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Melanoma Skin Cancer

Written by Morag Currin on September 25th, 2018.      0 comments

Melanoma Skin Cancer
Malignant melanoma is one of the most aggressive cancers in humans and is responsible for almost 60% of lethal skin tumors. The American Cancer Society’s estimates for melanoma in the United States for 2017 are: about 87,110 new melanomas will be diagnosed (about 52,170 in men and 34,940 in women) and about 9,730 people are expected to die of melanoma (about 6,380 men and 3,350 women).

The rates of melanoma have been rising for the last 30 years.

The risk of melanoma increases as people age. The average age of people when it is diagnosed is 63. But melanoma is not uncommon even among those younger than 30. In fact, it’s one of the most common cancers in young adults (especially young women). This covers the spectrum from boomers to millennials.

Melanoma is usually, but not always, a cancer of the skin that begins in melanocytes, which are pigment-producing cells in the skin that synthesize melanin, the pigment that gives skin its color.
While our focus may have been only on suspicious lesions with melanin, melanoma can also be a type of skin cancer in which the cells do not make melanin. This is known as amelanotic melanoma and these lesions can be pink, red, purple or of normal skin color, therefore it may be DIFFICULT to recognise the lesion as a melanoma. Typically they have an asymmetrical shape, and an irregular faintly pigmented border.

Melanocytes are the cells responsible for the formation of moles, within which melanoma often develops. Melanomas are found most often on the arms and legs of women. In rare cases, they can occur in the vaginal and cervix areas. Men tend to get more melanomas on their chest, back, abdomen, head or neck. The palms of the hands, the soles of the feet and the nail beds are common areas for dark skinned people to have a melanoma.

These areas of the body where melanoma’s are prevalent are important for your client medical history. If your client is a woman the focus for melanoma would be on her arms and legs especially when providing any type of service to those areas. If your client is a male you will need to focus on their chest, back, abdomen, head or neck. When dealing with clients who have a dark skin, focus on the palms of the hands, the soles of the feet and the nail beds. Any lesions that are “different” or “suspicious” looking from other moles on the client’s body – the client needs to be referred to a dermatologist for further evaluation.

The A, B, C, D, E, F’s Characteristics of Melanoma
(A) Asymmetry: One half of the area does not match the other half.
(B) Border: The edges are uneven or ragged.
(C) Color: The color is not the same all over and may have more than one shade or color present.
(D) Diameter: The size is larger than a pencil eraser (6 millimeters).
(E) Evolving: The mole is changing in size, shape or color.
(F) Feel – for many estheticians we work with touch and we ‘feel’ our client’s skins.

Screening and referring
Skin care clients with numerous benign nevi—small, regularly shaped and uniformly pigmented moles—are at increased risk of melanoma. The same applies to your clients who have few dysplastic nevi—large, irregularly shaped and heterogeneously pigmented moles. Clients in either group listed here may have a five-times increased risk of developing melanoma compared with those with few benign nevi or without dysplastic nevi. However, it is critical to recognize that these pre-existing moles represent a risk factor for melanoma, rather than precursor lesions, in most cases. The vast majority of dysplastic nevi do not give rise to melanoma.

If a mole on the body has been dismissed by a physician as “nothing” and is changing, this is serious. A changing mole is a dangerous one and always needs evaluation. By performing self-skin examinations on a regular basis, clients and estheticians have the power to detect changing moles and to bring them to the attention of their physician – even if insisting on a biopsy. When melanoma is caught in the earliest stages, it’s almost 100% treatable.

Spas wanting to create skin cancer awareness can create an add on service to their spa menu, which can be a mole counting and measuring service* (see box). It needs to be very clear that you are only counting and measuring moles and are helping your client be aware of the number of moles they have, without making any type of diagnosis. Remember to work within the scope of your license. Our focus as estheticians is the skin, and with many of our services, we are exposed to our client’s body.

While estheticians do not offer hair services unless they are dually licensed…..it is important for estheticians during facial or hair removal services to also pay any attention to the client’s scalp. Scalp melanomas are more lethal than other melanomas. One nationwide study found that people with scalp and neck melanomas die from the disease at nearly twice the rate of people with melanomas elsewhere on the body.¹ In fact, although only six percent of patients have skin lesions on the scalp and neck, they account for 10 percent of all melanoma deaths.²

Scalp melanomas may be deemed more lethal due to a delay in diagnosis because of their location, in an area usually hidden by hair, where one cannot see them without some effort. Be aware that the scalp is well vascularized area with numerous blood vessels, and the lymphatic drainage in this area is varied and complex. It may be that melanoma in this location can easily spread to the brain, making it more aggressive.³

Melanoma Diagnosis - Psychological Distress
A melanoma diagnosis can bring about short and long-term psychological distress. Estheticians who can provide an atmosphere of relaxation and understanding, and have the knowledge of how to handle a client who has undergone treatment for melanoma, can make a hugely positive difference.

Melanoma Prevention
With the incidence of melanoma still rising, it is clear that primary prevention efforts have not yet taken hold. The only approach firmly rooted in evidence is to:
  • minimize sun exposure and to not burn. See * below
  • use sun-protective clothing including a broad-brimmed hat and UV-blocking sunglasses.
  • use a broad spectrum (UVA/UVB) sunscreen** every day. Reapply every two hours or immediately after swimming or excessive sweating.
  • avoid tanning and UV tanning beds.
  • Self-examine your skin head-to-toe every month.
  • See your physician every year for a professional skin exam.

*According to Dr Des Fernandes, rated one of the top 5 plastic surgeons in the world points out that that low vitamin D status seems associated with melanoma and a worse prognosis. According to him, we make vitamin naturally between 10.30am and 3pm in the most populated areas of the world……the times we recommend that people stay OUT OF THE SUN!!! So the question is ‘Do we need midday sunlight to prevent melanoma’?

Evidence does show that people with thicker, or higher stage, melanomas have lower vitamin D status compared to those with thinner tumours which supports Dr Fernandes statement. So we should be recommending especially to people with a genetic predisposition or history or risk of melanoma to ensure they do get sufficient SUN AT MIDDAY to ensure sufficient Vitamin D levels for prevention.

So, based on this knowledge – let’s also educate our clients about the important of Vitamin D – especially if they are a high risk for getting melanoma. If your client is fair skinned, it is recommended you spend 10-20 minutes outside in the midday sun with minimal clothing and no sunscreen – this should give them enough radiation to produce about 10,000 international units of the vitamin. Your dark-skinned clients and your older clients also produce less vitamin D, and many folks don't get enough of the nutrient from dietary sources like fatty fish and fortified milk. So, they need to be outside for longer and more often, to get the same effect.

**Sunscreens do work however today the game seems to be that manufacturers try and outdo each other by ‘upping’ the SPF numbers game. Based on the information above, we should how and when to be in the sun and when to use sunblock. The natural SPF that protects darker skinned people from common skin cancers is about 12-14 and we know that a product with an SPF 8 provides protection – so why apply more chemicals than necessary?

Are we, as estheticians confident that the higher concentrations of free radical generating sunscreen molecules are safe? Many questions, but no answers! This is why it is important for us to be constantly trained with updated information from experts in our field.

Dr Fernandes wonders if the old greek advice of ‘moderation’ in everything is healthiest for melanoma as well.
Box: This mole measurement guide is made of flexible plastic to mold to rounded parts on the body. It has pre-cut holes that measure from 3mm to 9mm. Anything larger than 6mm with unusual signs need to be referred to the Physician.
For this FREE mole measurement guide, plus a mole counting and measuring intake form that can completed in the spa please place order for this FREE item: at http://oti-oncologytraining.com/product-category/retail/
 
Morag Currin Photo-534 As a leader in our industry, Morag has spent over 25 years in the wellness industry, researching and learning about cosmetic chemistry, advanced skin analysis, reflexology, aromatherapy and other modalities. She is the pioneer for oncology aesthetics globally and she researches and teaches to inspire therapists who want to make a positive impact on their clients living with cancer.

She is the author of Oncology Esthetics: A Practitioner’s Guide (Allured Books 2009 and 2014) and Health Challenged Skin: The Estheticians’ Desk Reference (Allured Books 2012) and her work has appeared in numerous national and international publications. More than an esthetician, she’s a sought–after speaker who loves being a trailblazer and she also continues to reach out to those suffering from a variety of health challenges through equine therapy.


References:
  1. Lachiewicz AM, Berwick M, Wiggins CL, Thomas NE. Survival differences between patients with scalp or neck melanoma and those with melanoma of other sites in the Surveillance, Epidemiology, and End Results (SEER) program.Arch Dermatol2008; 144(4):515-52
  2. Hareyan A. Scalp, neck melanomas most dangerous: carcinoid symptoms. EmaxHealth. http://www.emaxhealth.com/101/21814.html. April 22, 2008. Accessed Dec. 10, 201
  3. Frangou C. Scalp melanomas carry worse survival prognosis than other melanomas. General Surgery News 2012; 39(08). Accessed Dec. 10, 2012
  4. American Cancer Society – Statistics - https://www.cancer.org/
  5. Candy Wyatt,1,* Robyn M. Lucas,#2,3 Cameron Hurst,4 and Michael G. Kimlin#1. Vitamin D Deficiency at Melanoma Diagnosis Is Associated with Higher Breslow Thickness. PLoS One. 2015; 10(5): e0126394. Published online 2015 May 13. doi: 10.1371/journal.pone.0126394. PMCID: PMC4430535
Topics: Skin Care
 

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