Skin cancer is a condition that involves the growth of abnormal cells in your skin tissues. One of its types—melanoma—forms in cells called melanocytes. And this could also start with what may look like just moles. Well, if you wonder what and how to detect it, The Pioneer brings to you a detailed analysis, just as we connect with health experts to understand the morphing of moles into cancer.
Tejal Sinha
Kevin Jonas opening up about being diagnosed with skin cancer recently, came up as an eye-opener for many of his fans and audience. When we say eye-opener, it certainly was because the reason behind the cancer he revealed was something that turned out to be a bolt from the blue for many.
While he spoke of undergoing surgery to remove the basal cell carcinoma and also advised people to get their moles checked, during our research, we came across another form of skin cancer called melanoma. Basically, it is a type of skin cancer, which means black tumours and one of the most deadly kinds. It spreads easily to any organ and expands swiftly. Melanocytes, which are skin cells, are the source of melanoma. Melanin, the dark pigment that gives skin its colour, is produced by these cells. While pink, red, purple, or skin-coloured melanomas are rare, the majority are black or brown in hue.
The majority of melanomas start in normal skin; however, about 30% do so in moles that already exist.
In fact, according to the National Center for Biotechnology Information, the age-adjusted rates (AAR) per 100,000 cases of melanoma of the skin were highest in the North region of India for both males and females, with 1.62 and 1.21, respectively. The incidence of nonmelanoma of the skin or other skin cancers for males was highest in the East region with 6.2 and for women in the Northeast with 3.49.
So to understand more in detail, The Pioneer connects with health experts to understand more about melanoma and its causes.
Melanoma, Dr. Sunil Kumar Prabhu, Consultant Dermatologist and Aesthetic Physician, at Aster RV Hospitals, shares that it is generally more aggressive than other forms of skin cancer like basal cell carcinoma or squamous cell carcinoma.
Key points about melanoma include
Risk factors: Exposure to UV radiation (from sunlight or tanning beds), fair skin, a history of sunburns, family history of melanoma and having many moles or unusual moles can increase the risk.
Fair skin type: Caucasian and White Races (only a small proportion of Indian races)
High risk: Fair-skinned individuals with light hair and blue or green eyes are at the highest risk for melanoma. This is primarily due to their lower levels of melanin, which provides natural protection against UV radiation.
Sun sensitivity: Fair skin tends to burn more easily and tan less effectively, leading to increased sun damage and a higher melanoma risk if adequate sun protection measures are not taken.
Dark skin type: (a larger proportion of Indian races)
Lower risk, but still possible: People with darker skin tones have more melanin, which provides natural protection against UV radiation. As a result, they have a lower overall risk of melanoma compared to fair-skinned individuals.
Misdiagnosis: Melanoma can sometimes be more challenging to diagnose in individuals with darker skin tones because it may not present the classic signs seen in fair-skinned individuals (such as changes in moles or freckles).
Dr. Anand K., Chief Consultant, Plastic & Reconstructive Surgery, SPARSH Hospital, meanwhile, shares that it has been found that only 30% of the time existing moles turn into melanoma, however, most melanomas grow on normal skin. But moles transform into melanoma mostly because of cellular changes, DNA damage due to prolonged exposure to UV rays, tanning beds and issues in the immune system.
The signs of melanoma can be identified through the asymmetry, border, colour, diameter and evolving (ABCDE) rule and other symptoms include itching, tenderness, swelling or redness, changes in surface texture, new pigments or moles near existing moles and oozing or bleeding. When melanoma occurs on skin surfaces, it shows signs of unexplained weight loss, lymph node swelling, fatigue and pain in the area where the where the melanoma has metastasized.
Meanwhile, going ahead and describing more in detail, Dr. Sunil highlights:
Asymmetry: One half of the mole or birthmark doesn’t match the other.
Border: The edges are irregular, ragged, notched, or blurred.
Colour: The colour is not uniform. Shades of black, brown and tan may be present. There can also be areas of white, grey, red, or blue.
Diameter: The spot that is larger than 10 cm in diameter is more prone to melanoma.
Evolution: The mole is changing in size, shape, or colour.
Itching or tenderness: Some melanomas may become itchy, tender, or painful.
Bleeding or oozing: In advanced cases, melanomas might bleed or ooze.
Early detection
ABCDE tule: Useful for recognising potential signs of melanoma. Any colored mole that shows:
l Asymmetry
l Irregular Border
l Varied Colour
l Larger Diameter
l Evolving
l Prevention and early treatment
Dr. Shireen Furtado, Sr. Consultant, Medical & Cosmetic Dermatology, Aster CMI Hospital, shares, “People with fair skin, blonde or red hair, and blue eyes have a higher risk of melanoma. This is because melanin, a pigment that shields skin from the sun’s harmful UV rays, is less abundant in these individuals.”
l Fair skin: Lighter skin tones produce less melanin, leaving them more vulnerable to UV damage.
l Light hair colour: Blonde and red hair are indicators of reduced melanin production, making these individuals more sun-sensitive.
l Blue eyes: The iris of blue eyes has less melanin compared to brown eyes, offering less protection for the delicate eye tissues from UV rays. This increases the risk of sun damage around the eyes, which can contribute to melanoma in that area.
The number of moles does have an have an impact!
Dr. Anand, on the other hand, says that the number of moles on a person’s body does indicate if a person’s skin is at risk for developing melanoma. “Individuals with a higher number of moles, also known as nevi and atypical moles, i.e., dysplastic nevi, have an increased risk of developing melanoma.”
Meanwhile, Dr. Shireen highlights that having more than 50 moles increases your risk compared to having fewer. Moles with irregular borders, uneven color, or a diameter larger than 6 millimeters (about the size of a pencil eraser) are considered atypical and warrant evaluation by a dermatologist.
A family history of melanoma or a high number of moles and genetic mutations associated with mole formation also correlate with a higher risk of melanoma. Some genetic syndromes, such as Familial Atypical Multiple Mole Melanoma (FAMMM) syndrome, are characterised by the presence of numerous atypical moles and a significantly higher risk of melanoma.
Preventing melanoma
To avoid the sun’s harmful rays and minimise skin cancer risk, it is vital to stay away from direct sunlight. It is advisable to get out during the peak hours, especially from noon to 4 p.m. “While stepping out, wear hats, scarves, and long sleeves, and do not miss on the UVA/UVB-blocking sunglasses and sunscreen with SPF 30 or higher, which should be applied liberally and evenly to all exposed skin 15 minutes before sun exposure and reapplied every two hours, or more often if sweating or swimming. Avoid tanning beds altogether, as their artificial UV rays are just as damaging as sunlight. Finally, become familiar with your skin through regular self-checks from head to toe, including your scalp, ears, and feet,” explains Dr. Shireen.
Also, some preventive measures by Dr. Anand:
Regular skin checks: Regular self-examinations and annual dermatological check-ups are essential. Use the ABCDE rule to evaluate moles.
Photographic records: Keeping photographic records of your moles can help track changes over time and identify new moles or changes in existing ones.
Sun protection: Use broad-spectrum sunscreen with at least SPF 30, wear protective clothing, and avoid peak sun exposure times. Regularly apply sunscreen and reapply it every two hours, or after swimming or sweating.
Early detection and treatment significantly improve the prognosis for melanoma. Regular skin self-exams and awareness of changes in moles or skin spots are crucial. Prevention through sun protection measures also plays a vital role in reducing melanoma risk. If you notice any suspicious changes on your skin, consult a doctor promptly for evaluation and appropriate management.
