As early as the 1930’s, sun tanning was encouraged by medical professionals to promote skin health. Scientific research during the late 1890’s played a huge role in contributing to the skin diseases we now know to exist today. During the turn of the 19th century, there was a chronic and progressive disease known as Lupus Vulgaris. The disease left infected individuals with painful cutaneous skin sores. Lesions appeared on individuals around the face, nose, lips, cheeks, ears and eyelids and proved resistant to all treatment leaving individuals with disfiguring skin ulcers.
It was not until 1896 when a physician and scientist named Niels Ryberg Finsen discovery the relationship between sunlight and the deficiency of vitamin D in patients. Based on his findings, “he demonstrated that the most refractive rays form the sun may have a stimulating effect on the tissues”. (“Niels Ryberg Finsen”). The breakthrough used “concentrated light radiation”, now known as Photobiomodulation, to be beneficial in use to treat diseases like Lupus Vulgaris and proved to be successful. (“Niels Ryberg Finsen”).
The success of these light treatments went on to win Finsen the Nobel Prize Award in 1903 in Physiology/Medication for his findings. Later by the 1930’s medical professions encouraged individuals to gain sun exposure to promote healthy levels of vitamin D and people began to spend more leisure time in the sun. (Randle, 2010). Eventually, the development of sunlamps, commercial tanning beds, and tanning salons came into our lives. Perhaps today, we may consider this to offer the beginning of the melanoma epidemic. Although it cannot pinpoint as when the melanoma epidemic began, but it could very well have attributed to it.
Skin cancer is described as an abnormal growth of skin cells that is often occurs due to over exposure of ultra-violent sun rays. It occurs when there are mutations are in the DNA of the body’s skin cells. These mutations grow out of control forming a mass of cancer cells beginning on the epidermis, the top skin layer, which provides protection to the other skin cells. The epidermis is comprised of: squamous cells that function as the skin’s lining, basal cells, which provide growth of new skin cells, and melanocytes which provide the pigmentation or skin color.
These cells contribute to the names of the three types of skin cancers known as: Basal and Squamous cell skin cancer (very common and very treatable), Lymphoma (rare and treatable) and Melanoma skin cancer. As noted by the American Cancer Society, “Melanoma skin cancer is the least common but the most serious of these skin cancers”. (American Cancer Society, 2012). Anyone can develop Melanoma skin cancer since it is the most common form of skin cancer. It is estimated that “over 1 million cases occur annually and nearly half of all Americans who live to age 65 will develop skin cancer at least once”.
(Medicine net, 2012). Melanoma can develop regardless of skin color, age, race and exposure to the sun is not necessarily a factor. Melanoma can be undetected for long periods of time and may be non-malignant or a malignant tumor, developing on any area of the body including those areas normally not exposed to sun light or internal organs. Many risk factors contribute to developing a form of skin cancer. Demographics can also play an important role in developing skin cancer.
This is due to the amount of extended sun radiation received from excessive exposure to the sun for long extended periods of the day, or from those that live in warmer sunnier places, or those that live in high-altitude climates are all exposed more than normal individuals and have in increased risk of development. Other mentionable contributing factors include abnormal moles that may look irregular or are increased in size, commonly located on the face, head, and hands of the pale skinned people. Research has proved that there is also interplay between genetics and environmental factors. (Cole, 2012).
The individuals with greatest risk are those with blonde or red hair. These individuals are more susceptible to be fair skinned that burns easily due to a decreased amount of melanin which protects the skin cells from damaging UV radiation. Those individuals with darker skin and have more melanin and are less likely to develop skin cancer. Individuals with a direct family history of skin cancer, such as a sibling or parent connection, may increase the risks of development. And lastly, if an individual has developed a form of skin cancer in the past, then the risk of developing cancer again is increased.
Melanoma skin cancer, the most serious of the skin cancers, can develop anywhere on the body externally or internally. It can develop in hidden areas on the body like between the toes, on the soles of feet, on the palms of hands, on the scalp, or on the genitals. In rare forms, it can develop in the eyes (Mayo Clinic Staff, 2012) but is most commonly recognized in abnormal mole growths. It is important to know that normal moles tend to be uniform in color, shape and are usually smaller than ? inch or less than 6 millimeters in size. Over time and with age the size and shape of a normal mole can change.
Unusual shaped moles may be an indicator of melanoma. The Mayo Clinic educates individuals on identifying characteristics to help to detect symptoms of this cancer. Indicators include asymmetrical shaped moles, irregular borders such as notched or scalloped borders, changes in color of the moles whether uneven color or uneven distribution, diameters larger than ? inch, and moles that are evolving or continuing to grow. Other changes to be cautious about include scaliness, itching or spreading of pigments in color, oozing or bleeding moles. (Mayo Clinic Staff, 2012).
If any of those symptoms occur, an individual should immediately make an appointment with a dermatologist who specializes in skin diseases or physician who specializes in cancer treatment such as an oncologist, to address those concerns and be examined. If a physician suspects skin cancer they may request periodic screenings for cancer either by home exam to visually self-inspect moles, freckles or other abnormalities in skin marks, or in office examinations may be conducted. The accurate way to diagnose melanoma is by a skin biopsy to analyze a skin sample.
The three main biopsy procedures used to diagnose melanoma are punch biopsy (performed with a tool and a circular blade pressed into the skin around a suspicious mole to remove a section of skin for diagnosing melanoma), or excisional biopsy (involves the removal of suspicious mole or growth with a small border of what appears to be normal skin for examination to diagnose melanoma), or a third type of biopsy is known as an incisional biopsy (the most irregular part of the mole is removed and taken for laboratory analysis to diagnose melanoma). (Mayo Clinic Staff, 2012).
Diagnoses of melanoma skin cancer and the stage of cancer is determined by the doctor upon performing careful examination of the melanoma under a microscope and then determining the thickness. A procedure known as a sentinel node biopsy may be performed by injecting the area of removed melanoma with a tracer or dye that flows to the nearby lymph nodes to determine if the melanoma has spread. According to the Mayo Clinic, if the lymph nodes are “cancer-free, there’s a good chance that the melanoma has not spread beyond the area where it was first discovered. ” (Mayo Clinic Staff, 2011).
At this time, a doctor would also determine the aggressiveness of the melanoma and inspection under the microscope would determine if cancer cells are dividing or spreading. This information assists the doctor in determining the stage of melanoma using Roman numerals I through IV. These stages help to determine the treatment plan and prognosis for a patient. A person diagnosed with Stage I would have the greatest odds for a successful rate of treatment whereas a person diagnosed with Stage IV would have the lowest chances for a full recovery since this staging of diagnosis can often mean the cancer has spread to nearby organs.
The best form of treatment for Melanoma will depend on the stage of cancer, the individuals overall health and age, and of course personal preferences. Treatment may options may include: surgery, chemotherapy, radiation therapy, biological therapy, targeted therapy, or experimental melanoma treatments that are clinical trials of new treatments. Melanoma detected in early stages or that have not metastasized have an excellent prognosis and can be removed with surgery or entirely during a biopsy and may require only surgery and no further treatments.
“This is why it is of great importance to remove the entire melanoma at its earliest stage to preclude the possibility of metastatic spread” (Cole, 2012). Later stage melanoma that has spread beyond the skin would receive surgery, or even multiple surgeries, to remove nearby affected lymph nodes. Chemotherapy may is medication given in pill form or intravenously or the combination of both, to destroy cancer cells, by forcing the medication directly to the area around the melanoma and not affecting other parts of the body.
Radiation therapy is a treatment that uses high-powered energy beams such as x-ray beams to kill cancer cells or to relieve symptoms of melanoma that may have spread already to another organ. Side effects commonly are fatigue during treatment. Biological therapy uses a substance such as interferon or interleukin-2, to boost the immune system in hopes of helping the body to fight cancer. Side effects may be similar to flu-like symptoms including headache, muscle aches, chills, fever or fatigue.
Targeted therapy uses medication called Zelboraf, which only treats melanoma of a certain genetic mutation to target the cancerous cells, but may not be an option for everyone. (Mayo Clinic Staff, 2012). Clinical trials of new medications may be available and is something that should be discussed with a doctor to determine if it is right of each individual depending on their specific case. Clinical treatment trials include new targeted therapies and vaccine treatment therapy that might alter cancer cells influencing the immune system to take action on those cells.
The best known prevention of developing skin cancer is to avoid midday sun, when UV radiation is the highest, and when the sun’s rays are the strongest. In most places, this is during the hottest parts of day or between 10 a. m. and 4 p. m. daily. Wearing sunscreen year-round with a SPF of 15 or higher can prevent sunburn on exposed skin lowering the risk of developing skin cancer. When sunscreens don’t provide enough protection wear protective clothing in the sun such as hats to protect the head and scalp, long loose sleeved clothing to provide shade to the body and sunglasses to protect the eyes from UVA and UVB rays.
Avoid tanning beds and natural sun tanning; these greatly increase the risk of developing skin cancer. Perform self-examination of your skin from head-to-toe, to check moles and freckles for abnormalities. Survival rates as reported by the National Cancer Institute over a 5 year period of 18 SEER geographic areas concluded there was a 91. 2% survival rate. By race and sex 88% is reported white males; 93. 4% is reported white females; 62. 5% is reported black males; and 78. 5% is reported black females.
Based on the rates reported from lifetime risks, during the years of 2007-2009, 1. 99% of men and women born today will be diagnosed with melanoma of the skin at some time during they lifetime. (National Cancer Institute, 2010). Although it was once believed that sun tanning provided therapeutic results to the skin providing ample supplies of vitamin D, research now has proven that it causes skin cancer in nearly 2% of every born individual at some time in their lifetime. In some cases, melanoma causes irreversible skin damage and in severe stages of diagnosis eventual death.
It is estimated by the National Cancer Institute that nearly 76,000 men and women will be diagnosed and die of melanoma of the skin in 2012. (National Cancer Institute, 2012). Adequate self-prevention of over exposure to UVA and UVB rays includes the use of sunscreens with a SPF of 15 or higher, the use protective clothing or hats, and regular skin examinations. These essential steps can help to lower the risks of skin cancers and provide the opportunity to enjoy the sun without the increased risks normally associated without skin cancer prevention and therefore, can provide a lifetime of fun in the sun.
References American Cancer Society. (2012). Skin cancer. Retrieved from http://www. cancer. org/cancer/skincancer/index Mayo Clinic Staff. (2011, August 11). Mayo clinic. Retrieved from http://www. mayoclinic. com/health/melanoma/DS00439/DSECTION=symptoms Mayo Clinic Staff. (2012, June 12). Retrieved from http://www. mayoclinic. com/health/melanoma/DS00439 National cancer institute. (2011, January 11). Retrieved from http://www. cancer. gov/cancertopics/wyntk/skin/page6 National Cancer Institute (2010). Retrieved from http://seer. cancer. gov/statfacts/html/melan.
html “Niels Ryberg Finsen – Biography”. Nobelprize. org. 9 Dec 2012 Randle, H. (2010, May 7). Suntanning: differences in perceptions throughout history… Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/9146690 “Works cited” Ramchander G, Shrihar R, Gupta TP, Aggarwal S. U. S. National Library of Medicine, National Institute of Health. (2011). Disseminated lupus vulgaris. Retrieved from website: http://www. ncbi. nlm. nih. gov/pubmed/21548522 Cole M. D. , G. W. (2012, December). Melanoma causes symptoms and treatments. Retrieved from http://www. emedicinehealth. com/melanoma/page2_em. htm.