Almost 43 years ago, the world lost a legend when reggae artist Bob Marley died after a four-year struggle with melanoma skin cancer that started on his toe.
This may seem unusual, as melanoma is usually linked to patients with fair skin and constant exposure to UV radiation from the sun. But the "No Woman, No Cry" singer was diagnosed with a rare but fast-growing type of skin cancer known as acral melanoma, which isn’t strongly correlated to UV exposure.
What is melanoma?
The American Cancer Society describes melanoma as a type of skin cancer that develops when melanocytes (the cells that give the skin its tan or brown color) start to grow out of control.
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can then spread to other areas of the body.
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Melanoma is much less common than some other types of skin cancers. But melanoma is more dangerous because it’s much more likely to spread to other parts of the body if not caught and treated early.
How does the cancer start?
Per the American Cancer Society, most skin cancers start in the top layer of skin, called the epidermis. There are 3 main types of cells in this layer:
- Squamous cells: These are flat cells in the upper (outer) part of the epidermis, which are constantly shed as new ones form.
- Basal cells: These cells are in the lower part of the epidermis, called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skin’s surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells.
- Melanocytes: These are the cells that can become melanoma. They normally make a brown pigment called melanin, which gives the skin its tan or brown color. Melanin protects the deeper layers of the skin from some of the harmful effects of the sun.
- The epidermis is separated from the deeper layers of skin by the basement membrane. When skin cancer becomes more advanced, it generally grows through this barrier and into the deeper layers.
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What are the risk factors?
UV Rays
Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. Sunlight is the main source of UV rays. Tanning beds and sun lamps are also sources of UV rays.
UV rays damage the DNA (genes) inside skin cells. Skin cancers can begin when this damage affects the DNA of genes that control skin cell growth.
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Moles
A mole (also known as a nevus) is a benign (non-cancerous) pigmented tumor, and they usually appear as we develop through and are not born with them.
Atypical moles (dysplastic nevi): These moles look a little like normal moles but also have some features of melanoma. They are often larger than other moles and have an abnormal shape or color. They can appear on skin that is exposed to the sun as well as skin that is usually covered, such as on the buttocks or scalp.
Family history of skin cancer
Genetics definitely plays a role in your susceptibility to skin cancer.
Your risk of melanoma is higher if one or more of your first-degree relatives (parents, brothers, sisters, or children) has had melanoma. Around 10% of all people with melanoma have a family history of the disease.
The increased risk might be because of a shared family lifestyle of frequent sun exposure, a family tendency to have fair skin, certain gene changes (mutations) that run in a family, or a combination of these factors.
Age
Melanoma is more likely to occur in older people, but it is also found in younger people. In fact, melanoma is one of the most common cancers in people younger than 30 (especially younger women). Melanoma that runs in families may occur at a younger age.
Gender
In the United States, men have a higher rate of melanoma than women, although this varies by age. Before age 50, the risk is higher for women; after age 50 the risk is higher for men.
RELATED: Is It Just A Mole Or Cancer? Here’s How to Tell…
What are the preventative measures?
- Have regular skin exams by a dermatologist
- Thoroughly examine their own skin once a month
- Be particularly careful about sun protection and avoiding manmade UV rays (such as those from tanning beds)
How is it treated?
Per the Mayo Clinic, here are some treatments for skin cancer.
Freezing. Your doctor may destroy actinic keratoses and some small, early skin cancers by freezing them with liquid nitrogen (cryosurgery). The dead tissue sloughs off when it thaws.
Excisional surgery. This type of treatment may be appropriate for any type of skin cancer. Your doctor cuts out (excises) the cancerous tissue and a surrounding margin of healthy skin. A wide excision — removing extra normal skin around the tumor — may be recommended in some cases.
Mohs surgery. This procedure is for larger, recurring or difficult-to-treat skin cancers, which may include both basal and squamous cell carcinomas. It's often used in areas where it's necessary to conserve as much skin as possible, such as on the nose.
During Mohs surgery, your doctor removes the skin growth layer by layer, examining each layer under the microscope, until no abnormal cells remain. This procedure allows cancerous cells to be removed without taking an excessive amount of surrounding healthy skin.
Curettage and electrodesiccation or cryotherapy. After removing most of a growth, your doctor scrapes away layers of cancer cells using a device with a circular blade (curet). An electric needle destroys any remaining cancer cells. In a variation of this procedure, liquid nitrogen can be used to freeze the base and edges of the treated area.
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These simple, quick procedures may be used to treat basal cell cancers or thin squamous cell cancers.
Radiation therapy. Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy may be an option when cancer can't be completely removed during surgery.
Chemotherapy. In chemotherapy, drugs are used to kill cancer cells. For cancers limited to the top layer of skin, creams or lotions containing anti-cancer agents may be applied directly to the skin. Systemic chemotherapy can be used to treat skin cancers that have spread to other parts of the body.
Photodynamic therapy. This treatment destroys skin cancer cells with a combination of laser light and drugs that makes cancer cells sensitive to light.
Biological therapy. Biological therapy uses your body's immune system to kill cancer cells.
BDO’s Black History of Health series is designed to show the correlation between the health of historical Black figures and Black Americans today. Many of the health disparities we currently experience have been in our community for centuries. This series is meant to bring these conditions to the forefront and provide blacks with preventative and management steps to reduce these disparities and improve the overall health of the Black American community. It’s time to change the narrative.
