Today, most people understand the benefits of protecting skin, but that doesn't necessarily mean they're vigilant about their exposure. And in many incidences of melanoma, the danger has been present since a childhood spent in the sun – complete with frequent sunburns and a lack of sunscreen.
CancerQuest.org lists infrequent but intense exposure to sunlight during childhood as a major risk factor. In fact, the number-one risk factor for melanoma is exposure to sunlight, specifically ultraviolet light (UV) rays. It seems that an increase of blistering sunburns positively correlates to developing melanoma. Skin care experts overwhelmingly agree that how skin is treated and exposed to the sun make a significant difference in skin problems, including skin cancer, later in life.
Seventy-five percent of all known melanoma cases occur in persons over the age of 45. But younger people should remain vigilant. Melanoma is the third most common cancer among women aged 20-39 years and the second most common cancer in men aged 20-39 years, according to the Aim at Melanoma Foundation.
Melanoma: Who is at risk?
Family history and skin type are two major risk factors for melanoma. Ten percent of people who have melanoma have family members who have had it, and worldwide, Caucasian populations have the highest risk of contracting melanoma. In fact, Caucasian-Americans are 23 times more likely to develop melanoma than African-Americans. Asian populations have the lowest risk worldwide.
Caucasians with light hair and eyes, fair complexions that easily sunburn and freckles, are at highest risk for melanoma. Melanin, the pigment protein that colors the skin, hair and some places around the eyes, also protects from UV radiation. The particular makeup of melanin is a matter of DNA.
For people with known family histories of melanoma, it's important to see a dermatologist regularly and to conduct skin self-examinations regularly, looking for any marks – freckles, moles or other irregularities – that are new, change in appearance, bleed or simply seem suspicious. Numerous moles, or nevi, can indicate an elevated risk for melanoma.
One frequently misdiagnosed or ignored type of melanoma can be deadly. Acral lentiginous melanoma (ALM) growths appear most often on palms, between toes and fingers, on the soles and under nails. Often mistaken for an injury or fungus, those afflicted may ignore it. Sometimes by the time this cancer is diagnosed, it can be quite advanced. This type of skin cancer does not have anything to do with UV exposure, so people of all races and ethnicities can develop. This type of melanoma does not seem to have a genetic component, either.
Melanoma's Grim Odds
There's no denying that melanoma kills. In fact, though it's the least common skin cancer, it is more deadly than its counterparts, squamous cell carcinoma and basal cell carcinoma, which can recur but are rarely fatal. With a 200 percent increase in its incidence since 1973, melanoma has become the most rapidly increasing cancer. The good news is that the five-year survival rate for melanoma has increased in the same time frame.
But for some ethnic groups, melanoma can be deadlier and more advanced when detected than for others. A Washington Cancer Institute study found that 32 percent of African-American melanoma patients were diagnosed with Stage III or IV melanoma. Only 13 percent of Caucasians were diagnosed with late-stage melanoma. Long-term survival for African-Americans is far less than that for Caucasians, too. Just 58.8 percent survived five years past diagnosis, compared with 84.8 percent of Caucasians.
Attitudes have changed, but for many, sun exposure and tanning are still symbols of vitality, carefree beach living, and even financial freedom. Some figure only the wealthy can afford discretionary time spent at the beach – picture people sunbathing while reading and sipping cocktails. It feels like only in the latter part of the last century did general concerns over skin care raise alarms about the dangers of sun exposure. Today, the mainstream message includes the phrase, “There's no such thing as a safe or healthy tan.”