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Melanoma: The Negative Impact
By: Morag Currin
Posted: August 1, 2011, from the August 2011 issue of Skin Inc. magazine.
page 5 of 7
Skin care clients with numerous benign nevi—small, regularly shaped and uniformly pigmented moles—are at increased risk of melanoma. The same applies to clients who have few dysplastic nevi—large, irregularly shaped and heterogeneously pigmented moles. Patients in either group may have a five-times increased risk of developing melanoma compared with those with few benign nevi or without dysplastic nevi. However, it is critical to recognize that these preexisting moles represent a risk factor for melanoma, rather than precursor lesions, in most cases. The vast majority of dysplastic nevi do not give rise to melanoma.
If a mole on the body has been dismissed by a physician as “nothing” and is changing, this is serious. A changing mole is a dangerous one and always needs evaluation. By performing self-skin examinations on a regular basis, clients and skin care professionals have the power to detect changing moles and bring them to the attention of a doctor. When melanoma is caught in the earliest stages, it’s almost 100% treatable.
As with sun exposure, recent studies indicate a relationship between the use of tanning beds and malignant melanoma, as well as nonmelanoma skin cancers, such as squamous and basal cell carcinomas. Thus, the consequences of regular tanning bed use may include disfigurement from the removal of skin cancers and early death if the cancer is a malignant melanoma, as well as substantial costs for screening, treating and monitoring skin cancer patients. Young adults should be discouraged from using indoor tanning equipment and restricted access to tanning beds by minors should be strongly considered.
With the incidence of melanoma still rising, it is clear that primary prevention efforts have not yet taken hold. The only approach firmly rooted in evidence is to minimize sun exposure. The use of sun-protective clothing appears to be the next best strategy. There is conflicting data regarding the protective effect of suncreens for melanoma, although there is no controversy regarding their ability to prevent basal and squamous cell carcinoma. Protection against UVA has been a long-standing feature of widely available suncreens, whereas UVB protection has more recently been engineered into all mainstream products. It is possible that the increased widespread use of these broad-spectrum sunscreens will provide more meaningful protective effects throughout the coming decades.
A new option is becoming available for early melanoma detection in the ability to test for the mutation of the cyclin-dependent kinase inhibitor 2A (CDKN2A) gene. This mutation has been linked to a very high risk of melanoma and was recently the focus of a study reported in the May 2011 issue of Genetics in Medicine. All people with a family history of melanoma showed a reduction in anxiety and depression after getting tested. Patients in this study had a strong family history of melanoma, with at least three relatives affected by the disease. These same patients who tested positive for the high-risk gene became more likely to use sunscreen and to undergo regular skin examinations by a physician for early melanoma detection.