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Melanoma on the Rise in the U.S.

WebMD Health News
Reviewed by Merle Diamond, MD

Sept. 1, 2000 -- He wasn't on the popular TV show of the same name, but U.S. Sen. John McCain could certainly be classified as a survivor.

McCain had more than five hours of surgery last month to remove melanomas, a form of skin cancer, from his temple and upper arm. After studying the tissues around the cancers, his doctors said the melanoma hadn't spread to McCain's lymph nodes. McCain, 63, was released from the Mayo Clinic Hospital and returned to his Phoenix home Aug. 22.

Cancer of the skin is the most common of all cancers, and melanoma is the deadliest of skin cancers, accounting for about 4% of skin cancer cases but about 79% of deaths. And, although statistics show an overall decline in rates of cancer cases and death over the past few years, melanoma is on the rise: New York University statistics say the incidence has been increasing by about 2% annually since 1960. The American Cancer Society estimates 47,700 new melanomas will be diagnosed this year and some 7,700 Americans will die of melanoma.

Yet experts say this type of cancer may be virtually preventable with simple behavioral changes.

"Despite exciting developments in the treatment of advanced malignant melanoma, prevention and early detection remain the primary goals in the war against this cancer," Darrell S. Rigel, MD, writes in the journal CA -- A Cancer Journal for Clinicians. Rigel is a professor of dermatology at New York University Medical School.

For many of us, prevention means slopping on some sunscreen before we hit the beach or the tennis courts. But this may only cause a false sense of security.

"People generally don't use sunscreens right," Martin A. Weinstock, MD, PhD, tells WebMD. "They may not put it on until after they've been in the sun, they spread it unevenly, or don't reapply it after they sweat." Weinstock is a professor of dermatology at Brown University, chairman of the American Cancer Society Skin Cancer Protection Federation, and chief of dermatology at the VA Medical Center in Providence.

A combination of wearing protective clothing, avoiding the midday sun, and regular use of broad-spectrum, high sun protection factor (SPF) sunscreen are the best defense, according to Rigel and the American Cancer Society.

Parents should be particularly careful with children, Weinstock says. A recent nationwide survey of children ages 11 to 18 showed that many were developing sunburns despite using sunscreens of SPF 15 or greater, he says. "Prevention now will prevent problems later in their lives," he says.

Skin cancers are divided into two general types: melanoma and non-melanoma cancers, says the American Academy of Dermatology. The difference is what type of cells the cancers develop in.

The epidermis is the very thin outer layer of skin that protects the deeper layers of skin and the body's organs. Its outermost part is made up of dead cells called keratinocytes, which are continually shed. Below are layers of living keratinocytes, called squamous cells. The lowest part of the epidermis is formed by basal cells, which continually divide to form new keratinocytes.

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