Often caused by excessive exposure to ultraviolet (UV) rays in sunlight, melanoma accounts for only 4 to 5 percent of skin cancer cases, but is responsible for most skin cancer-related deaths. As with many forms of cancer, melanoma is often misunderstood, and myths persist.
When detected and treated in its earliest stages, however, melanoma is often curable. The key is to avoid overexposure to UV rays – by limiting time outdoors during the peak hours of sunlight and wearing sun-protective clothing and sunscreen – and to be on the lookout for changes in moles and other blemishes that can be an early sign of the disease.
Jennifer Y. Lin, MD, of Dana-Farber Cancer Institute’s Melanoma Treatment Program, sets the record straight on five of the most common myths about melanoma.
Myth 1: A diagnosis of melanoma means that I have months to live.
There are four stages of melanoma — five if you include a form known as melanoma in situ, an early form of the disease that affects only the top layer of skin. Stage 1 melanomas, which are less than one millimeter thick and almost always have not spread beyond their original site, have an excellent prognosis and are generally cured by surgery. The depth of the original melanoma is critical to determining how it will be treated and how people with it are likely to fare. Although more melanomas are being diagnosed, the largest portion are made up of Stage 1 melanomas. Before worrying about the worst outcomes, speak with your doctor about what stage melanoma you have.
Myth 2: There is no difference between SPF 30 and SPF 100 sunscreen.
Although the baseline protection from SPF 30 and SPF 100 is not vastly different, the higher number provides longer coverage. (SPF stands for sun protection factor, or the amount of ultraviolet radiation the skin can absorb without burning while the sunscreen is on.)
If it normally takes you 10 minutes in the sun to burn, an SPF 30 sunscreen protects you for 300 minutes. An SPF 100 should, in theory, provide 1,000 minutes of coverage. If you are sweating and active, the sunscreen can rub off and should therefore be reapplied every two hours. When you are using a high SPF, there is a smaller likelihood of having a “missed spot.” A good way to know that you are applying enough sunscreen is to use the measurement of a shot glass of sunscreen for exposed sites.
Myth 3: If it is a cloudy day, I do not need to wear sunscreen.
About 80 percent of ultraviolet radiation reaches the earth even through clouds. Use a moisturizer with sunscreen daily, especially for areas that have high exposure, such as your face.
Myth 4: If I am low in vitamin D levels, I must get some sun exposure.
Although the skin is the most efficient site of vitamin D production, adequate amounts can be obtained from your diet and from supplements. Vitamin D helps you absorb calcium and build strong bones, so we frequently recommend supplements that include vitamin D and calcium.
Myth 5: If I have dark skin, I can’t burn and won’t get melanoma.
Even people with dark skin can burn if they’re exposed to the sun long enough. Although melanoma is much more rare in individuals of darker skin, it can occur. We recommend that darker-skinned individuals inspect their hands and feet once a month.
Learn more about skin cancer and melanoma from Dana-Farber Cancer Institute.
hi jennifer, i was just diagnosed this week with a mucosal melanoma of the cervix. there are only 70 known cases worldwide. basically there aren’t any typical treatments for this kind of cancer. what oncologist do you recommend i see at the hospital?
thanks
laura
Sorry to learn of your diagnosis, Laura. Your best bet is to seek an appointment with any of our gynecological cancer experts. You can do this online:
http://www.dana-farber.org/Adult-Care/Treatment-and-Support/Treatment-Centers-and-Clinical-Services/Gynecological-Cancer-Treatment-Center.aspx
Best wishes to you.
Hi Dr. Lin,
My wife is 38 and has been diagnosed with melanoma in situ by her dermatologist. She has had a few abnormal moles removed in the past but never melanoma. Would you recommend a second opinion by an oncologist?
Jack M.
I have have just been diagnosed with melanoma had MOH’s surgery and and the first stage if a forehead flap to the nose. I am blessed that it was in situ, my next surgery is 8/21 and I will be booking an appointment at the clinic. What can I expect from here ?
There’s a lot we still don’t know about melanoma. When I was diagnosed at 23, it seemed like I was told something different by every single dr I went to. I wouldn’t consider my sun exposure ”excessive” considering I’ve never had a job that required me to be in the sun for long periods of time and I live in a region with short summers. In fact, I’ve had to take vitamin D supplements since elementary school. The effected mole was a large irregular birth mark on my back. It was removed and tested when I was in high school and the results came back normal, so when it partially grew back, the dr said she probably just didn’t go ”deep enough” and not to worry about it, so I didn’t. Basically what I was left with was a large birthmark with a piece missing out the middle and a false sense of security.. When dr’s would ask me about it, they would ask me questions like how long I’d had it and if I ever used a tanning bed and determine that it was probably benign and not test it, considering I’d never used a tanning bed and especially considering it had came back benign in the past. My first time ever using a tanning bed was the spring I was diagnosed. Using the tanning bed was probably the only reason it was tested it to begin with. Later my dr said it would have had to have been melanoma already, considering the staging (T1B). Given my age and the fact that the tumor was on my torso and not more sun exposed areas of my body like my arms or my legs, my dr said I could carry a gene for melanoma. It wasn’t until after my diagnosis I found out my great grandfather died of state 4 metastatic melanoma and I have an aunt who had melanoma. My parents never enforced the sunscreen rule.. I didn’t burn easily and it wasn’t well understood back then that cancer ran in families, and, like any kid, I spent a lot of time outside in the sun. Luckily my margins and my lymph nodes came back clear and I’m not taking any chances with my daughter that was born in Feb. I cant control genetics, but now that I know she’s high risk, I can catch it early enough. Take it from me, know your family history. It’s not just an environmental cancer, like many people think. If your not sure, get it removed.
The article says: ”A good way to know that you are applying enough sunscreen is to use the measurement of a shot glass of sunscreen for exposed sites.” How do you define 1 exposed site? Do you mean face as 1 exposed site. 1 arm or 1 leg as another? Please clarify because if clearer could be very useful advice. Thanks.
Can you recommend protective clothing, what to get, where to buy it, etc.
Also, is protective clothing better than sunscreen?
Thank you.
My daughter was diagnosed with melanoma at 21. She had a sentinel node biopsy and was told it was gone. For two years it spread through her blood stream. She was 23. She started feeling ill, had horrible back and leg pain and was dropping weight. They kept saying she had a virus. She then started getting subcutaneous nodules. Finally they biopsies one and it was melanoma. By that time it was everywhere. She lived 11 months.Last year I was diagnosed with melanoma. They did wide excision and said I was good. I am fair, was strawberry blonde, freckled, had tons of blistering sunburns, tanned in tanning beds for years. I have also had 2 basil cell and 4 squamous. Should I worry that the same thing will happen to me?
Dear Evelyn —
We are so sorry to hear about the loss of your daughter. Sending you and your family our deepest condolences.
Unfortunately, we cannot give out any medical advice on this blog or over email. However, it is important to keep an open conversation with your physician and care team about you and your daughter’s history. It is best to bring up these concerns with your doctor to talk about ways to monitor your risks and prevent further health problems.
Wishing you all the best.
For sun protective clothing, there are many brands offering hats, shirts, pants, etc. with a rating. Google the topic. llbean.com, sunprecautions.com and coolibar.com are examples. (The last two are not inexpensive.) I had a melanoma removed from my cheek at Brigham & Womens 10 years ago March 17, and have had no recurrence. Rit (the dye maker) has a product which you can use to apply a SPF factor to your existing clothing; I do not know if it is really effective. When I am mowing my lawn, doing yard work, veg. gardening, etc., I wear this straw hat with oversized 4 inch brim all around it http://www.coolibar.com/product/Men/Sun-Hats/Straw/Straw-Beach-Hat/pc/2146/c/2203/sc/2225/155466.uts — it is a bargain. I have not found a men’s hat with a wider brim.
What do you know about whether their is any effect in treating melanoma with polio vaccine?
Dear Margaret —
Thank you for your comment and for reading Insight. At this time, we are not looking at the polio vaccine. If you would like more information on clinical trials for melanoma, visit the National Cancer Institute’s clinical trial page. Wishing you the best.