MUSC, talks to colleagues.
Dr. Ramsay Camp, director of the Jenny Sullivan Sanford Melanoma & Skin Cancer Program at MUSC, talks to colleagues.

However, the chance of surviving is cut in half if melanoma is diagnosed after lymph node involvement and less than 20 percent when diagnosed after it has already spread to other sites in the body.

Since early detection is key to survival, everyone should engage in regular self-examination of their skin to identify any moles and to look for the ABCDEs (asymmetry, border irregularities, color variegation, diameter greater than 6 mm, and enlargement or evolution in color change, shape, or symptoms). If a suspect lesion is found, consult a dermatologist for further evaluation.

Learn more about the diagnostic tools and treatments available for melanoma at MUSC Hollings Cancer Center’s Jenny Sullivan Sanford Melanoma & Skin Cancer Program, directed by E. Ramsay Camp, M.D., and designated a Melanoma Center of Excellence in 2008, in the May-June 2013 issue of Progressnotes, available at MUSChealth.com/progressnotes.

Editor’s note: “Progress Notes” is a bimonthly publication produced by Business Development & Marketing Services and sent to all physicians licensed in South Carolina to inform them about clinical and research innovations at MUSC.

 
 
 

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