Sidney Brown thought the mole on his nose was just an annoying pimple. He didn’t consider that it could be a cancerous tumor, because, Brown thought, “skin cancer is something white people get.”
The misconception that people with more pigment – called melanin – in their skin cells are protected from cancer-causing ultra-violet rays nearly cost Brown his life.
Brown’s mole turned out to be a melanoma, the least common form of skin cancer, but also the deadliest.
While most people associate skin cancer with sun exposure, melanomas are more likely to be caused by genetics than the sun’s ultraviolet radiation, and far more likely to develop on sun-protected areas of the body in blacks, Hispanics and Asians.
May is Melanoma/Skin Cancer Detection and Prevention Month, the occasion for numerous messages about the importance of limiting time in the sun and using sunscreen.
While those protective actions are important, they can mislead people into making the same dangerous mistake Brown made.
‘Anyone – regardless of skin color – may develop melanoma’
Brown, who is black and a father of two, wasn’t worried about the mole on his nose until it began to change. “It started out flat. I didn’t really pay much attention to it, because I had an oily face and pimples on my nose anyway,” he says.
“So, when I saw the black mark, I didn’t think much about it. But then it kept irritating me, itching. Then it grew into a lump.”
His primary care doctor referred him to Rhodes, who quickly diagnosed the mole as cancerous.
“He explained that once a mole starts growing up, it is also spreading cancer cells down through the body. That can be too late for many, but catching mine in time saved my life.” Brown recalls.
A 2016 American Academy of Dermatology study, “Racial Disparities in Melanoma Survival,” showed that while melanoma incidence is higher in whites, death rates are relatively higher among people of color.
“But anyone – regardless of skin color – may develop melanoma, in both sun-exposed and sun-protected sites. Not noticing or ignoring a new or changing mole in a sun-protected site can be fatal.”
Early diagnosis key to survival
Melanomas develop from skin cells called melanocytes, which reside in the superficial layer of the skin called the epidermis.
Melanocytes in the epidermis produce pigment (melanin) that gives the skin its color and protects skin cells from the damaging effects of the sun’s ultraviolet radiation.
Abnormal varieties of melanocytes cause common skin growths known as moles. Most moles are harmless, but unique varieties of atypical moles may develop into melanoma.
While less common than other types of skin cancer, melanomas are deadlier, because the malignant cells can spread even though the tumor is relatively small and not bleeding or causing pain or itching.
This capacity to metastasize underlies the importance of early detection, especially among people of color.
Rhodes stresses the need for monthly self-examination and examination in difficult-to–see areas on the body in family members, seeking the presence of a new mole, or a change in a pre-existing mole – a change in size, shape or color.
Some of the most aggressive forms of melanoma may occur on areas that receive little or no direct sunlight.
Melanoma is reason for sole searching
A delayed diagnosis is common for melanomas in these difficult-to-self-examine sites. “Early diagnosis results in a cure, while delayed diagnosis may be deadly,” Rhodes warns.
“Half of all melanomas in non-whites occur on the palms of the hands, soles of the feet, nailbeds, mucous membranes, perianal area, genitalia, and other areas that are not exposed to the sun, areas that are difficult-to-self-examine and commonly ignored.”
Melanoma in a relatively hidden site will tend to thicken without symptoms or signs, leading to a delayed diagnosis that may result in a higher melanoma death rate, especially for people of color, including blacks, Hispanics, and Asians.
Since Rhodes removed his cancerous melanoma ten years ago, Brown has been counseling friends and family to pay closer attention to their skin. “Dark-skinned people think it’s nothing,” Brown says.
“A lot of times we get moles, and we don’t think anything about it. Don’t accept that it can’t be something; go see what it is. Don’t say ‘Eh, (melanoma is) something that white people get.'”