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Risk Factors for Melanoma

April 17, 2019 | Dermatology


We often don’t think that skin cancer is life-threatening, but it can be. There are several types of skin cancers, and the most concerning is melanoma.

Melanoma is a serious skin cancer that should be treated immediately. According to the American Cancer Society, about 96,480 new melanoma cases will be diagnosed this year, and every year over the past 30 years, the numbers keep rising.

Melanoma is a form of skin cancer of melanocytes, the cells in the skin that produce protective tan or brown pigment, called melanin, according to Dr. Richard Johnson, a dermatologist at Penn Highlands Healthcare. 

It often appears as dark brown, black or multi-colored growths with irregular borders that may become crusted and bleed.  Signs and symptoms vary, Johnson said but any changing lesion may be suspect, and should be evaluated by your physician.

“The classic melanoma is dark – sometimes it may even be tri-colored, and very often just looks different than all of your other moles,” he said. “For example, you may have three moles; two look the same while the third has a different look making you ask: ‘What is this really strange looking one?’” 

Johnson added that sometimes moles are symptomatic but if you have had a mole for years, and it develops new symptoms, such as itchiness or it bleeds, you should have it evaluated.

“Melanoma is a type of skin cancer often induced by a severe sunburn in youth,” Johnson said. “That’s as opposed to basal and squamous cell skin cancers, which tend to be the result of long-term ultraviolet exposure.”

But it is not just that simple. It is also important to be aware of all the risk factors. They include:
• Organ transplantation;
• Parkinson’s disease;
• Any tanning booth use;
• Participating in outdoor activities particularly during peak mid-day sun times;
• Blistering or any sun burns as a child and even as an adult;
• Having family members who have had melanoma.

Johnson said if you fall into any of these categories, you are more likely than the general population to develop a melanoma. “In fact,” Johnson said, “there is about a 40 percent increase in melanoma risk in tanning booth users as opposed to people who don’t go in the tanning booth.”

Melanoma also tends to run in families and is more common in first degree relatives of melanoma patients - moms, dads, brothers and sisters, and children - than the general public, Johnson said. “Once you get out to then next generation, your risk of developing melanoma is almost back to the general populations risk level.”  
 
Regarding survival rates, Johnson said one factor in determining survival rates is the depth of the lesion.
 
“With early detection and treatment of melanoma, that particular melanoma can be cured, but the patient becomes a member of what I call the ‘Melanoma Club,’ requiring life-long surveillance,” he said. 

With very superficial melanomas, there is a 98-99 percent five -year survival rate if caught early and removed. He said with deeper lesions, a patient may have a 20-30 percent survival rate.  

“So untreated melanoma can be lethal,” Johnson said, “If you don’t seek treatment it will eventually kill you; they need to be treated.”  

According to Johnson, the survival rate may also be based on other medical conditions. “If you have 20 years of tanning booth use and multiple blistering sunburns, you are at a higher risk of developing melanoma or multiple melanomas and potentially a lower five-year survival rate than a patient who does not have that history and develops a new melanoma,” he said.
 
If you want to help prevent melanoma, “stay out of the tanning booth, use sun screen daily/regularly, practice UV avoidance, and wear sunglasses and protective clothing,” he said adding, “It’s a good habit to start early. Sunscreen use should be started as early as six months of age!”
 
Surgery is generally the standard treatment option for melanoma. Some patients may need chemotherapy or radiation, too. For advanced melanomas and metastatic melanomas, there are biological treatments available, such as immunotherapy. Immunotherapy is a medication that stimulates the immune system to work harder to attack cancer cells, or it can give an immune system the proteins or another component to fight cancer cells better. Immunotherapy is useful in a number of types of cancer. There are specific cell structures that indicate when it will be effective. 

If you have questions or concerns about your skin, contact your physician or Johnson’s office at 814-375-4466.