by Dr. Kelly Ott
Researchers estimate that nearly one-third of cases of melanoma, the most serious form of skin cancer, are diagnosed in women during their childbearing years. Since many women now are delaying pregnancy until their 30s or 40s, coupled with the fact that melanoma is the most common form of cancer for young adults 25-29 years old, more women could be faced with developing melanoma before or during pregnancy.
Per the Mayo Clinic, the definition of melanoma, the most serious type of skin cancer, develops in the cells that produce melanin which is the pigment that gives your skin its color. Melanoma can also form in your eyes and, rarely, in internal organs, such as your intestines. The exact cause of melanoma isn’t clear, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds increases your risk of developing melanoma. The risk of melanoma seems to be increasing in people under 40, especially women. Knowing the warning signs of skin cancer can help ensure that cancerous changes are detected and treated before the cancer has spread. Melanoma can be treated successfully if it is detected early.
Melanomas most often develop in areas that have had exposure to the sun, such as your back, legs, arms and face. Melanomas can also occur in areas that don’t receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds. The first melanoma signs and symptoms often are a change in an existing mole and the development of a new pigmented or unusual-looking growth on your skin. Melanoma doesn’t always begin as a mole. It can also occur on otherwise normal-appearing skin.
Normal moles are generally a uniform color such as tan, brown or black with a distinct border separating the mole from your surrounding skin. They’re oval or round and usually smaller than 1/4 inch (about 6 millimeters) in diameter, the size of a pencil eraser.
To help you identify characteristics of unusual moles that may indicate melanomas or other skin cancers, think of the letters ABCDE:
- A is for asymmetrical shape. Look for moles with irregular shapes, such as two very different-looking halves.
- B is for irregular border. Look for moles with irregular, notched or scalloped borders.
- C is for changes in color. Look for growths that have many colors or an uneven distribution of color.
- D is for diameter. Look for new growth in a mole larger than 1/4 inch (about 6 millimeters).
- E is for evolving. Look for changes over time, such as a mole that grows in size or that changes color or shape. Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding.
Factors that may increase your risk of melanoma include fair skin, excessive ultraviolet (UV) light exposure, living closer to the equator or at a higher elevation, having many moles or unusual moles, a family history of melanoma, or a weakened immune system. Based on your risk factors, you may decide on more frequent skin examinations by a trained professional. You can also do skin exams at home. A self-exam may help you learn the moles, freckles and other skin marks that are normal for you so that you can notice any changes. It’s best to do this standing in front of a full-length mirror while using a hand-held mirror to inspect hard-to-see areas. Be sure to check the fronts, backs and sides of your arms and legs. In addition, check your groin, scalp, fingernails, soles of your feet and spaces between your toes.
Diagnosis requires a biopsy of the lesion and possibly excision of the lesion. For those women who are diagnosed with melanoma during their childbearing age, they will undergo treatment based on the stage and grade of the melanoma. Those in whom a melanoma is detected early and the melanoma is not more than one mm in depth nor has spread to other tissues, it is not recommended that she delay pregnancy. For those women with a melanoma more than one mm in depth, the recurrence rate is higher than those diagnosed with a thinner melanoma. In these cases, it may be worth delaying pregnancy for two to three years as that is the most common time for a melanoma to recur.
According to the Mayo Clinic, you can reduce your risk of melanoma and other types of skin cancer if you:
- Avoid the sun during the middle of the day. For many people in North America, the sun’s rays are strongest between about 10 a.m. and 4 p.m. Schedule outdoor activities for other times of the day, even in winter or when the sky is cloudy. You absorb UV radiation year-round, and clouds offer little protection from damaging rays. Avoiding the sun at its strongest helps you avoid the sunburns and suntans that cause skin damage and increase your risk of developing skin cancer. Sun exposure accumulated over time also may cause skin cancer.
- Wear sunscreen year-round. Sunscreens don’t filter out all harmful UV radiation, especially the radiation that can lead to melanoma. But they play a major role in an overall sun protection program. Use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring. The American Academy of Dermatology recommends using a broad-spectrum, water-resistant sunscreen with an SPF of at least 30.
- Wear protective clothing. Sunscreens don’t provide complete protection from UV rays. So cover your skin with dark, tightly woven clothing that covers your arms and legs and a broad-brimmed hat, which provides more protection than a baseball cap or visor does.
Don’t forget sunglasses. Look for those that block both types of UV radiation — UVA and UVB rays.
- Avoid tanning lamps and beds. Tanning lamps and beds emit UV rays and can increase your risk of skin cancer.
Become familiar with your skin so that you’ll notice changes. Examine your skin regularly for new skin growths or changes in existing moles, freckles, bumps and birthmarks.
With the help of mirrors, check your face, neck, ears and scalp. Examine your chest and trunk and the tops and undersides of your arms and hands. Examine both the fronts and backs of your legs and your feet, including the soles and the spaces between your toes. Also check your genital area and between your buttocks.
MAY