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Friday, September 30, 2022

The Quiet Battle of Melanin vs Melanoma

 

Before we dive in, some of us may, or may not even know what Melanoma is. Melanoma is a cancer of the skin and usually comes in the form of an odd pigmentation on your skin. Similar to the myth that Melanated people do not need sunscreen, it is common to think Melanoma does not exist as a threat to the Melanated community as well. There is a stigma amongst black and brown communities that darker skinned people do not experience sun burn and are less susceptible to melanoma. That stigma must be debunked and become an open discussion in the black, and brown community.

Figure 1: Instagram: @Melanoma

 

While thinking of sunburn most people assume bright red or pink in color on the skin. Black and brown people do experience sunburn however they are tough to identify due to the skin being darker.

Signs or symptoms of a sunburn on darker skin may be:

  • hot
  • sensitive to the touch
  • painful
  • irritated
  • itchy
  • dizziness or nausea
  • blistering or visually swollen skin
  • an exceedingly high temperature
  • shivering or chills
  • muscle cramps
  • headaches

 

Figure 4: https://medicaladvise.org/cancer/how-does-sunburn-affect-dark-skin/

As stated by the American Academy of Dermatologist Association, “People with skin of color are prone to skin cancer in areas that are not commonly exposed to the sun, like the palms of the hands, the soles of the feet, the groin and the inside of the mouth. They also may develop melanoma under their nails.”

 

According to the American Cancer Society, when looking for the signs of melanoma one should follow the ABCDE rule, and lookout for the following:

  • A is for Asymmetry: One half of a mole or birthmark does not match the other.
  • B is for Border: The edges are irregular, ragged, notched, or blurred.
  • C is for Color: The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
  • D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), although melanomas can sometimes be smaller than this.
  • E is for Evolving: The mole is changing in size, shape, or color.

 

Figure 2: Instagram: @Melanoma

Figure 3: Instagram: @melanoma

Figure 4: Instagram: @melanoma

 

The American Society of Clinical Oncology, says, generally, there are four stages of Melanoma:

Stage 0: This refers to melanoma in situ, which means melanoma cells are found only in the outer layer of skin or epidermis. This stage of melanoma is very unlikely to spread to other parts of the body.

 

Stage I: The primary melanoma is still only in the skin and is relatively thin. Stage I is divided into 2 subgroups, IA or IB, depending on the thickness of the melanoma and whether a pathologist sees ulceration under a microscope.

 

Stage II: Stage II melanoma is thicker than stage I melanoma, extending through the epidermis and further into the dermis, the dense inner layer of the skin. It has a higher chance of spreading. Stage II is divided into 3 subgroups—A, B, or C—depending on how thick the melanoma is and whether there is ulceration.

 

Stage III: This stage describes melanoma that has spread locally or through the lymphatic system to a regional lymph node located near where the cancer started or to a skin site on the way to a lymph node, called in-transit metastasis, satellite metastasis, or microsatellite disease. The lymphatic system is part of the immune system and drains fluid from body tissues through a series of tubes or vessels. Stage III is divided into 4 subgroups—A, B, C, or D—depending on the size and number of lymph nodes involved with melanoma, whether the primary tumor has satellite or in-transit lesions, and if it appears ulcerated under a microscope.

Stage IV: This stage describes melanoma that has spread through the bloodstream to other parts of the body, such as distant locations on the skin or soft tissue, distant lymph nodes, or other organs like the lung, liver, brain, bone, or gastrointestinal tract. Stage IV is further evaluated based on the location of distant metastasis:

 

  • M1a: The cancer has only spread to distant skin and/or soft-tissue sites.
  • M1b: The cancer has spread to the lung.
  • M1c: The cancer has spread to any other location that does not involve the central nervous system.
  • M1d: The cancer has spread to the central nervous system, including the brain, spinal cord, and/or cerebrospinal fluid, or lining of the brain and/or spinal cord.

 

Recurrent: Recurrent melanoma is melanoma that has come back after treatment. If the melanoma does return, there will be a round of tests to learn about the extent of the recurrence. These tests and scans may be like those done at the time of the original diagnosis.

 

Black and brown people experience a high melanoma mortality rate compared to whites. At “The estimated five-year melanoma survival rate for Black people is only 67 percent, versus 92 percent for whites.” In most cases melanoma cancer is caught in the advanced stages amongst black and brown communities. The CDC says, “Late-stage melanoma diagnoses are more prevalent among Hispanic and Black people than non-Hispanic white people; 52 percent of non-Hispanic black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced-stage melanoma, versus 16 percent of non-Hispanic white patients.”

 

While the black and brown community may not suffer from sun burn and skin cancer at a higher rate than the white community; the mortality rate is higher being that it is usually caught at the late stages.

Therefore, sunscreen is not only excellent for your skin, but also can save your life in the future. So, my advice to whoever is reading this, look up your nearest dermatologist.

 

Research his/her experience in all skin types and get a consultation. And always, always, always wear sunscreen. Let us end this deadly disease in our community once and for all.

 

 

 

 

Admin. (2019, September 18). How does sunburn affect dark skin? Medical Advise. https://medicaladvise.org/cancer/how-does-sunburn-affect-dark-skin/.

Melanoma – Stages. Cancer.Net. (2020, September 2). https://www.cancer.net/cancer-types/melanoma/stages.

Melanoma: Skin Cancer in Skin of Color: Melanoma in blacks. Skin of Color Society. (n.d.). https://skinofcolorsociety.org/dermatology-education/melanoma/.

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