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defendernetwork.com
JULY 21 | 2016 | DEFENDER
1B
Defender Special Edition
The truth about Blacks & skin cancer By MARILYN MARSHALL Defender
A
t first glance, it would seem that African-Americans have little to worry about when it comes to skin cancer. The risk of contracting melanoma – the most serious type of skin cancer – is much higher for whites than African-Americans. There is, however, cause for concern. In order to shed light on the subject, the Defender spoke with Valencia Thomas, M.D., a dermatologist and associate professor in the Department of Dermatology at MD Anderson Cancer Center, and a dermatopathologist at
the UT Houston School of Medicine. Defender: What is the number one thing AfricanAmericans should know about skin cancer? Dr. Thomas: That African-Americans can get skin cancer. [Though] our pigment gives us a natural sun protection factor or SPF of about 13.4, compared to the average white person who has a natural SPF of about three, we are not immune. About two percent of cancers that African-Americans get come from the skin. So we still need to recognize what is abnormal in our skin and what is normal. Defender: What are the most common skin cancers? Dr. Thomas: We have two major categories of skin cancer – melanoma and non-melanoma. Even though melanomas are fairly rare in the African-American population, we have a tendency to be diagnosed at a more advanced stage. Melanoma is the type of skin cancer that killed Bob Marley. He discovered a tumor on his foot – and African-Americans tend to get these lesions on their soles – but by the time it was diagnosed it was more advanced. It is often diagnosed at a later stage in African-Americans which means we have a poorer outcome so we have a higher chance of dying from the cancer. On the flip side, the other large category of cancers is the non-melanoma skin cancers. This year alone we’re going to have a million cases of people who have skin cancers in the United States. African-Americans are going to see squamous cell carcinoma more commonly. The squamous cell carcinomas tend to be a bump of skin that’s fairly hard and they have a clear border and firm top. It’s almost like you’re growing a wart but can grow
much more rapidly. There is a form of this which is often seen in African-Americans called squamous cell carcinoma insitu. It is a very early form of squamous cell carcinoma and tends to arise in the settings of chronic scarring, burn scars, radiation and chronic inflammation, like lupus. It can also be seen in people who have hepatitis B, HIV or organ transplants. We tend to grow these most commonly in our fifties and sixties. It will show up as a scaly patch that doesn’t go away and has a little bit of pigment. Defender: What is the treatment for skin cancer? Dr. Thomas: The treatment depends on the type of cancer. For melanomas the treatment is fairly consistently excision where we remove the abnormal tissue. Once we determine how deep the tumor is, if it’s thin, sometimes the excision is all we need. If it’s thicker we can use other therapies like chemotherapy or radiation. With non-melanoma skin cancers we have a lot more options because in general they’re easier to kill. We can sometimes use special chemotherapy creams that alter the immune system and selectively destroy the abnormal cells. You can sometimes destroy them through freezing them or scraping them or burning them off. We can use a laser to destroy them, and we can excise them. If they tend to be more evasive or aggressive, additional surgery is necessary and we will have chemotherapy or radiation available. Concerning prevention, in melanomas, we have not been able to figure out the relationship between sun exposure and melanomas and people of color. In the white population we have been able to associate melanomas with episodic, intense sun. Until we know otherwise it is important to use sunscreen of SPF 30 or greater, wear protective clothing such as long sleeves and hats, avoid being outdoors during the peak hours of the sun and seek shade whenever possible.
“Melanoma is often diagnosed at a later stage in AfricanAmericans, which means we have a poorer outcome so we have a higher chance of dying from the cancer” defendernetwork.com • Serving the Houston area for over 85 years