The popular belief is that people with darker skin are less likely to develop skin cancer. That's not true. In actuality, dark-skinned races have higher melanoma mortality rates than whites, according to Rush University Medical Center.
My dad had olive skin, and would develop a deep, dark tan every summer from long hours in the sun on our farm in Michigan. His brown skin accentuated his sparkling blue eyes, and of our family of five, my brother and I were the two who inherited his skin color.
We grew up using tractors without cabs, and with more than 1,000 acres of corn and soybeans and 400 acres of hay to bale, we spent a lot of time outside. People often asked if I was Native American or some other nationality in the summer, since I’d get so dark and had long, dark brown hair.
To be honest, I loved being in the sun. I’ve since learned, however, that those early years were already creating a deadly scenario for the future.
About 12 years ago, I noticed a bump on the end of my nose. I thought it was an odd place for a pimple, since I’d never had one there before, and it didn’t seem to go away. My elderly family physician told me it was a wart, and to use a topical antiseptic. This didn’t seem plausible and when his quick diagnosis didn’t work, I went to a dermatologist.
The skin specialist knew the moment he entered the room that the bump on my nose was a form of skin cancer, and scheduled surgery for the following week.
In my mind, I thought, “This is no big deal.” The doctor would simply slice off the bump and I’d be good to go.
It didn’t work that way. The time between when I’d first gone to my local doctor and when I was actually diagnosed had allowed the cancer cells to grow, and “fingers” of the abnormal cells and extended out from the original bump. I ended up with a hole in the end of my nose about a half-inch in diameter and about 3/8 in. deep. The surgeon cut two flower-petal-shaped skin graphs from other parts of my nose: One to cover the hole on the end of my nose, and the other to cover the first petal.
Fortunately, the doctor who did that surgery was excellent. Within a few hours, I had two black eyes and a face that looked like a volleyball, but he assured me everything would be fine (I didn’t believe him.) It took several months, but it’s true – the scar on my nose is barely visible.
But since that first incident, I've since had several more surgeries for skin cancer, and I'm sure the trend will continue. I carefully look for any change in my skin or new spots and see my dermatologist at least once a year or more frequently if I see something new.
Early Diagnosis is Key
Melanomas develop from skin cells called melanocytes, which reside in the superficial layer of the skin called the epidermis, the American Skin Association reports. Melanocytes in the epidermis produce pigment (melanin) that gives the skin its color and protects skin cells from the damaging effects of the sun’s ultraviolet radiation.
Abnormal varieties of melanocytes cause common skin growths known as moles. Most moles are harmless, but unique varieties of atypical moles may develop into melanoma.
Most radial melanomas can spread internally within 6 to 18 months from the first noticeable change of a pre-existing mole or appearance of a new mole, notes the Melanoma Education Foundation. Radial melanomas that develop from age or liver spots (which typically occur in people 70 or older) can take as long as 10 to 15 years to spread internally.
So, even though you had no problems with your skin as a young person, that early exposure to the sun has already caused damage, which is why it’s so important to see a dermatologist right away for any skin changes you observe. Keep in mind, it’s not just exposure to the sun.
“The misconception that the sun is responsible for all cases of melanoma leads to lower survival rates because of delayed diagnosis, particularly among people of color,” explains Arthur Rhodes, MD, MPH director of the Rush Melanoma Surveillance Clinic in the Rush University article. Rhodes estimates that only 10% to 15% of melanomas are caused by excessive sun exposure, typically in heavily freckled and sun-damaged skin.
While less common than other types of skin cancer, melanomas are deadlier, because the malignant cells can spread even though the tumor is relatively small and not bleeding or causing pain or itching. This capacity to metastasize underlies the importance of early detection.
Rhodes stresses the need for monthly self-examination and examination in difficult-to–see areas on the body in family members, seeking the presence of a new mole, or a change in a pre-existing mole – a change in size, shape or color.
Melanoma Risk Factors
According to the Rush Department of Dermatology, a variety of physical, historical, and genetic traits increase the risk for developing melanoma. If you have one or more of the following factors, see your dermatologist, and make it a yearly habit.
· Having a mole present within the first two weeks of life (a birth mole) (10-fold increased risk)
· Having a personal history of melanoma (nine-fold increased risk)
· Having a family history of melanoma (eight-fold increased risk)
· Having numerous moles and/or atypical moles (eight-fold to 40-fold increased risk)
· Having had a Spitz tumor removed (eight-fold increased risk)
· Having had an atypical nevus removed (seven-fold increased risk)
· Having had at least 2 moles removed in the past (five-fold increased risk)
· Prior treatment for psoriasis with more than 200 PUVA treatments (psoralen pills and ultraviolet A radiation) (five-fold increased risk)
· Having had a basal cell cancer or squamous cell cancer (four-fold increased risk)
· Presence of dense sun-induced freckles (three-fold increased risk)
· Immune suppression related to disease or medication (three-fold increased risk)
· Having red hair (two-fold increased risk)
· Having Parkinson disease (two-fold increased risk)
· Multiple sunburns in early childhood (two-fold increased risk)