I just found out that today is Melanoma Monday — an awareness campaign developed by the American Academy of Dermatology — so decided to update a post I wrote last year about protecting your skin from the sun. I also checked in with Mike Cushman, who was diagnosed with malignant melanoma in 2010. At the end of the post, you’ll find a list of upcoming free skin cancer screenings in the Greater Portland area.
Does sunscreen prevent malignant melanoma?
The short answer is not necessarily. Two reasons why:
1. People slather it on and then bake in the sun twice as long they should.
2. Some sunscreens are not broad-spectrum. In other words they protect against UVB rays but not UVA rays, which may also cause skin cancer — including malignant melanoma, which can be deadly.
Updated sunscreen guidelines for manufacturers
- In order to claim that a sunscreen protects against skin cancer, it must be at least SPF-15 and must protect against UVB and UVA. If the claim can’t be made, a warning must be added to the label: “This product has not been shown to prevent skin cancer or premature skin aging.”
- No sunscreen is really waterproof so only the term water-resistant can be used and only if studies prove that the product retains its value after being exposed to water.
- The term sunblock can no longer be used, because no sunscreen can completely block the sun.
Even if you choose the right kind of sunscreen, you also have to use common sense.
How to use sunscreen
- Don’t put on sunscreen and then stay in the sun so long you get a sunburn.
- If your skin starts to get red or feel uncomfortable, don’t just reapply sunscreen, cover up or get in the shade.
- Wear protective clothing, a hat, and sunglasses along with sunscreen.
The goal isn’t to avoid getting any sun exposure at all. In fact, sunlight is an important source of Vitamin D. The recommendation is that we get from five to 30 minutes of sun exposure between 10 am and 3 pm at least twice a week to our face, arms, or back.
What you want to avoid is sunburn because sunburns increase your risk of developing malignant melanoma.
Did you know malignant melanoma is now the most common cancer among people 25 to 29 years old? The Mayo Clinic recently published research that showed the incidence of malignant melanoma has increased more than sixfold in the past 40 years. Multiple studies have shown a strong connection between sunburns during childhood and adolescence and malignant melanoma.
Dr. Frederick Aronson, a cancer specialist at Maine Center for Cancer Medicine in Scarborough says, “Most of the ultraviolet radiation that causes melanoma is delivered to the individual at risk before age 20. There are migration studies that show if you grow up in a high sun region and move to a lower sun region in your 20s, your melanoma risk is as if you lived in the high sun region all your life and vice versa. If you live in a low sun region and move to a high sun region in your 20s your melanoma risk remains relatively low.”
Mike Cushman’s story
Mike Cushman, who lives in South Portland, was diagnosed with advanced malignant melanoma in 2010. “I had a suspicious mole on the back of my head under my hair,” he told me. “My daughter spotted it and suggested my doctor check it out. The biopsy came back benign. Late July I felt a lump in that same area. In early August it was removed for biopsy and came back malignant melanoma. I cannot trace the melanoma to my family. I seem to be the only one. As a child growing up in the 50s and 60s I probably had my share of sunburns.”
The most effective treatment for melanoma is surgery. Depending on a variety of factors, chemotherapy, radiation therapy, and immunotherapy may also be used. Several promising new treatments are now being studied in clinical trials, including a targeted therapy that Mike was hoping would help him. It targets a mutated gene found in about half the people diagnosed with metastatic malignant melanoma. Mike has a Braf mutation and when we spoke last year was participating in a clinical trial. This morning he told me the trial failed and he is now on a new drug called Yervoy, which is pitting his own body’s own immune system against the cancer cells, now spread to his liver and bones. So far, he’s had two out of four treatments. “It’s too early to tell if it’s working,” he said. “I’m tired and nauseous, having a rough time right now — typical chemo side effects. But, I’m still here, I’m still functioning.”
Mike says there’s a 20 percent chance the new drug will stop the melanoma from spreading more. “I’m a little bit hopeful, but not overly excited,” he admitted.
Even though he clearly didn’t feel well, Mike was more than happy to talk with me and share his message, which is powerful. “If you find a suspicious mole, get it checked. Don’t let it go. If I’d acted earlier, I would have made out a lot better than I am now.
Signs of melanoma in a mole
- Asymmetrical shape — one half doesn’t match the other
- Borders are irregular — ragged or blurry edges or pigment that spreads into surrounding skin
- Color is not even — usually shades of brown, black, and tan, but sometimes white gray, red, pink or blue
- Diameter — usually bigger than a pea, but can start tiny and get bigger
- Evolving appearance — a change that happens in just weeks or months.
What malignant melanoma might look like
Mike says at his age he chooses not to dwell on sunburns he got when he was younger. “I cannot go back and undo the past. What I would have done differently is talk to my doctor about follow up care with a dermatologist. I am very thankful that my daughter brought to my attention the suspicious mole on the back of my head. My two daughters now have a family history of melanoma and they see a dermatologist at regular intervals. Believe me, I ask them if they have been going to their appointments.”
UPCOMING FREE SKIN CANCER SCREENINGS
If you’ve been meaning to get screened for suspicious moles or are worried about one in particular, take advantage of these free screenings:
May 20, 2013
SMMC Saco Health Center
13 Industrial Park Rd., Saco
May 21, 2013
Mercy Oncology-Hematology Center
195 Fore River Parkway, Suite 360, Portland
May 22, 2013
Maine Medical Center Cancer Institute
100 Campus Dr., Scarborough
May 23, 2013
Cancer Care Center of York County
27 Industrial Ave., Sanford
All screenings ar 6:00 – 8:00 PM
You need an appointment. Call 1-877-831-2129 to schedule. Space is limited and patients who have never been screened by a dermatologist will be given priority.
Please, follow Mike’s advice. If you have a suspicious looking mole, get it checked. Now.