Melanoma: The Silent Danger of the Sun’s Gaze
“Welcome to our first article in the Sun ☀️ series. which deals with Melanoma, a type of skin cancer that originates in specific cells, in the body, called melanocytes“. 
Global Incident Rates of Melanoma are Increasing
According to the World Cancer Research Fund International, skin cancer overall is the 17th most common cancer worldwide.
Indeed, a press release by International Agency for Research on Cancer [(IARC) – part of the World Health Organisation] states that cutaneous melanoma remains the most serious type of skin cancer and accounts for approximately 1 in 5 of all skin cancers.
Furthermore, a new study published in 2022 by scientists from IARC predicts that the number of new cases of cutaneous melanoma per year will increase by more than 50% from 2020 to 2040. As the number of new cases in 2020 was approx. 325 000 (with 57,000 deaths) this prediction translates to nearly half a million people in 2040! This is indeed alarming!
Melanocytes and Melanin
Melanocyte cells*, where melanoma originates, produce melanin which is the pigment that gives your skin its colour. The darker the skin-type, the greater the amount of melanin. However, what is important is the proportion of type of melanin present in your skin as there are two types: eumelanin and pheomelanin. Darker skins are associated with more eumelanin whilst lighter skin tones preferentially contain more pheomelanin.
In fact, exposure to UV radiation, causes a short-term increase in melanin production regardless of skin tone. This melanin production is to protect the skin from damage by solar ultraviolet (UV) radiation (UV-A, UV-B rays) although this protection is much greater in darker skins due to a higher amount of eumelanin which is photoprotective. Certainly, in lighter skin-tones, protection through melanin alone is not enough, due to the lower proportion of eumelanin. Thus, complementary sunscreens are essential for photoprotection.
While it is less common than other skin cancers, melanoma is more dangerous because it is more likely to spread to other parts of the body if not detected early.
What Causes Melanoma?
The primary cause of melanoma is exposure to UV radiation from the sun or tanning beds. UV radiation damages the DNA in skin cells, which can lead to mutations and the development of cancer. Other risk factors include having a fair complexion, a history of sunburns, numerous moles, and a family history of melanoma.
Signs and Symptoms
Early detection of melanoma is crucial for successful treatment. The ABCDE method was initially developed at New York University in 1985 as a tool aimed at helping physicians and the general public to differentiate between common moles and cancers. Note that its not full-proof so its best to seek medical advice.
Here are some signs to watch for, often remembered by the acronym ABCDE:
- Asymmetry: One half of the mole doesn’t match the other.
- Border: The edges are irregular, ragged, or blurred.
- Color: The color is not uniform and may include shades of brown, black, pink, red, white, or blue.
- Diameter: The spot is larger than 6mm across (about the size of a pencil eraser).
- Evolving: The mole is changing in size, shape, or color.
UV Radiation and UV-A vs UV-B vs UV-C
Ultraviolet light is a type of ionizing radiation which damages the body, is measured in wavelengths of nanometers and ranges from 10 – 400nm.
- UV-A (315-400 nm): has the longest wavelength. It can penetrate deep into the skin and is associated with skin aging and skin cancer
- UV-B (280-315 nm): has a medium wavelength and is more harmful than UVA. It affects the outer skin layers and is responsible for sunburns and can contribute to skin cancer.
- UV-C (100-280 nm): This type has the shortest wavelength and is the most harmful. However, it is completely absorbed by the Earth’s atmosphere and does not reach the surface
Therefore, UV-A and UV-B radiation are the types to be concerned with for either skin aging and/or skin cancer.
Also, bear in-mind that heavy sun exposure can also lead to “sun spots”, or a form of “hyper-pigmentation” which are essentially melanin deposits on the skin.
Preventing Melanoma
The best line of defense against melanoma is prevention. Preventing melanoma involves protecting your skin from BOTH UV-A and UV-B radiation and yes, a lot of discipline but the rewards are worth it …with good skin in later years and hopefully, no melanoma!
Use Sunscreen:
- Apply a broad-spectrum sunscreen (meaning it offers protection against BOTH UV-A and UV-B rays
- Use at least SPF30, even on cloudy days and in winter (yes, in winter as there are still UV rays)
- Re-apply sunscreen every 2 hours and especially after sweating and/or swimming
Sunscreens play a crucial role in protecting your skin against melanoma by blocking or absorbing harmful ultraviolet (UV) radiation from the sun. Sunscreens are essentially emulsions of oil in water (O/W) containing “active ingredients” such as inorganic and/or organic filters.
Organic means chemical compounds which are based on carbon, e.g. Octinoxate. Inorganic means the opposite in that they are not based on carbon but rather include metals and minerals, e.g. Titanium Dioxide or Zinc Oxide.
- Block UV Radiation: these active ingredients either absorb or reflect UV rays. Organic filters absorb UV radiation and convert it into heat, which is then released from the skin. Physical (mineral) sunscreens reflect rays away from the skin.
- Reduce DNA Damage: UV radiation can cause direct damage to the DNA in skin cells, leading to mutations that can result in skin cancer, including melanoma. By filtering out these harmful rays, sunscreens help prevent this DNA damage.
- Lower Melanoma Risk: Studies have shown that regular use of sunscreen can significantly reduce the risk of developing melanoma. For instance, using a sunscreen with an SPF of 15 or higher daily can lower your melanoma risk by about 18%.
- Prevent Sunburn: Sunburn is a clear sign of skin damage from UV-B radiation, which increases the risk of melanoma. Sunscreens help prevent sunburn by providing a protection of your own skin protection x SPF factor, i.e. SPF50 will provide 50 times your own skin protection.
- Broad-Spectrum Protection: It’s important to use a broad-spectrum sunscreen that protects against both UVA and UVB rays.
Wear Protective Clothing:
- Long sleeves, hats, and sunglasses can help shield your skin from the rays
- Remember, to use long sleeves in water as you get DOUBLE the amount of ways from the reflection of the water
- Same goes for the mountains with reflection from snow and high altitudes
- Take care of babies and children as their skins are much more delicate and require greater protection
Avoid UV Rays at Their Strongest:
- Avoid direct sun exposure, especially between 11 AM and 4 PM when UV rays are strongest
- The artificial UV radiation from tanning beds can be just as harmful as the sun
To maximise your protection, use a combination of ALL the above measures.
Conclusion
Melanoma is a serious but often preventable form of skin cancer. By taking steps to protect your skin and being vigilant about changes in your moles and skin, you can reduce your risk. Early detection and treatment are key to a positive outcome, so regular skin checks and prompt medical attention to suspicious changes are essential.
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