Malignant Melanoma

by Charles H. Booras, MD


Malignant Melanoma is a major health concern in Florida and other places where sun exposure is common. It is a form of skin cancer that is always lethal if left untreated. Melanoma is the most common form of cancer in women between the ages of 25-29, and is second only to breast cancer in women between ages 30-35. The incidence seems to be rapidly rising each year and is most common in people with blue eyes and red or blonde hair, who sunburn easily. Other risk factors include those with a family history for melanoma (like yourself), atypical nevi (a type of pre-cancerous mole), a personal history of non melanoma skin cancer, and a record of painful or blistering sunburns as a child or teenager. Each blistering sunburn doubles your risk of skin cancer later in life.

The death rate from these cancers gets higher as they penetrate deeper into the skin. Thus, the goal of screening is to catch the cancer early, while it is on the superficial skin levels. In order to do so, a meticulous skin (and back of the eye) inspection by a trained physician is a must. This exam should be done yearly in the high risk population. A thorough self exam, however, can be done monthly. All parts of the body should be inspected since melanoma can be overlooked on the palms of the hands, soles of the feet, scalp, lining of the mouth, and under the nails. A mirror or partner can be used to inspect hard to reach areas of the back, back of legs and genital creases.

Be familiar with ABCD's of self examination.

A for Asymmetry. Benign moles are symmetrical, melanoma's are not, meaning, a line drawn through the middle will not create matching halves.

B for Border. Benign moles have even edges while melanoma's are uneven with notched edges.

C for Color. Most benign moles have a single shade of brown while melanoma's will usually have different shades of brown, black, red, or even a whitish appearance.

D for Diameter. Common moles are usually less than 1/4 inch (6 mm), the size of a pencil eraser. Early melanoma's tend to be larger than this.

Malignant Melanoma

The best prevention is adequate protection from the sun. One half of our entire lifetimes sun exposure has been accumulated before age 18! We need to try and limit our exposure and use sunblocks that screen out both Ultraviolet A and Ultraviolet B rays.

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