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For Everyone Touched By Cancer
Melanoma is a type of skin cancer that can spread rapidly. It is important for people to be able to identify melanoma and understand who it can affect. Many myths and rumours about who it can and cannot affect. However, melanoma is not to be misunderstood. As with many cancers, people must understand that it can affect anyone. In this article, we’ll be looking at who melanoma is most and least likely to affect, based on UK-based statistics.
To put it simply, melanoma can affect anyone. Being the 5th most common cancer overall in the UK, melanoma is not specific to a certain skin type, age or sex. There are however factors which increase/decrease someone’s likelihood of developing melanoma. Although it is a common cancer, this does not mean that it is well-known or fully understood. This is important for people to know, so that they may take the correct precautions, while also not being overwhelmed by the chances of developing melanoma; especially as there are many things we can do to help people understand what increases the likelihood of developing melanoma, and what preventative methods can be used.
A common misunderstanding is that only older people can get melanoma. This is not accurate. This myth may have stemmed from the statistic that around 30% of people diagnosed with melanoma are aged 75 years or over. However, compared to other cancer types, melanoma is also relatively common in younger people. Older patients with melanoma are also more likely to die from it than younger patients. Experiencing more recurrences after treatment, their tumours are more likely to spread or metastasize around the body. We can understand that the older our bodies get, the slower they are at healing, and fighting off all the bad. It makes sense then that the older generations who develop melanoma tend to suffer from it more than the younger patients.
But why do the older generations typically develop melanoma more often in the first place? Well, we have to consider that melanoma is a skin cancer. This may seem obvious, but as we get older, our skin stiffens and loses elasticity. Consider wrinkles for example. Wrinkles form when the skin becomes less elastic, and is unable to return to its original smooth surface. It is this weakening in the skin that results in the skin’s increased susceptibility to skin-related issues.
Lymph nodes also play a big part. Lymph nodes contain immune cells that can help fight infection by attacking germs that may be carried through the lymph fluid. Melanoma and many other cancer types tend to spread first into lymph nodes before entering the blood and spreading to other parts of the body. When it comes to melanoma, cancer cells can break away from the original tumour, and enter the nearest lymph vessels to form a new tumour somewhere else in the body. As lymph nodes must filter foreign substances, they work as part of the immune system. The older we get, we know that our immune systems don’t work as well as they used to. A part of this means that the immune system becomes less effective at recognising and attacking cancer cells. Melanoma cells are then more likely to survive in the system and spread more easily. Ageing also affects the structure and function of the lymphatic system. Meaning, it potentially alters the way cancer cells travel and settle in lymph nodes. All in all, as we get older, our bodies have weaker systems to fight the cancer from both developing, travelling, and spreading.
Another myth is that only pale skin develops melanoma. Again, melanoma can affect anyone. Although rare, people with black or brown skin in the UK can and do get melanoma. Typically, people with natural red hair, white skin and/or a lot of freckles are more likely to develop melanoma. With more moles and/or freckles, there is a higher risk of melanoma. It is important to check moles that look strange, appear large, or change. Moles are not the same as birthmarks. However, a very rare type called a giant congenital melanocytic naevus, can develop into melanoma if it's larger than 20cm.
White skin is also more likely to be affected by melanoma as it lacks the pigment that protects the body from ultraviolet light (UV). Over time, skin without such pigmentation, and repeated exposure to UV, enough DNA damage can cause cells to grow out of control, possibly leading to cancer. Repeated experiences of sunburn also increase the likelihood of developing melanoma, as the exposure to UV is very high.
However, it is not only fair skin that’s affected. As we have established, melanoma can affect anyone. Acral Lentiginous Melanoma (ALM) is more commonly found in darker-skinned people. Melanoma is often thought to only be discovered in areas exposed to UV light. This isn’t true and can be discovered later than other types after they have invaded deeper layers of skin or metastasized. This is why it's important for everyone to know who it can affect so that everyone can look out for the symptoms, without having any misconceptions. ALM specifically often develops in the hands and feet, or even under the nails. So it's important to keep an eye out.
Excessive sun exposure is the first element that increases the risk of melanoma. In the UK, around 85 out of 100 melanomas (around 85%) are caused by too much UV light. Even in the wonderful weather we get in the UK, you can see that the risk is there.
Having such generally grey weather in the UK means that people very often go on holiday to sunnier parts of the world. As getting a sun tan has become so culturally significant, people have been going on holiday to somewhere hot and sunny, and getting a short break in the hot, direct sunshine. The issue with this is that people are then only getting intermittent sun exposure. Those who work outdoors are in constant exposure to the sun and UV, even if the weather isn’t particularly sunny. Having intermittent exposure also might mean that people don’t look after their skin properly. Protecting your skin from UV isn’t just a cosmetic fad. Protecting your skin from UV rays is very important to protect yourself from melanoma, but also from other issues that might be a step towards it. Sunburn isn’t just painful and itchy, but people who have had sunburn are more likely to get melanoma. The more sunburn, the higher the risk for all ages. It is very important that we never ignore the FPS, no matter the circumstances.
Sunbeds have a similar story. Research has been done that suggests that the type of UV light used in sunbeds can cause melanoma and non-melanoma skin cancer. The International Agency for Research into Cancer (IARC) has identified sunbed use as a cause of melanoma. The highest risk is for people who use sunbeds before the age of 35. Some countries (like the UK) ban sunbed use for anyone under 18.
Unfortunately, if your family has had melanoma, then your risk may be slightly higher. If your family member who experienced it was a close family member, the risk is to be kept in mind when considering how you protect your skin and the importance of the lifestyle factors I discussed earlier. The risk is higher if more than one first-degree relative has had melanoma, or if your relative had it when they were younger than 30. About 10% of melanoma can be linked to inherited gene change. Increased risk can be associated with a number of genes. One of these is a gene called CDKN2A, known to cause an inherited condition called familial atypical multiple mole melanoma syndromes (FAMMM). FAMMM is usually characterised by more than 50 melanocytic nevi (moles) and a family history of melanoma.
There are other elements that are related to melanoma too. One of which is Inflammatory bowel disease (IBD). This illness includes Crohn’s disease and ulcerative colitis. Ioannis Economou, MD, associate director of the Columbia University IBD Center in New York, says that there is some evidence of melanomas developing in areas of the body that have been repeatedly sunburned. Some believe that this may be the result of a faulty immune system that doesn’t detect cancerous tumours, or that the sunburn has caused inflammation in the skin, which can make the body more susceptible to sun exposure. Others suggest that people with IBD typically visit doctors and healthcare facilities more often than the average person. So, there is a higher likelihood of them having cancer detected by a healthcare professional. Although having IBD does not mean that you will get melanoma or another type of skin cancer, it just means that like everyone, you should take care of yourself to the best of your ability, including your skin.
Another element that might increase your risk of melanoma is a weakened immune system. Immune systems are our body's guardians against the baddies that try to enter or develop in our bodies. Simply, it can tell the difference between healthy and abnormal cells, and anything else that could threaten our bodies. While doing this, it also makes sure that our cells aren’t presenting proteins that are suspicious for cancer. When the immune system does find these abnormalities in our system, it attacks them and destroys them, before they’re able to develop into anything further. We can understand then, that if we have any issues with our immune systems, some of these suspicious proteins can go undetected and carry on developing into cancer.
Scientists have found that people who are on immunosuppressant medications for an organ transplant are much more likely to develop basal and squamous cell cancers. In some studies, the risk is 20 to 60 times greater than in the general population.
Illnesses associated with both a weakened immune system and a risk of melanoma, are HIV and AIDS infection. Although more studies are being carried out as to the intricacies and connections between these illnesses and melanoma. Taking medicines that weaken your immune system (immunosuppressants) after an organ transplant also increases this risk.
All in all, it is important to understand that no one is invincible, so how can we protect ourselves? Take a look at our guide on melanoma prevention, while also considering your risk level. It is also important to remember that if you tick every box for being high risk, this doesn’t mean that you are guaranteed to develop melanoma, just to be aware and protect yourself in any way you can, to ensure your own safety.
Ella is a University student who is currently finishing her second year at the University of Exeter. Studying English Literature and Creative Writing, Ella is a passionate writer. Originally from South Wales, Ella is currently following her passions for writing in Exeter, in and outside of her studies. Her main goal with her writing is to expand her skills and knowledge, while helping people, especially when it comes to knowing the truth about health. She believes that the information online can be overwhelming, and wants to help reduce it to an easily consumable level. These motivations are what makes Ella so passionate in being a volunteer for the Cancer Care Parcel.
