Melanoma is the most serious form of skin cancer. It occurs in the melanocytes, which are the pigment-producing cells of the skin. If left untreated, melanoma has the potential to spread, or metastasize, to other parts of the body, resulting in severe illness or death. The statistics regarding melanoma are cause for alarm because, according to the American Academy of Dermatology, it has become the most common form of cancer in people between the ages of 25 and 29. In addition, every year approximately 50,000 new cases of melanoma are diagnosed in the U.S. Because the vast majority of melanomas occur on the skin, catching them early in their development makes their cure a relatively simple surgical procedure. That is what makes early detection and understanding the warning signs of melanoma essential. Therapists are able to detect possible signs even better than clients, as they are able to touch and see parts of the body, such as the scalp and back, that clients can’t. For that reason, it is important that they be trained on what to look for while performing a treatment.
While anyone can develop melanoma, making sure therapists understand the risk factors is the first step in early detection. Clients with fair skin and light eyes have a greater risk of developing skin cancer, particularly those who burn easily and rarely tan. Individuals with red or blond hair and blue or green eyes tend to burn and develop freckles more easily than those with darker skintones. After the age of 50, the risk increases, particularly in clients who have large or unusual-looking moles.
Recent research shows that women appear to develop melanoma at a slightly higher rate than men until age 40. At that point, men are more likely to be diagnosed with malignant melanoma. The rate of melanoma in both men and women, however, increases with age, so it is important for therapists to look for warning signs on both male and female clients.
While regular full-body skin examinations by a dermatologist are essential so that moles can be properly checked, therapists can also be trained to spot warning signs. The signs of melanoma are referred to as the ABCDE’s (the E being a relatively newer addition):
A is for asymmetry, where one side of the mole is unlike the other.
B is for borders, which are irregularly shaped, scalloped, or poorly defined.
C is for color changes within a mole, varying from tan to brown, black, and blue.
D is for diameter, and although this is not a hard and fast rule, melanomas tend to be greater in diameter than 6mm, or the size of a pencil eraser.
E is for evolving, which refers to moles that look different from the others on the skin or that are changing in size, shape, or color.
It is also important to be aware of nail changes, because although less common, melanomas can first appear as dark brown or black streaks under a fingernail or toenail. Melanomas can also look like bruises that do not heal.
While those with lighter skintones are at higher risk for skin cancer, darker-skinned clients do not have immunity against skin cancer, including malignant melanoma. Whatever your clients’ coloring, educate them that the best prevention is a lifestyle approach, which includes practicing good sun safety habits. Encourage clients to always apply broad-spectrum sunscreen with a high SPF (30 or higher), seek shade during peak sunlight hours, wear a wide-brimmed hat and sunglasses with lenses treated to filter out UV rays, and watch their skin for any changes in moles.
If a therapist notices any of the above signs while performing a service, they should encourage the client to visit a dermatologist. Regular full-body skin examinations are essential, so that moles can be properly checked. A therapist can play a key role in early detection, which can save a client’s life.—Jeannette Graf, M.D.
@bio: Jeannette Graf, M.D., is consistently featured in national publications and scientific journals for her dermatology, skin science, and anti-aging expertise. She is the author of the best-selling book Stop Aging, Start Living (Three Rivers Press, 2008), in which she recognizes the impact of pH balance on the way we look and feel. For more information, visit www.askdrgraf.com.