Understanding Melanoma
- A 42-year-old Nigerian-Irish nurse practitioner in Dallas, Texas, thought a molelike spot on her body was a “birthmark,” but it turned out to be the most dangerous type of skin cancer.
- Ilia Smith, who was diagnosed with stage 2B melanoma, is sharing her story in hopes to inspire “all ethnicities” to pay attention to their skin and get checked when something seems off.
- Melanoma is a type of skin cancer that forms in the same cells that give your skin, hair and eyes their color.
- Approximately 90% of melanomas are caused by ultraviolet radiation from the sun, so it's important to protect your skin.
- According to the American Cancer Society, melanoma is “20 times more common in White people than Black people.”
- Paying attention to moles or growths on your skin is an easy way to look out for melanoma since changes to a mole you've had for a while or developing a new growth you don't remember having on your skin could be signs of this cancer, according to SurvivorNet's experts.
Perhaps Ilia Smith never worried about the disease as it’s not seen as often in patients of color. However, when nonwhite racial ethnic groups are diagnosed with skin cancer, it’s usually at a more advanced stage. Smith is sharing her story in hopes to inspire “all ethnicities” to pay attention to their skin and get checked when something seems off.
Smith stopped stressing about her “birthmark” until 2020 came around, when her now-four-year-old daughter Arya was just an infant and her skin mark became itchy.
Month’s later, her “birthmark” started bleeding after she scratched it, and Smith consulted her PA friend for advice again, only to be urged to get a biopsy.
She ultimately learned she had stage 2B melanoma at the dermatologist appointment that followed.
Smith, who also spoke with ELLE about her experience, revealed that January 2021 was when a piece of tissue that was “8.5 centimeters wide and 4 centimeters deep” was removed from her thigh.
Recounting to Insider in a recent interview about how she previously enjoyed spending time in the sun, Smith said, “A lot of my family members are darker-skinned. I wanted to be like my family. Being African-American, you don’t think about skin cancer.”
She explained further, “All this time, I could have been protecting my skin and not maybe have fallen down this route where I can’t even be in the sun at all.”
Smith admitted to using “more of a tanning lotion that had more of a 3 or 7 SPF” instead of sunscreen, which is much less than our experts’ suggested use of SPF 30 sunscreen.
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Luckily, Smith only needed the cancerous mole removed as the cancer didn’t spread to her lymph nodes.
Smith, who now must undergo skin cancer screenings every six months, has since changed her habits and practices better sun skin safety. She makes sure to wear at least SPF 30, a hat, and long sleeves when she’s in the sun.
As Smith continues to share her story to inspire others to get checked for skin cancer, she told Insider, “I think all ethnicities, not just pigmented people, need to just look at themselves. If you have freckles or moles, look at them and get them checked out at least once a year by a board-certified dermatologist.”
Racial Disparities in Skin Cancer
According to the American Cancer Society, melanoma is “20 times more common in White people than Black people.”
The ACS explains that the lifetime risk of being diagnosed with melanoma is 2.6% (1 in 38) in white people, 0.1% (1 in 1,000) for Black people, and 0.6% (1 in 167) for Hispanic people.
However, just because the percentage of melanoma diagnoses is low in people of color (which the American Academy of Dermatology Association explains as “diverse skin colors” including “people of African, Asian, Latino, Mediterranean, Middle Eastern, and Native American descent”) doesn’t mean this racial-ethnic group doesn’t have to worry about getting sun damage.
The AADA warns that anyone can get skin cancer, even if their skin never burns.
Additionally, the AADA says skin cancer is usually found at a more advanced stage in people of color, making treatment less successful.
The Melanoma Research Alliance warns that people of color are four times more likely to receive an advanced melanoma diagnosis and 1.5 times more likely to die from it.
A 2016 study, published in the Journal of the American Academy of Dermatology, on the racial disparities in melanoma survival, concluded, “Despite higher incidence of cutaneous melanoma in whites, overall survival for cutaneous melanoma in non-whites was significantly lower. Our results suggest that more emphasis is needed for melanoma screening and awareness in non-white populations to improve survival outcomes.”
Meanwhile, Mona Gohara, MD, associate clinical professor of dermatology at Yale School of Medicine, told ELLE, “Patients of color are much more likely to wear sunscreen or get screenings if a dermatologist of color is telling them to do so. Dermatology is one of the least diverse specialties.”
Our experts agree.
Dr. Marilyn Fraser, CEO at the Arthur Ashe Institute for Urban Health, previously told SurvivorNet that increasing the number of people of color and the diversity of nationalities and ethnicities within healthcare professions can help provide better care to the people they serve.
"Diversity helps to bring to the forefront equity, and it brings to the forefront some of the challenges that we may have and that we can come together to try to tease those out," she said.
Learning About Melanoma
Melanoma is the most dangerous type of skin cancer and develops in the same cells that give your skin, hair and eyes their color.
As per the American Cancer Society, approximately 97,610 new melanomas will be diagnosed (about 58,120 in men and 39,490 in women) in the United States in 2023.
Although the ACS says the risk of melanoma increases as people age with the average age of diagnosis being 65, the disease is not uncommon among those under the age of 30. Melanoma is actually one of the most common cancers in young adults, a significant number of those adults being women.
Top 5 Ways to Protect Your Skin From Skin Cancer
The disease can arise from an existing mole or appear as a dark or pink growth on the skin even in places on the body that never see the sun.
Dr. Anna Pavlick, a medical oncologist with Weill Cornell Medicine who specializes in treating skin cancer, told SurvivorNet in an earlier interview, “Melanomas are the deadliest type of skin cancer because they have a tendency to spread to other parts of the body.”
About 90% of melanomas are caused by ultraviolet radiation from the sun, as per the City of Hope Cancer Center, meaning that excessive time in the sun even as a child can put you at a higher risk.
Paying Attention to Your Skin
Taking time to regularly survey moles or growths on your skin is an easy way to be attentive for melanoma. Signs of this type of cancer could show up as changes to a mole you've had for a while or a new growth you don't remember having on your skin.
Examining Your Skin for Melanoma Remember ABCDE
Dr. Cecilia Larocca, of the Dana-Farber Cancer Institute, previously gave SurvivorNet an overview of things to look out for with moles using the ABCDE self-screening method:
- Asymmetrical moles: "If you drew a line straight down the center of the mole, would the sides match?"
- Borders that are "irregular, jagged, not smooth." It can also stand for bleeding.
- Colors: "Multiple distinct colors in the mole."
- Diameter: "Larger than 6mm, about the size of a pencil head eraser."
- Evolution: "This may be the most important," she says. "Anything that is changing over time such as gaining color, losing color, painful, itching, hurting, changing shape, etc."
Spots on our skin are often harmless, but it's still important to keep an eye on them and reach out to your doctor if you see any changes or find a growth anywhere on your skin that looks suspicious.
The Importance of Sunscreen
When it comes to sunscreen, it's important to remember that choosing the right product can be just as important as consistency.
Dr. Larocca recommends you use sunscreen with at least SPF 30 and reapply it every two hours. Your sunscreen should also be broad spectrum, says Dr. Larocca, meaning it covers both UVB and UVA rays.
Choose the Right Sunscreen and Use It Often
Dermatologist Dr. Snehal Amin, the co-founder and surgical director of MDCS Dermatology: Medical Dermatology & Cosmetic Surgery, advises that although brand names are not very important, being aware of the ingredients and feel of the sunscreen can make a difference.
“My recommendation is really focus on the ingredients rather than the brands,” Dr. Amin says. “If you like the way the brand feels on your skin, if you like the purpose of the brand for instance, sport versus daily use or daytime use versus a short burst of activity use I think those are more important factors than actual brands.”
Removing Stage Two and Three Melanomas
Contributing: SurvivorNet Staff
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