Because nonmelanoma skin cancer is the most common cancer diagnosis among Canadians, you may think the deadlier type—melanoma—is rare. "Melanoma is the skin cancer everyone should worry about," says Dr. Anatoli Freiman, dermatologist and medical director at the Toronto Dermatology Centre. "Not only is it the bigger killer but it's also not that rare when you look at the statistics." According to the Canadian Cancer Society, melanoma is the seventh most common cancer in Canada, and rates are on the rise, especially among young women.
Melanoma is named after the cell in which it originates (melanocyte), which is responsible for producing melanin, the pigment that gives your skin colour. Those same cells can produce moles, and atypical moles—those that are irregular, more than six millimetres across and multiple shades of brown or red-brown—are more likely to develop into melanoma.
Experts estimate that 90 percent of melanomas are the result of severe UV exposure and sunburns, and therefore, avoidable. So check your understanding of melanoma against the following common misassumptions and help reduce your risk.
1. People who tan easily and rarely burn won't get melanoma.
It's ironic that a golden skin tone appears so comely when the reality couldn't be less so: There's no such thing as a healthy tan, says Dr. Freiman. "Anyone who burns or tans is exponentially increasing their risk factor for melanoma." That's why avoiding UV exposure, especially between 10 a.m. and 4 p.m. is recommended, as well as donning protective clothing and hats, wearing a sunscreen with an SPF of 30 and checking your skin for moles.
2. Only people who tan regularly are at risk.
False. There are key risk factors for melanoma outside of habitually basking in the sun, namely having: fair, sun-sensitive skin that burns; freckles; red or blond hair; many moles (more than 50); moles that are large or unusual in colour or shape; or a close family history of melanoma. But anyone can get melanoma, including dark-skinned people.
Unfortunately for former sun worshippers, risk factor is cumulative, says Dr. Freiman. UV rays cause irreversible damage to the skin, so the tanning (and burning) you did at a young age can increase your risk of melanoma, which is why it's important to screen for risk.
The handy, confidential online tool at My CancerIQ, developed by Cancer Care Ontario and the Ministry of Health and Long-Term Care, allows you to determine your personal risk for six cancers, including melanoma. You'll receive a personalized risk-assessment action plan, with tips and resources based on your personal risk factors for melanoma (or breast, cervical, colorectal, lung or kidney cancer), that you're encouraged to share with your primary health-care provider.
3. My doctor will check for signs, so I don't bother.
In fact, self-checking has been shown to be very successful, according to the Canadian Dermatology Association. Research shows that patients discover 53 percent of melanomas and that checking your own skin could lead to a 90 percent cure rate.
"Those with risk factors should check their skin every three months for signs of melanoma," says Dr. Freiman. Ask a loved one to check areas you can't see yourself for moles, such as your back, and follow the ABCDE of melanoma, looking for asymmetry, ragged borders, colour variation, diameter of six millimetres and evolution or changes, such as tenderness, itching or bleeding.
"If you spot any changes, alert your health-care practitioner," says Dr. Freiman. And, if you do fall into a high-risk category, you should be seen once a year by a dermatologist, he recommends.