Skin Cancer Awareness & Prevention for People of Color - The Dermatology Review

Skin Cancer Awareness & Prevention for People of Color

When we think about melanoma, we often associate dark skin with safety. The less pigment in the skin, the thinking goes, the less protection against this damaging form of skin cancer.

In reality, people of color can and do get melanoma. But the form of skin cancer they get comes with a low survival rate even when it’s found early. 

Melanoma can change the way your skin looks and feels, although it’s rarely painful. It’s easier to treat when the lesion is small and hasn’t spread to another part of the body. Surgery, radiation, and other conventional cancer treatments can help you fight back.

Everyone should check their skin for melanoma signs. People of color should focus on the soles of their feet and other parts of the skin that don’t always get a lot of sun exposure.  Follow with simple lifestyle changes to protect your skin too. 

Sunscreen is critical for everyone, but it’s common for people of color to avoid its use. Choose the right product and apply it often for the best results.

Melanoma looks and behaves differently in people of color. Even doctors don’t always notice the differences that occur when it develops in people of color. But with vigilance and persistence, you can keep yourself and your family safe.

Skin Cancer in People of Color

Melanoma is among the deadliest of skin cancers, and it’s more common among people with light skin. In fact, researchers say the incidence of melanoma among Black people is about 10 percent of that in white people. Even so, Black people can develop melanoma.

Researchers say Black people develop a form of melanoma that often forms on less obvious body parts, such as:

  • The palms of the hands.
  • The soles of the feet.
  • Beneath the fingernails and toenails.

This form of cancer, acral lentiginous melanoma, has a lower survival rate than other forms of melanoma. Even when it’s found before it has spread to other body parts, it tends to lead to death.

Researchers say, for example, that 90 of 100 white people are still alive five years after a melanoma diagnosis. Only 66 out of 100 Black people are still alive five years after their melanoma diagnosis. 

What Does Skin Cancer Look Like?

Your skin is full of streaks, speckles, and spots. Everyone has unique, identifiable color variations within their skin. But melanoma can change the way your skin looks, and that could be the only symptom you notice.

Researchers say people of color often believe they can identify cancer through pain. A lesion that could take your life should hurt, right?

But melanoma is often painless. Rather than causing discomfort, this form of cancer tends to spark lesions on your skin that are:

  • Asymmetrical. If you divide the lesion right down the center, one side is bigger, longer, or more jagged.
  • Border challenged. The edges of the lesion are jagged, not smooth.
  • Colorful. The lesion has bands of black, brown, red, or orange flashing through it.
  • Diametrically large. The spot is bigger than 6 mm. That’s the size of a pencil eraser.
  • Evolving. An existing spot grows in shape, size, or color.

A melanoma under your fingernail might look like a band of pigment, and it’s typically on your thumb, big toe, or index finger.

Skin Cancer Moves Quickly

As the name implies, skin cancer starts on the surface. Changes begin as speckles you can see, and sometimes you don’t even need a microscope to do that.

But as the disease worsens, the cancer burrows into deeper tissues. And in people of color, that process happens very quickly.

Experts use a staging system to determine cancer severity. Three aspects are included.

  1. Tumor: How thick is the primary tumor, and does it look blistered or ulcerated?
  2. Nodes: Has the immune system been triggered? If so, cancer cells might dig into nearby lymph nodes.
  3. Metastasis: Have cancer cells migrated from the primary tumor to other parts of the body? Melanoma can spread to spots such as the lungs, brain, and bones.

Numbers included after each of these reference points indicate severity. The higher the number, the more serious the cancer. Often, experts combine all of the readings into one general stage. Someone with a mild form of cancer might get a Stage 0 reading, while someone with a serious case might have a Stage 4 reading.

Researchers say people of color are often diagnosed with melanoma when the cancer is in Stage 3 or 4. Often, people who are white are diagnosed early

An early diagnosis matters. When cancer is caught early, surgeries to save lives are less dramatic and severe. Smaller scars lead to a better overall appearance and higher self-esteem. But later cancers also mean deeper spread, and that can lead to a shortened life span.

A tumor in your lungs can impede breathing, which can make you wheeze and moan with even small amounts of exertion. And tumors within the brain can cause blinding headaches and nausea.

Skin cancer treatments, when provided early, can halt this spread. And doctors have plenty of treatment options to choose form.

Perform a Skin Cancer Check

Since skin cancer develops on the surface of the skin, everyone has the opportunity to spot it and ask for help. But people of color need to perform very thorough checks, as cancers develop on places that you might not examine every day.

Conduct a skin self-exam in five steps:

  1. Look at your body in a full-length mirror. Start with your arms at your sides, and then do another check with your arms raised overhead.
  2. Look at your underarms, palms, and forearms.
  3. Sit on a chair, and examine your legs, feet, and toes. Make sure to check the bottom of your feet.
  4. Pick up a mirror and examine your neck and scalp. You can also ask a loved one to check these areas for you.
  5. Use that same mirror to examine your lower back and buttocks.

People of color should pay close attention to their legs, feet, and toes. Researchers say that most melanomas in people of color originate on these sites, and you may not spend much time each day looking closely at the skin on your lower extremities. Take the time to look them over very carefully, and bring any changes to your doctor’s attention right away.

Researchers also say people of color should check for melanoma inside their mouth and under their nails, as melanoma has been found in these sites too.

Melanoma is dangerous, but the lesions you see may not look angry, pulsating, and red. People with melanoma describe their spots with terms like these:

  • Dusty grey
  • Wart-like
  • Flesh-colored
  • Pimple-like

Don’t be afraid to talk with your doctor about anything you’ve seen. If you’re monitoring a spot, such as a mole or a freckle, take photos of it with your smartphone camera every day. Bring those snaps with you to your doctor’s appointment, so you can demonstrate how the spot has changed over time. That data could be critical for your doctor to understand the big picture.

5 Skin Cancer Prevention Suggestions

Finding skin cancer early leads to effective treatment. But focusing on prevention can mean avoiding the risk of cancer altogether.

Limit your risk with these steps:

  1. Stay in the shade. It’s tempting to lounge in the warm sun. But the rays can damage your skin, and the time you spend outside can lead directly to an enhanced cancer risk. Choose the shade whenever you can.
  2. Cover your feet. Choose shoes that wrap all the way around your feet, including your toes. Since many forms of cancer in Black people develop on the feet, it’s critical to keep them covered.
  3. Choose long pants. Skip the shorts, and wear long pants and full socks. These layers protect your lower extremities from the sun, and those are melanoma hot spots.
  4. Avoid tanning beds. People of color rarely use sun lamps and other forms of artificial sunlight, but those who do have a higher risk of cancer. Avoid any product like this.
  5. Wear a hat. Choose a wide-brimmed hat that shades both your face and neck. Protect the skin at the top of your head from the sun’s dangerous rays.

Sunscreen Specifics for People of Color

Sunscreen is one of the most effective tools available to protect against melanoma. And studies suggest that about half of Black people rarely or never use any product like this.

Choose a sunscreen that offers full protection. Look closely at the labels before you buy, and opt for a product that promises:

  • Broad-spectrum protection. Sunscreens like this protect your skin from UVA and UVB rays from the sun. Both can cause cancerous changes in skin.
  • High sunburn protection. Products that boast an SPF of 30 or higher offer complete protection from sunburn.
  • Water resistance. Products with this label will stay on for 40 minutes after you’ve taken a dip in a body of water.

Choose a lotion with a fancy smell that reminds you of the beach. Or reach for a bottle that has no scent at all. Be careful and choosy, so you’ll select a product that you’ll use each day. You won’t get any level of protection from something that sits in your closet rather than on your skin.

Take care and follow these sunscreen rules:

  • Plan ahead. Put on sunscreen about 15 minutes before sun exposure begins. If you’re heading to the beach, don’t wait until the sand hits your toes to slather on a product. Apply before you leave the house.
  • Use plenty. Most adults need an ounce of product for full coverage. Be generous with the product, and apply an even coat.
  • Pay attention to borders. Any part of your body that isn’t completely covered by clothing needs sunscreen. Don’t reach beneath sleeves and pantlegs and hope you’ve applied a thick coat. Apply sunscreen first, and then get dressed to ensure the sun doesn’t seep into the areas of skin that border your clothing.
  • Reapply often. If you’re staying in the sun, put on more lotion every two hours. If you’ve taken a dip in water, reapply when your skin is dry.
  • Use every day. You can experience the sun’s damage on cloudy, dry days as well.

Using so much sunscreen isn’t always fun or easy. It’s tempting to skip this critical step when you’re busy or in a hurry. Remember that your skin always needs protection. Follow these steps consistently, and they’ll become a habit you follow subconsciously.

Skin Cancer Differences by Skin Color

It’s worth repeating that people of color have a different experience of skin cancer than people who are white. Those differences can threaten their lives.

People of color experience:

  • Different tumor placement. Melanoma in people who are white appears in sun-drenched areas, like the hands and face. Melanoma in people of color often appears under the fingernails, between the toes, and on the soles of the feet.
  • Deeper tumors. Researchers say people of color often have tumors that dig much lower into skin layers when compared with their white counterparts.
  • Higher death rates. Melanoma is always serious. But researchers say people of color tend to survive the cancer at much lower rates when compared to white individuals.

Fair-haired people with light skin and eyes often develop melanoma. And any form of the disease is serious. But as these statistics prove, people of color face a serious crisis involving melanoma. It’s wise for everyone to take action.

Skin Cancer Treatment

Skin cancer treatment choices are guided by the severity of the cancer. The more serious your cancer, the more significant therapy you’ll need to fight back. But doctors have many tools available to help excise tumors and guide patients to a healthy outcome.

We’ve outlined typical treatments per stage.

  • Stage 0: Surgeons remove the lesion or tumor, and they may use radiation or imiquimod cream to remove traces left behind.
  • Stage 1:  Surgeons remove the tumor and a wide swath of skin around it. If the cancer has spread to lymph nodes, those are removed too.
  • Stage 2: Surgery starts the process, and impacted lymph nodes are removed. Targeted cancer drugs remove remaining cancer traces.
  • Stage 3: Surgery begins the treatment plan, but patients often need medications and radiation after surgery.
  • Stage 4: Surgeons remove the tissues they can, but sometimes, the cancer is too aggressive and large. Immunotherapy drugs may help some people to fight back.

Many people are involved in a melanoma treatment team, including:

  • Dermatologists
  • Surgeons
  • Oncologists
  • Radiologists
  • Dermatopathologists

Everyone on the team shares information about your cancer, your treatment, and your progress. You all work together to fight back against the cancer, and you may visit different professionals depending on your progress and prognosis.

Some people with melanoma benefit from clinical trials. Researchers examine new therapies, including new medications, to see if any are effective in the fight against disease. Your doctor might recommend vaccine therapy or some other form of clinical trial if the conventional methods aren’t working.

Advocate for Skin Health Education

Many people of color know that melanoma is both serious and on the rise. But some experts say doctors aren’t aware of the dangers of melanoma in people of color. Dermatology studies often focus on white skin, and doctors aren’t always sure of what to look for.

You know your skin better than anyone else does. If you see changes, document them and talk with your doctor about them. Bring a photographic record, and ensure that your concerns are taken seriously.

If you are diagnosed with melanoma, confirm that your doctor has access to your photos and uses them to educate others. You could offer help that saves another life in time.

We can’t eliminate melanoma altogether. But the more we talk about this cancer and push for both awareness and change, the better we might all be in the future.

References
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