Melanoma: More Colorblind Than You’d Think

Before sitting down to write this article, I had never worn sunscreen, because I almost never burn.

I had always vaguely seen myself as some sort of melanin superwoman, impervious to UV rays, cancer etc. Skin cancer, I thought, was reserved for towering Swiss women who spent too much time luging, not for short Asians who liked to read.  Wrong: turns out skin cancer, melanoma in particular, is more colorblind than you’d think.

To be fair, my skin-arrogance was somewhat founded. Skin cancer is less common in people of color, comprising only two to four percent of all cancers in Chinese and Japanese Asians, according to The Skin Cancer Foundation. In African Americans, skin cancer represents one to two percent of malignancies.

But here’s the rub: when people of color do develop melanoma, it is more likely to be fatal, as in the case of Bob Marley, who developed an aggressive form of melanoma under his toenail, and died at the age of 36. “Many people are under the impression that non-Caucasian people are immune to skin cancer,” says dermatologist Mona A. Gohara MD, spokesperson for The Skin Cancer Foundation. This misperception can have fatal consequences, especially in regards to melanoma—if caught early, melanoma has a survival rate of around 90%, according to The American Cancer Society. If caught late, survival rates plummet to 40%. What this means, of course, is that an early diagnosis is a matter of life and death.

The Problem

“I really thought that being of color protected me from skin cancer,” says artist and designer Pablo Solomon of Austin, TX. Of Arab descent, Mr. Solomon waited until he was 60 to see a dermatologist for a baseline exam. “The doctor walked into the examining room and the first thing he said was ‘You have a cancer on your forehead, we have to take it off today.’”

Luckily, the skin cancer the doctor removed from Mr. Solomon’s forehead was not melanoma. But attitudes like Mr. Solomon’s and mine have led people of color to premature deaths. A sense of immunity can lead to late diagnoses, which many dermatologists blame for the discrepancy in survival rates between whites and non-whites. Cheryl Burgess, MD, member of the American Society for Dermatological Surgery, explains how late diagnosis can lead to a lower survival rate among minorities, African Americans especially: “When cancer is detected among African Americans, it has often advanced to its most life-threatening stages. In fact, the overall melanoma survival rate for African Americans is only 77%, compared to 91% for Caucasians.”

The misperception that people of color are immune to skin cancer is not specific to patients, according to Debra Jaliman, MD, a dermatologist in New York City: “Many doctors don’t do thorough skin cancer screenings on people of color… generally, patients don’t know how to ask for it and doctors aren’t screening them.” She says the American Academy of Dermatology is aware of this problem and has emphasized the importance of screening patients thoroughly. Other organizations like the National Cancer Institute, the American Society for Dermatologic Surgery and the Skin Cancer Foundation are also taking steps to address the problem.

What You Can Do

Buy a bottle of SPF, cover yourself, and avoid tanning and long exposure to the sun. And, like Mr. Solomon, realize that “being a shade darker does not prevent skin cancer…yes, it reduces the odds, but do not have a false sense of security and do not tempt fate.”

For more information on skin cancer and health, visit the American Society for Dermatologic Surgery or The Skin Cancer Foundation. To learn how to identify dangerous moles, read our blog on the subject.

To locate a dermatologist near you, download iTriage for free or visit www.itriageheatlh.com.

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