GET IT BEFORE IT GETS YOU: BEATING MELANOMA
In the life cycle of a melanoma there is a dreaded moment that no doctor can predict. It is the moment when the first malignant cell detaches itself from the melanoma and quietly slips into the bloodstream.
Once in the blood, it can travel to distant parts of the body. Other cells follow, and their combined potential for destruction is considerable.
If a melanoma is detected and removed before this crucial moment occurs, a man’s chance of survival is 100 per cent. This is why early detection is crucial.
In Australia, men fare far worse in a battle with melanoma than women. Although the incidence is almost equal – 3695 men and 3081 women were diagnosed with melanomas in 1994 -there is a vast difference in the death rate. In that year, 609 men died, compared to 288 women. If all factors are matched and a man and woman of the same age have identical melanomas in the same place, the woman’s chance of survival is far greater than the man’s. Men also have double the chance of developing a second primary melanoma.
For these reasons men should be highly vigilant about their skin. Unfortunately, in reality they pay less attention to it than women do. In fact, it is often women who first discover men’s melanomas.
Boston University’s School of Medicine conducted a survey to determine who ‘discovers’ melanomas and found that women are more likely than men to identify not only their own (66 per cent versus 42 per cent) but also their spouses’ (23 per cent versus 2 per cent).
Men tend to get melanomas on their back, head or neck. Women often get them on their legs, which might partly explain why they detect them sooner.
Even if their melanoma is in an obvious and visible position, men often fail to notice it because they expect that if they get a melanoma it will arise from a pre-existing mole and will be raised and ugly.
But 70 per cent of melanomas arise on normal skin and in the early stages are flat and look no different from a freckle. They do not itch, bleed or do anything to attract attention.
The depth of a melanoma usually determines a man’s likelihood of survival. If it is thinner than a credit card (less than 0.75 mm) his chance of survival is 100 per cent. If it is thicker than a 50 cent coin (3 mm) his chance drops to about 59 per cent. If it grows just a little more, to a thickness beyond 4 mm, his chance is less than 30 per cent and death occurs quickly, usually within 3 years.
Although Australia has the highest rate of malignant melanoma in the world, its survival rates are generally higher than those of other countries because of the high proportions of thin lesions.
About 15 years ago the incidence of melanoma was a touch higher among women but now it’s higher among men. After the age of 45, the incidence among women flattens out, but among men it continues to rise. This is probably due to their different habits of sun exposure. As women enter childbearing years they reduce sun exposure and protect themselves more. Men continue with their outdoor recreational activities. Intermittent exposure, such as on weekends and summer holidays, is more risky than continuous exposure. Men who work outdoors develop a tan and thickened skin, which gives them some protection against the sun.
The steady rise in melanoma deaths that was witnessed in Australia last century has been reversed. Figures show the number of Australians dying from melanoma peaked more than a decade ago. But while there is a distinct drop in the death rate among women, there is only a flattening in the death rate among men. The drop is attributed to greater awareness and increased early detection. It is anticipated that the death rate among men will drop in the next decade.
In the meantime, however, continue to examine yourself for odd spots (usually between 5 and 10 mm in diameter – the size of a shirt button) and don’t forget to check out-of-the-way places like the soles of your feet and between your toes.
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