Life After Melanoma

Summer is fast approaching, and with it comes sunburn season. For some people, however, avoiding a sunburn is more than just a passing thought on the way to the beach — it’s a matter of life and death. Why? Because of melanoma, the deadliest form of skin cancer.

Preventing skin cancer is discussed frequently, but during this Melanoma Awareness Month it’s time to discuss how to prevent it from coming back when you’ve already had it.

Melanoma survivors at higher risk

The rates of melanoma have been rising for the last 30 years. It is the fifth most-common cancer among men and the sixth most-common cancer in women.

While it only accounts for about 1 percent of skin cancers, melanoma causes the largest majority of skin cancer-related deaths. As with many cancers, however, the best chance for survival occurs when melanoma is detected early. In fact, the five-year survival rate for early-stage melanomas is as high as 97 percent.

Unfortunately, melanoma survivors have a higher risk of the cancer coming back. Therefore, the American Cancer Society suggests melanoma survivors talk with their doctor about developing with a care plan for post-melanoma life. This plan could include:

• A schedule for follow-up exams and tests
• A schedule for other tests they might need in the future
• Information on possible latent side effects from treatment, as well as what to look out for and when to contact their doctor
• Diet and exercise suggestions

For melanoma survivors, skin and lymph node exams should be performed regularly by a self-exam and by a doctor to watch for any new or recurrence of skin cancer. New lumps or a change in skin color should be seen by a doctor and new symptoms that do not go away should also be reported.

Typically, physical exams after early-stage melanomas occur every six to 12 months. For thicker melanomas, the time frame may shorten to every three to six months.

Common second cancers after melanoma

While survivors of melanoma have a 28 percent increased risk of a second cancer, another skin cancer is the most common. Survivors also have a higher risk of:

• Female breast cancer
• Non-Hodgkin lymphoma
• Prostate cancer
• Salivary gland cancer
• Small intestine cancer
• Kidney cancer
• Thyroid cancer
• Soft tissue cancer

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For men, melanoma is most commonly found on their chest and back. For women, it is most commonly found on their legs.

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Reducing the risk of cancer recurrence

To maintain good health and lower the risk of cancer recurrence, it is important for melanoma survivors to attend all follow-up appointments and do the following:

Limit your exposure to ultraviolet, or UV, rays

To minimize risk of getting melanoma, the most important thing to do is avoid UV rays, both manmade (tanning beds and sun lamps) and natural (the sun).

Sailesh Konda, M.D., an assistant clinical professor of dermatology at the University of Florida, recommends staying out of the sun when UV rays are strongest, which is between 10 a.m. and 4 p.m. If you can’t avoid the sun during those hours, he encourages the use of sunscreen of at least 30 SPF.

“I recommend broad-spectrum sunscreens with titanium dioxide or zinc oxide, which offer protection against both UVA and UVB rays,” Konda said. “UVA and UVB rays can cause premature skin aging and an increased risk of developing skin cancer.”

He also suggests sun-protective clothing, a broad-brimmed hat, legally tinted car windows and UV-blocking sunglasses. That’s right — your eyes need protection from sunburn as well.

Adopt healthy habits

Put down that cigarette and pick up an apple. Not smoking, eating nutritious food, exercising and maintaining a healthy weight may help reduce the incidence of most cancers, according to the American Cancer Society.

Keep a strong immune system

A weak immune system could leave room for melanoma, or any cancer, to come back. Boosting your immunity isn’t easy, but steps can be taken to help an immune system fight back. Adopting those healthy habits, avoiding infections, washing hands, getting adequate sleep and minimizing stress will help an immune system stay healthy and fight off germs. Immune systems tend to weaken with age, so it is especially important for older people to take these precautions to help avoid cancer recurrence.

How to spot melanoma

Melanoma survivors should conduct regular self-exams. When looking for melanoma during a self-exam, keep the ABCDE rule in mind:

• A stands for Asymmetry. Be on the lookout for a mole or birthmark where one half does not match the other.
• B is for Border. If the edges of a mole are ragged, blurred, irregular or notched, it could be a sign of melanoma.
• C has Color. Melanoma may show itself in the form of color inconsistency. Colors may include different shades of black and brown or patches of pink, red, white or blue.
• D stands for Diameter. It is abnormal for a spot to be larger than six millimeters, so, if it is, talk to a doctor. While some forms of melanoma are smaller than this, larger spots are signs of melanoma.
• E is for Evolving. A mole or mark that changes in size, shape or color is cause for concern.

Others signs and symptoms of melanoma are:

• A sore that doesn’t heal
• Spread of pigment from the border to surrounding skin
• Redness beyond the border
• Itchiness, tenderness or pain
• Change in the surface of a mole

Have fun in the sun, but don’t forget to protect your skin while doing so!