Question on Melanoma

Dear Dr. Spence,
Being light skinned, I am concerned about the possibility of developing melanoma. Is there any way I can protect myself? What are the warning signs of melanoma? Please tell me about the disease?
Signed,
Holy Moley

Dear Holy Moley,
Melanoma is the least common of the skin cancers, but unfortunately, it is the most deadly. The American Cancer Society estimates an annual incidence of 62,000 new cases of melanoma of which 8000 people will ultimately die. It is most commonly a direct result of sun exposure – UV radiation may cause damage to the DNA of melanocyte cells in the skin. Sustained damage may eventually result in cancer formation. We use the standard acronym of ABCD to describe the identifying factors in melanoma diagnosis.
A: asymmetry – If the lesion is cut in half, does it match the other half?
B: border – Is the edge of the lesion irregular, ragged or blurry?
C: color – Is the color of the lesion uniform or variable, or dramatically dark?
D: diameter- Is the lesion greater than 6 mm wide? These are all potential warning signs. For example, a mole that has a ragged border, is itchy, and multi-colored (black/blue) has a greater likelihood of malignancy.
Perhaps even more important is "E" – an "evolving" lesion. This may represent a change in color or size, or may be a mole that has suddenly bled or itched. All would warrant a trip to the doctor.
Prevention is key. The most obvious risk, sun exposure, is easily controlled. Intermittent exposures with associated burns appear to be more dangerous than chronic exposure. Darker skin (as with chronic sun worshippers) may be protective against the development of melanoma. It is also speculated that chronic exposure may increase the amounts of vitamin D in the body. Vitamin D has been shown to potentially limit a patient’s risk of developing certain cancers. The easiest way to prevent melanoma is to avoid the sun entirely, especially between the hours of ten and two. Application of sunscreen with SPFs of 15 or more, or the use of sun protective UV blocking clothing are other methods that decrease risk. Avoiding sunburn is critical! As noted above, since vitamin D may decrease the development of certain cancers, including melanoma, dietary supplementation may confer some benefit at prevention. Vitamin D rich foods such as salmon and cod liver oil can be added to the diet, or one may also supplement with 800-1000 IU of vitamin D per day. Simply put, if you are concerned about melanoma, avoid direct sun exposure and tanning beds. If your idea of tanning is sitting on a tar roof with the assistance of accelerants like baby oil, Crisco or PAM, you are setting yourself up for skin cancer, or at the very least, alligator skin.

Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.