During Melanoma Awareness Month in May, Yampa Valley Medical Center is providing free information, including a Taking Care of Me program featuring Dr. Maryann Wall.
To learn more about melanoma, see a skin self-examination guide at www.cancerreasearch.opj/melanomabook.html
Know the signs
Asymmetry; border irregularity — edges are notched, blurred, etc.; color variation — pigment is not uniform, more than one color; diameter — greater than 6 millimeters; evolving — lesion changes shapes; ugly duckling — lesion looks different from the rest
Steamboat Springs More than 300 days of sunshine per year, a moderate or high ultra-violet index from March through October and an elevation of more than 6,000 feet combine to give Northwest Colorado bragging rights for incidence rates for melanoma that are 30 percent higher than the U.S. average.
Although the rates of most other cancers in the U.S. have been declining, the incidence of melanoma is increasing — tripling in the white population during the past 20 years.
Melanoma is thought to affect about 68,000 people each year, causing about 8,000 deaths annually. The current lifetime risk for Americans is 1 in 58. One person dies each hour from metastatic melanoma.
So where’s the silver lining in this cloud spoiling our sunny days? Melanomas almost always are curable when diagnosed early. Prevention and early detection through education can change these gloomy statistics.
Melanoma is a cancer that begins in pigment-producing cells called melanocytes that predominantly are found in the skin. The sequence of events that leads to melanoma formation is multifactorial but poorly understood.
About 90 percent of melanomas are caused by exposure to sunlight. Sunlight can cause mutations in the DNA of skin cells. Accumulate enough mutations, and cancer will result. Melanomas may develop in pre-existing moles or arise in unpigmented skin.
Risk factors include fair skin, multiple severe or blistering sunburns, increased number of common or atypical moles, family history of melanoma, a changing mole and older age. Statistically, we can add living in Steamboat Springs or other high-altitude areas to that list.
Diagnosis of melanoma usually begins with a physical exam and ends with pathologic confirmation of a tissue sample. A new or changing mole or blemish is the most common presentation.
The criteria listed in the “Know the signs” box are helpful in determining which moles might be melanomas or atypical moles. Lesions exhibiting these features should undergo a biopsy.
Treatment for melanoma depends on the stage, which is determined by tumor thickness, tumor ulceration, lymph node status and spread to other organs. Surgery is the primary treatment for skin melanomas.
The amount of tissue removed depends primarily on the thickness or depth of the cancer. Thicker melanomas might require sampling of lymph nodes to determine whether cancer cells have spread beyond the skin.
While thinner melanomas do not require an extensive metastatic work-up, thicker melanomas require blood work and imaging studies. Follow-up care is critical, including frequent full-body skin exams and monthly self-exams for early detection of a new melanoma.
Melanomas diagnosed early can be treated successfully and have greater than a 90 percent five-year survival rate.
So, should you just move to Scotland, the least sunny spot on the planet? Absolutely not! Check back May 9 for a Monday Medical article that will teach you how to defy the statistics of living in Northwest Colorado.
Maryann Wall, M.D., of Northwest Colorado Ear, Nose, Throat and Facial Plastic Surgery, PC, is board-certified in otolaryngology-head and neck surgery and facial plastic and reconstructive surgery.