Melanoma can be deadly. But experts say it’s easy to protect your skin and catch it early

Across the country, the days are getting warmer and soon you might be pulling out your straw hat and reaching for that bottle of sunscreen from last summer.

But did you know that melanoma experts recommend wearing sunscreen 365 days a year?

“The first thing I did this morning was get up in the dark and put on some sunscreen,” said Toronto dermatologist Dr. Julia Carroll.

Carroll said she doesn’t bother to check the weather first because ultraviolet or UV rays — the main risk factor for melanoma — can damage your skin, regardless of the season.

“It’s the [ultraviolet] The B levels that go up and down, and the ultraviolet A levels are the deep penetrating ones that can damage DNA,” Carroll told CBC show host Dr. Brian Goldman. The dose.

Melanoma is a type of skin cancer that occurs in our melanocytes, the cells in our skin that make pigment.

UV rays from the sun or tanning beds damage melanocytes, said Dr. Elaine McWhirter, medical oncologist at the Juravinski Cancer Center in Hamilton and associate professor at McMaster University.

“Their inability to repair this DNA damage is what leads to proliferation and tumors,” McWhirter said.

Melanoma rates are rising in Canadabut experts say this type of skin cancer is highly preventable if you protect yourself from sun exposure and check your skin for uneven moles.

Who is most at risk?

If you have fair skin that burns easily, lots of freckles or moles, or had more than two burning sunburns before the age of 20, you’re at higher risk for melanoma, say the experts.

Simon Blakesley was diagnosed with melanoma in 2015. He believes he developed it after many years of sun exposure while growing up in southern Ontario.

“We ran outside, got completely sunburned, then at night doused in painkillers or rubbed butter where it was really badly burned,” said Blakesley, who now lives in Whitehorse and is an educator. retired.

“There really was no understanding or awareness of the long-term effects of sun exposure.”

After Blakesley had his melanoma removed and learned more about the risk factors, he talked about it with his three older brothers and his father.

His brothers were checked, but his father refused.

“Being the youngest, I think he was like, ‘Ah, I don’t need to listen to you,'” Blakesley said.

But about a year later, “he started developing lesions on his back, which once they started bleeding, he knew he had to see a doctor.”

Blakesley’s father was diagnosed with aggressive melanoma which had already spread to his lymph nodes.

After a number of painful surgeries, he chose medical assistance in dying in 2018, Blakesley said.

“The melanoma was so aggressive, so disfiguring, so demoralizing. It basically destroyed his outer body on his back and his shoulder,” he said.

Blakesley said that after his father died, he felt guilty for not pushing his father to go to the doctor sooner.

He now tries to spread the word about melanoma as often as he can.

“I don’t think people took it seriously enough because it’s often seen as some kind of cosmetic or vanity thing,” he said.

“I know from my own first-hand experience…how melanoma can fundamentally deconstruct your body.”

Early detection is the key

Experts say that since melanoma appears on the skin, it’s easy to spot it early and get it treated before it spreads.

“What happens with melanoma is that when you start to see these changes, it grows along the surface of the skin,” Carroll said.

“Over time it starts to grow and that’s when it metastasizes and can become deadly.”

Experts recommend putting a reminder in your calendar to check your skin for spots or uneven moles once a month.

you can follow the ABCs of Mole Assessmentsaid Carroll and McWhirter.

• A — Asymmetry. The mole should be symmetrical or have a uniform shape.
• B – Border. The mole should have smooth edges, not jagged or fuzzy edges.
• VS – Color. The mole should be a uniform brown color. Melanomas are often black, blue, reddish, or bleeding.
• D – Diameter. The mole should be no more than 6mm in diameter, about the size of a pencil eraser.
• E — Evolution and elevation. Melanoma often changes over time, unlike a benign mole which will stay the same. Melanomas can also rise above the surface of the skin.
• F – Family. If you have a group or family of moles, they should all look the same. Melanomas tend to stand out.

If you spot any of these signs when checking your moles, you should see a dermatologist, experts say.

How to protect yourself from the sun?

Along with regularly checking her skin for moles and seeing a dermatologist every year, Blakesley now takes a very different approach to sun protection.

He works as an aviation photographer and often spends all day outdoors.

“I always wear full coverage. I always wear a hat. Any exposed skin is always a minimum SPF of 30,” Blakesley said.

Experts say there are three key strategies for sun protection:

• Avoid peak hours.
• Cover up as much as you can.
• Wear a high SPF sunscreen.

Peak hours for sun exposure are 10 a.m. to 4 p.m., McWhirter said, so do your best to schedule outdoor activities for earlier or later in the day.

“But we have to be practical. Our summers are short, people like to go out,” she said.

That’s why she recommends SPF-based clothing, which has a UV-blocking weave, and a wide-brimmed hat.

If you’re outside in the middle of the day, Carroll recommends seeking shade, covering up and, of course, applying sunscreen.

Which sunscreen is the best?

Both Carroll and McWhirter said the most important thing to look for in a sunscreen — beyond at least SPF 30 — is a product you love.

“The best sunscreen is the one you’re willing to wear. And there’s sprays, there’s lotions, there’s sticks, there’s powders,” Carroll said.

It is essential to reapply every two hours when outdoors, or after sweating or swimming.

“Putting this on once in the morning and going out all day is insufficient,” McWhirter said.

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If it’s not a sunny day, you might assume you don’t need sunscreen, but that’s a myth, McWhirter added.

“If it’s cloudy, you might not feel the same warmth on your skin, but unfortunately the UV rays are still coming through,” she said.

If you have darker skin, you can still get melanoma, experts say, but it’s most often a type that isn’t caused by sun exposure.

It’s called acral lentiginous melanoma, which is found on areas of skin that aren’t usually exposed to the sun, and scientists don’t yet know what causes it.

“The soles of the feet, between the toes, skin cancers in these areas are more common in people with more pigmented skin,” Carroll said.

Experts recommend that everyone wear sunscreen, regardless of your skin tone.

What happens after a melanoma diagnosis?

Dermatologists like Carroll, along with primary health care providers, are on the front line in identifying and diagnosing melanoma.

If Carroll sees anything suspicious on a patient’s skin, she has it biopsied, she said.

If the mole turns out to be melanoma, Carroll says she tells her patients it’s not the worst news.

“It would be worse if it was about you and we didn’t know about it. So now at least we know and we can move on and do something about it,” she said.

Some dermatologists perform surgeries in their offices to remove melanomas, and surgical oncologists also perform surgeries, depending on severity, Carroll said.

A medical oncologist like McWhirter sees patients whose melanoma is at least stage 2, which means it has started to spread under the skin.

Advances in Melanoma Treatments

Over the past 15 years, there has been a significant evolution in the treatments offered for melanoma, McWhirter said.

Chemotherapy doesn’t work for melanoma, she says, but there are two main types of treatment: immunotherapy, which is intravenous, and molecular targeted therapy, which comes in pill form.

Before these new types of treatments were available, only about 25% of patients with stage 4 melanoma would live a year after being diagnosed, she said.

“Now when we offer treatments, we find that about 50% of patients are alive and well five years after starting treatment,” McWhirter said.

It’s gratifying to be in an area where there’s been so much improvement in treatment, she said.

“They’re not perfect. Patients are still dying from metastatic melanoma, but we’ve really made significant and important progress in the lives of our melanoma patients.”