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Mole patrol: How to detect and prevent the deadliest form of skin cancer

Mary Bressler, a nurse practitioner for Lake Region Healthcare’s dermatology department, shares advice on what makes us more susceptible to this cancer, how to detect it, and how to prevent it.

Thinking you can get a “healthy tan” this summer?

Think again.

That supposedly “healthy glow” is actually a sign of sun damage. And along with every suntan and sunburn comes an increased risk of skin cancer.

The most serious form of these is melanoma, which occurs in the melanocytes, the cells that color the skin and make moles. Melanoma is especially deadly because the cancer can spread – sometimes quickly – to lymph nodes and distant organs.

Melanoma has become the most common cancer in people 25-29 years old, and someone dies from melanoma every hour in the United States, according to the American Academy of Dermatology (AAD).

But there’s good news. It’s believed that nearly 90 percent of melanomas are caused by exposure to ultraviolet (UV) rays, which means we know what we need to avoid. Clinicians keep getting better at detecting it. And if melanoma is caught and treated at its earliest stages, cure rates can near 100 percent, according to the AAD.

Mary Bressler, a nurse practitioner for Lake Region Healthcare’s dermatology department, shares advice on what makes us more susceptible to this cancer, how to detect it, and how to prevent it.

Who is most susceptible

Melanoma is on the rise. In 2015, it’s expected that approximately 74,000 Americans will be diagnosed with some stage of melanoma, while another 63,000 will be diagnosed with melanoma “in situ” (early stage, with the cancer contained where it started).

The increase is partly because the Baby Boomer generation grew up tanning, Bressler says.

Other risk factors may make us more vulnerable to melanoma:

  • Skin: The AAD says the risk is higher for people who are fair-skinned, have red or blond hair, and have blue or green eyes. The risk is also higher for anyone with more than 50 moles on the body or anyone with sun-sensitive skin (rarely tans or burns easily). However, someone with brown or black skin can also develop melanoma.
  • Family or medical history: You are at a higher risk of developing it if first-degree relatives – parents, children, or siblings – are diagnosed with it. Those with weakened immune systems also are more likely to get it.
  • UV exposure: Research suggests that nearly 90 percent of melanomas are caused by exposure to ultraviolet rays. If you’ve experienced bad sunburns or spent time tanning, your risk is greater. Indoor tanning is especially dangerous: Research shows that tanning bed use before age 35 increases melanoma risk by 75 percent, according to the AAD.
  • Occupation: Farmers are among those who are especially prone to skin cancers. They spend many hours in the mid-day sun from May through October. Locally, outdoor workers may counter that they only spend time in the sun a few months each year, but if they spend time outdoors in the wintertime, snow will actually reflect and intensify their exposure to UV rays, Bressler says.

How to detect it

“A zebra in a horse pasture.”

That’s the analogy Bressler uses to tell patients what to look for when assessing their own skin. In short, watch for anything that looks out of place. She recommends a regularly scheduled, methodical self-assessment (for guidelines, check out the “body mole map” at http://bit.ly/1E8njZ7).

You should be suspicious of any mole or lesion that itches, bleeds, hurts, changes appearance, or shows an asymmetrical color or texture. Have a doctor check moles that show irregular borders, keep growing, or look like bruises or injuries that won’t heal.

Keep in mind that melanomas can pop up in areas that don’t seem to get a lot of sun exposure, such as the genital area, the scalp, or beneath your nails.

If your doctor thinks a mole or spot looks suspicious, he or she will order a biopsy, in which a small sample of skin is removed to be examined in a lab. The biopsy will help determine whether melanoma is present and, if so, what its stage is. (The stage describes how deeply the melanoma has grown into the skin.)

Depending on severity of the cancer, treatment may range from a simple excision of the cancerous spot to a more elaborate combination of surgery, chemotherapy, radiation, or removal of affected lymph nodes.

 

How to prevent it

Of course, it makes the most sense to avoid excessive UV exposure in the first place. That means limiting your sun exposure (especially between the hours of 10 a.m. and 2 p.m.), avoiding tanning beds, and performing regular mole checks.

Another weapon in your melanoma-fighting arsenal is sunscreen. Read the label to ensure it has an SPF of 30 or higher, is broad spectrum (meaning it protects the skin from both ultraviolet A and ultraviolet B rays), and is water-resistant.

When applying sunscreen, don’t be stingy. Use one ounce (enough to fill a shot glass) to get adequate coverage. And reapply it every 40 to 80 minutes, as even water-resistant sunscreens won’t hold up long to water sports, toweling off, or heavy perspiration.

As is often the case in health care, an ounce of prevention is worth a pound of cure.

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