Melanoma: The most dangerous of skin cancer

With the start of the summer, good weather invites us to enjoy the sun. Extended exposure to ultraviolet rays represents a high risk to the health of our skin. Spending long hours under the sun can cause the appearance of various tumours on the surface of our skin, which could lead to skin cancer.

Various precautions should be taken to fight the harmful effects of ultraviolet rays as recommended by experts. One should also be very attentive to any anomalies that may appear on the skin. Fashions, and often the lack of knowledge about problems linked to prolonged exposure without protection and without routine screenings, contribute to getting younger people suffering the unpleasant experience of having to face the appearance of melanomas or carcinomas.

Robert Lutz, dermatologist, explains the risks, the reasons and the precautions to take to avoid developing tumours such as melanomas.

What is a melanoma and how has it progressed in recent years?

It is a malignant tumour of melanocytes, which are cells that produce skin pigment granules (melanin).  The incidence of melanomas in recent decades has increased dramatically in most countries of the world. Of the different types of skin cancer, melanomas are the most dangerous.  They represent about 4% of skin cancers, and are responsible for 75% of deaths in relation to skin cancers.  Most of these tumours can be cured if detected early.

What causes the appearance of these tumours?

Sun exposure specially, often from childhood, in addition to genetic factors, have an effect on their development. Their increase is most certainly related to the lifestyle of different cultures who like the sun too much.  Places like Australia, which is one of the countries reporting the higher amount of melanomas, and perhaps the only country that has taken measures and managed to slow down the increase in these tumours.

How does a melanoma look like?

At first they look more like spots rather than lumps.  We also find carcinomas. These are quite frequent and less severe.  They present a crust or small wound that does not heal. Beware of any new moles and lookout for any changes in the size and shape of those you already have.

Fashion rules. Are young people too exposed?

Lifestyles have changed.  In the 50’s and 60’s, the incidence of melanomas started to increase because lifestyles changed. The commercial image of a darker skin in summer, the “beach or pool tanning”, was imposed against the exaggerated textile protection of the 20’s and 30’s.  We are paying the price of this trend with our lives. In USA, melanomas represent the most common cause of death among women aged between 25 and 30.

Will Spain also follows this trend?

In Spain, cases of melanoma, like other types of skin cancer, have increased considerably.  On the Costa del Sol this is even more noticeable.  When I worked in Bruselas, where there is less sunlight, I cared for patients aged 60 or 70. It was normal to find carcinomas. In comparison to our area, I have patients with 28, 30 or 40 already suffering the same type of pathology.  This is because of the abuse that young people nowadays make of the sun. Lifestyles also have an effect, we have more sun hours and spend longer outside, which has its advantages but also its risks for the skin.

How has the number of affected people increased in recent years?

Overall, melanoma data available shows that in recent decades, in most countries, the incidence of tumours has doubled.

What causes the increase in the number of people affected?

This increase is related to the sun and to climate change, although there are many who do not want to see it.  Today the sun is strongest, and linked to our lifestyle, which causes an increase in the number of people affected.

What kinds of people are more affected by these types of tumours in Spain?

People of around 50 have the main risk of skin tumours such as melanoma. It also frequently affects young people and is a frequent cause of death.

Is melanoma the only risk?

Melanoma is the most dangerous cancer among the most common ones, but there are also carcinomas.  There are also many other problems directly related to the sun affecting the skin such as wrinkles, blemishes or skin aging.

Is summer the most dangerous time to suffer the consequences of ultraviolet rays?

In Spain there is sun all year round. Summer is particularly relevant, as it is the most dangerous time for this kind of tumours.  If you wish to prevent such problems, and we are referring to sun protection, you must take precautions all year round. Lotions are not the only factor, also common sense.  It is important to look for the shade and not be exposed long hours to the sun, avoid the times when the sun is stronger between 10:00 and 16:00, and wear appropriate clothing and hats.

Are sunscreens effective to combat the appearance of melanomas?

It depends.  There are many sunscreens that prevent sunburns well, but do not protect you against ultraviolet rays.  You can spend hours on the beach without burning, but that doesn’t mean you’re well protected.  Currently in the European Community, manufacturers have to carry out tests to check protection against ultraviolet rays.

I recommend the use of high protection sunscreens with SPF 50.

Everybody has the same chance of developing these tumours?

Possibilities increase in those who have more moles, the risk is not the same for someone with 200 moles against someone with only 20. The presence of more or less moles should also be investigated, one can have many moles because of different factors both genetic or because of having been exposed to the sun as a child.

Is awareness in Spain higher regarding this problem?

Much remains to be done in Spain as we are not aware at 100%.  Quite the opposite, Australians and Americans have taken measures against this issue.

What to do when we find a possible melanoma?

If someone has a mole they do not like the appearance of, because it seems different from others they have, because it’s changing or because it itches, I advise them to quickly go to the dermatologist.  It is best to examine it and then, if necessary, remove it.  Signs of melanomas are the appearance of moles where there was nothing changing their shape. Identifying a melanoma is not easy. It is always advisable to use common sense and check with a specialist of your trust. Most patients who come to the consultation to remove a small melanoma because they do not like how it looks like. Instinctively they decide to see the doctor, and often because it feels different.

Children are undoubtedly the most sun sensitive risk group.

Children protection is very important because they have a very sensitive skin, and protecting them is also a way to protect them from these tumours as adults. Regarding melanomas, the more sun exposure there is in childhood, the more moles will appear on the skin.  There are other risks apart as sunstroke or sunburns.

What precautions should be taken with children?

The same as with adults.  Children should avoid exposure to sunlight when the sun strongest, use sunscreen of a high SPF and waterproof and also wear clothing to protect them and keep them in the shade.