By Mylika Scatliffe,
AFRO Women’s Health Writer
February is National Cancer Prevention month. Dr. Ashani Weeraratna is a leading, pioneering Johns Hopkins melanoma researcher and wants everyone to know that melanoma does not discriminate. People of color have traditionally been conditioned to think skin cancer is a White person’s disease, so largely goes ignored in communities of people with darker skin, including African-Americans, and people of Asian descent. By the time February rolls around people living in colder climates have been dealing with winter weather and conditions for at least a couple of months, sometimes more depending on what part of the country, and many people have just about had enough. They are ready to take a break from the snow, ice, and subzero temperatures. They’re craving beaches, palm trees and warm sunshine, and maybe completely unaware they might be giving themselves a higher predisposition to developing skin cancer. “People might go overboard in the sun after being indoors for so long. Just one blistering sunburn can significantly increase your chances of developing melanoma,” Weeraratna said.
Cutaneous melanoma is induced by too much exposure to ultraviolet rays from the sun and indoor artificial tanning. This type of melanoma is easily treated when caught early. Amelanotic melanoma is an aggressive type of skin cancer that has no pigment, so they don’t look like other melanomas. Instead of being dark, they appear skin-colored, pink or reddish, and with gray or brownish edges. Acral melanoma is the most common type of melanoma among people with darker skin. Unlike cutaneous melanoma, it is not believed to be associated with exposure to ultraviolet rays. Melanoma impacts people of color in unique ways. “People of color don’t get diagnosed as often as Caucasians because the lesions aren’t as obvious,” according to Weeraratna. She is especially motivated to encourage people of color to regularly perform self-exams, particularly of the soles of the feet, palms, and finger and toenail beds because acral melanoma tends to present on these areas. The misconception that skin cancer is only caused by sun exposure and that only fair-skinned people get it leads to acral melanoma going ignored by people of color, and not being diagnosed until later stages. Bob Marley, the legendary Jamaican musician had acral melanoma. He missed the early warning signs of the disease when a dark spot appeared under his toenail. He figured it to be the result of a soccer injury and didn’t believe it to be serious. Had it been detected early, it’s possible it could have been cured but it metastasized ultimately taking his life at age 36. Weeraratna explained that particular attention should be paid if a stripe or spot beneath is embedded in the flesh beneath the nail bed, causing the nail to be raised.
Melanoma affects different populations in unique ways. African-Americans and Hispanics, largely ignore signs or put off going to the doctor because they have been conditioned to think of skin cancer as a disease for White people. On the other hand, Asians culturally are very sensitive and attuned to pigmentation and surveillance of changes in the skin. Getting older is a major prognostic factor for skin cancer because it becomes more aggressive and harder to treat as we age. The younger population engages in riskier behavior such as spending time in the sun unprotected and using indoor tanning beds. Men have a higher incidence of melanoma which accelerates as they get older, are less likely to go to the doctor and may have jobs that put them at higher risk such as construction, where a lot of time may be spent outdoors. Prior to Covid, Weeraratna would go to high schools to speak frankly to students about the dangers of frequenting tanning salons prior to prom and vacations. “In that regard, we are really behind in this country. The use of tanning beds is completely outlawed in Australia, but we’re still using them here,” Weeraratna said.
In her new book, Is Cancer Inevitable? Weeraratna discusses the amazing advances made over the years in melanoma research. “Cancer is such an ugly word. When people hear cancer, their world just collapses around their ears,” Weeraratna said. In her book, she takes you into her lab and discusses how cancer might be inevitable, but because of the advances and therapies we’ve made, patient outcomes are dramatically improved. Today, people are still alive after 10 or 15 years with melanoma when even just 10 years ago they might have only lived 10 or 15 weeks. “My hope is to make a disease (that is often a death sentence) something we can manage, like diabetes,” Weeraratna said.
Is Cancer Inevitable? Is Weeraratna’s inspiring and deeply personal story and can be purchased at Amazon.com.
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