By Chuck Green
What makes melanoma more dangerous than other forms of skin cancer?
Unlike basal cell carcinoma and squamous cell carcinoma, melanoma is considerably more likely to spread throughout the body, experts explain. While all forms of skin cancer are harmful, melanoma’s potential to travel to the lungs, liver, bones and brain is particularly dangerous and potentially life-threatening. Melanoma accounts for 1 percent of all skin cancer cases but comprises the vast majority of skin cancer deaths, according to the American Cancer Society.
Even if caught in its early stages, there’s a 10 percent chance melanoma will recur, says Jason Luke, MD, a medical oncologist and assistant professor of medicine at University of Chicago Medicine. Even small tumors (less than one millimeter) are potentially dangerous and should not be overlooked.
Consequently, during Melanoma/Skin Cancer Detection and Prevention Month in May, it’s important to remember that the chief risk factor for melanoma is overexposure to the sun.
“People should wear sunscreen with an appropriate SPF (at least 30) and shouldn’t get fried,” Luke says. “That doesn’t mean they can’t be in the sun at all, but they should take reasonable precautions, such as limiting direct sunlight and repeatedly applying sunscreen, especially when around reflective surfaces such as water.” He also recommends yearly dermatologist visits to spot any early signs of skin cancer.
And, by all means, avoid tanning salons, which emit harmful UV radiation, Luke says. “It’s a national travesty that we have tanning beds. It’s a public health disaster. I can’t emphasize enough that tanning is a terrible scourge on our society.”
Individuals can fight against melanoma by paying attention to their skin, says Louise Perkins, PhD, chief science officer for the Melanoma Research Alliance in Washington, D.C. For instance, wear a wide-brimmed hat and cover skin with loose-fitting clothing “basically to create your own shade,” she says. And make sure to apply a broad spectrum sunscreen of SPF 30+ every two hours. “Most people either don’t use enough sunscreen or fail to put it on often enough.”
Most melanomas are preventable, Perkins says. “The thing about melanoma that’s both compelling and sad all at the same time is that a lot of people talk about preventing cancer —and melanoma is one of the most preventable ones.” Yet, people don’t connect the fact that the damage caused by ultraviolet light can, many years later, culminate in their death, she says.
“The evidence for the role of ultraviolet-induced DNA damage in melanoma is compelling,” Perkins says. “Yet, people are out using tanning beds, not using sunscreen and not staying in the shade. I don’t know why that message isn’t getting out,” says Perkins, who hopes that Melanoma/Skin Cancer Detection and Prevention Month will help raise awareness.
The primary tool to treat skin cancer is surgery, Luke notes. Less deadly forms of skin cancer can be frozen and removed in a dermatologist’s office. However, melanoma requires “a very rigorous and precise surgical plan and must be monitored very closely following surgery because of the risk that it can come back and can be life-threatening,” he says.
During the procedure, dermatologists excise the tumors with relatively wide margins to help ensure that they “cut enough skin out around them to get all (the melanoma),” he explains.
The treatment of melanomas has advanced recently with the development of immunotherapy treatments, which use the body’s immune system to fight the disease, Perkins says. The Melanoma Research Alliance has funded research into immunotherapy, imaging, biomarkers and molecularly targeted therapies. The Food and Drug Administration (FDA) has approved some immunotherapy drugs for melanoma, while many others are in clinical trials.
Despite the rather dim prospects for some individuals suffering from melanoma, there is hope. Since 2011, the FDA has approved 11 new treatments for those with advanced melanoma, Perkins says. “That number of treatments in that short of a time frame is kind of unheard of.”