Feb. 9, 2004 (Washington) -- It's rapidly climbing the charts, but this is one list you don't ever want to top: malignant melanoma. The most serious form of skin cancer is moving up through the ranks of the most common forms of cancer in the U.S., moving from the No. 6 slot in 1997, to a projected No. 1 by the year 2022, researchers predict.
"Melanoma is a social disease," says Mark F. Naylor, MD, associate professor of dermatology at the University of Oklahoma Health Science Center in Oklahoma City, speaking at a meeting of the American Academy of Dermatology here.
What Naylor means is that, as every advertising executive knows, sex sells, and popular culture -- TV commercials, magazine ads, reality shows, and programs such as "Baywatch" and "The OC" -- exert social pressure on us to strive for that "healthy glow" by glorifying tanned and toned bodies.
But the not-so-subtle message that going for the bronze can heighten your sex appeal has potentially deadly consequences: "While sunburn is the most efficient way to develop melanoma, chronic tanning is second best," Naylor says.
Melanoma is one of the most common forms of skin cancer. It is the deadliest type because it spreads easily to other parts of the body. It occurs in the cells that produce the pigments that give skin its natural color. When these skin cells are repeatedly damaged by sunburn, or through long-term exposure to ultraviolet rays in sunlight, this contributes to the risk of melanoma developing in some people. Melanoma generally begins in the skin, but can spread to other organs and bones through the blood or the lymph system.
One of the biggest risk factors for melanoma is chronic exposure to ultraviolet rays, primarily through tanning under the sun or in a tanning bed. Although sunscreens with an SPF (sun protection factor) of 15 or greater are effective for protecting exposed skin from damaging UV rays, many people mistakenly believe they can slather on the sunscreen and then lie lizard-like on the sand, patio, or poolside to get a gradual gentle tan. "There is no safe way to tan. How many times do we have to say this? It increases melanoma risk absolutely," Naylor says.
Prevention Is Key
Faced with damning evidence about increased melanoma risk, tanning-bed advocates have switched to a new marketing ploy, touting the theoretical health benefits of increased vitamin D exposure for preventing osteoporosis and some forms of cancer. "That's now the excuse of choice for going to tanning parlors," Naylor comments. Typical is a fitness center in British Columbia, Canada that offers "unlimited tanning" for a fixed monthly fee: "Our natural tanning process provides protection against burning," the center's web site copy promises.
"All I can say about that is that if vitamin D really does that, then the logical thing is to supplement it in the diet," Naylor explains.
Here's some information that can help you avoid the risk:
- Avoid excessive exposure such as sunbathing.
- Wear a wide-brimmed hat when you are out in the sun.
- Wear UV-blocking sunglasses and protective clothing.
- Use a sunscreen with a SPF of 15 or higher.
Apply sunscreen then re-apply every two hours, in order to maintain adequate protection.
Apart from prevention, the best chance for curing melanoma is spotting it early and having it surgically removed. Until recently, that meant regular top-to-toe skin examinations by a dermatologist or other health professionals trained to recognize melanoma's warning signs -- including suspicious moles with irregular borders or coloration. While this method is generally effective, it's not foolproof, and may lead to unnecessary surgery to remove noncancerous growths.
"The current numbers in terms of how accurate we are as dermatologists are relatively poor; at most we can get about 70% in [accuracy] of diagnosis of known melanomas," says John H. Tu, MD, a skin imaging specialist in the department of dermatology at the University of Rochester and Strong Memorial Hospital in Rochester, N.Y.
"There's an old saying among dermatologists: 'When in doubt, take it out,'" William Abramovits, MD, from the Texas Dermatology Research Institute in Dallas, tells WebMD. But now Abramovits and colleagues have a new tool called a mulitspectral dermoscope at their disposal. These handheld devices, about the size of a compact digital camera, use light and digital imaging technology to help highlight areas of concern, and help doctors to distinguish minor skin problems from potentially serious lesions. The digital images can also be transferred to a computer for enhancement.
"Dermoscopy is certainly becoming a clinical standard to make a clinical diagnosis beyond the simple visualization of the lesion, and the technology is becoming more and more sophisticated," Abramovits tells WebMD. "My impression is that you're less likely to leave a lesion on someone using this technology than you are just trusting your naked eyes."