Melanoma alert: Here's what to watch for when looking at moles


August 10, 1993|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

Melanoma is the most common cancer in women ages 25 to 29 and the second most common skin cancer in women between 30 and 34. A melanoma is a kind of skin tumor that resembles a dark mole. Because the incidence of melanomas in the United States has been increasing more rapidly than any other cancer, I thought it would be important, particularly for younger women, to know more about melanomas. I asked Dr. Elizabeth Whitmore, a Johns Hopkins dermatologist, about these serious skin tumors.


Q: What does a melanoma look like?

A: A normal mole is usually a light to dark brown flat dot or an an elevated soft bump that is symmetric -- that is, one half is the mirror image of the other half. It has a smooth, rounded border, the color is uniform and it is usually less than 6 mm -- the size of an eraser on a pencil.

The American Cancer Society has described abnormal moles, like melanomas, as having abnormal features, represented by the "ABCDs" of moles. These include:

* Asymmetry: If the mole could be folded in half, it would not match.

L * Border irregularity: The border is not regular and smooth.

OC * Color variation: Various shades of brown, black, blue, red or

white may be present.

* Diameter: Greater than 6 mm, or larger than a pencil eraser.

Pay attention to any moles that change abruptly in size or character, and any that begin to itch, bleed or have a discharge. If you detect any of the ABCDs or these other signs, you should see a physician as soon as possible. All women should perform monthly self skin exams, looking at all of their moles for changes or abnormal features.

Q: Can melanomas be treated successfully?

A: The best way to treat melanomas successfully is through early detection -- 53 percent of melanomas are detected by patients themselves. The earlier a melanoma is removed, the better the survival rates. In fact, when a melanoma is removed at a very early stage while it is very thin, the prognosis is excellent, with a 15-year survival rate approaching 100 percent. As time goes on and melanomas grow and get thicker, the 15-year survival rate drops to 50 percent.

Q: Can melanomas be prevented?

A: The very best way to guard against melanomas is to avoid sunbathing. Women who are fair-skinned and burn easily, particularly those who develop blistering sunburns, are at increased risk. Women with light hair and eyes, and those who have a family history of melanoma are also at increased risk.

A recent study that looked at people under 30 with melanomas found they were seven times more likely to be regular tanning salon or sunlamp users (more than 10 exposures per year) than others.

So, avoid suntan parlors, as well as outdoor sunbathing. When you are outside in the spring, summer or fall for more than 20 minutes between 10 a.m. and 4 p.m., use a sunscreen with an SPF of at least 15 on your exposed skin. And, although it is safe to use sunless tan accelerators, remember the "tan" that results offers no sunscreen protection, so you still need to use a unscreen when you're outside.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.

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