Facts About Melanoma
The facts about melanoma, with Dr Annika Smith, Melanoma Institute Australia.
Dr Annika Smith answers the questions you may not even have thought to ask.
How is melanoma different to other skin cancers?
Melanoma is less common than other skin cancers, but deadly if not detected early, so detection, early detection really is the key. Melanoma as distinct from other skin cancers often presents as a pigmented lesion, and this may be a new or changing lesion and up to 70% of melanomas may arise de novo, so that is they present as a new lesion, and a smaller number may arise from a preexisting mole, whether that be a normal or an abnormal looking mole. Additionally, melanoma often occurs on the calves or the legs in women and the trunk in men, but it’s important to note that it doesn’t necessarily need to occur on sun exposed sites. It can occur anywhere.
What are some of the symptoms of melanoma?
So often there may be no symptoms associated with melanoma. Often melanoma presents as a new or changing lesion and in particular you’re looking out for a change in size, shape or colour and this can be denoted by the A, B, C, D, E rule. A stands for asymmetry of the lesion, B is for the border being irregular, C is for colour, variegation, D is for diameter, and generally greater than 6mm and E stands for something that’s evolving.
With respect to symptoms, melanomas may present with itch, bleeding, or irritation, and at the end of the day, I really encourage all my patients that if there’s any lesion that’s piqued their attention or that’s of bother to them in any way whatsoever that they seek review and have it checked.
How prevalent is melanoma in Australia?
So both Australia and New Zealand report the highest rates of Melanoma in the world, Melanoma is the third most common cancer that affects men and women and up to 14,000 Australians this year alone will be diagnosed with melanoma. I think one of the most striking statistics is that Melanoma most commonly affects the younger cohort, so it’s the leading cancer in 15 to 39 year olds.
Who is most at risk of developing melanoma or other skin cancers?
People that are particularly susceptible to melanoma are those that have a previous history or family history of Melanoma or non-Melanoma skin cancer; those that are fair, phenotypically, so fair skin, light eyes, light hair, more susceptible to burning. In addition to that, those that have a large nevus or mole count and in particular a large number of atypical or funny looking moles. Additionally, those individuals that have seen a lot of sun in their formative years, particularly the first 20 years of life are most at risk, in addition to having used a solarium in some point during your life – solarium use increases your melanoma risk significantly. Additionally those individuals that are immunosuppressed, whether it be due to a medical condition, medications or even the transplant population are at particularly high risk of both melanoma and non-melanoma skin cancer.
What is the most effective type of sunscreen to use?
So ultimately the most effective sunscreen to prevent skin cancer is the one that you’ll wear and the one that you’ll use and I like to keep the message quite clear and quite simple, so the one that you like the aesthetics of, ideally we want it to be SPF 50, broad spectrum which means it’s protecting you against both UVA and UVB rays which contribute to your skin cancer risk, and I think the other important point to note is that it’s not just about sunscreen – it’s only one component of our armamentarium against skin cancer and we need to be mindful of the full complement of sun protection which includes a broad brimmed hat, seeking shade, avoiding the sun in the peak periods of the day and use of sun protective eyewear and clothing.
What is the ideal amount of sunscreen to apply?
The amount you apply really depends on your activity and the amount of skin exposed, but typically speaking, for a whole body application we want about 30mL or a shot glass full and this equates to about 7 teaspoons, so a teaspoon for the face and neck, a teaspoon for each limb, and two for the trunk.
Does sunscreen impact on Vitamin D production?
There are a number of concerns that have been raised regarding sunscreen safety and use which really has served to interfere with the sun safe message. The first one really is regarding Vitamin D status, and whether sunscreens impact on your Vitamin D levels, and I can safely say that the evidence well and truly supports that sunscreen does not impact on your Vitamin D status and does not cause Vitamin D deficiency.
Are nanoparticles in sunscreen dangerous?
So the Nano particle debate has also served to confuse the issue regarding sun safety. Extensive review of the scientific literature, supported by a recent review by the Australian Government Therapeutic Goods Administration has concluded that Nano particulate use in sunscreens poses absolutely no risk to human health.
Can I trust the SPF on the bottle?
The manufacture of sunscreens in Australia is tightly regulated by the Therapeutic Goods Administration, our sunscreens are made to exacting standards and they undergo rigorous testing to ensure they meet the appropriate quality and safety standards and we really do need to trust in this process. At the end of the day the benefits of sunscreen, that being preventing skin cancer and saving lives, far outweighs any potential risk that to date have not been substantiated by any firm evidence.
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