African-Americans are constantly warned about cancers that disproportionately affect them.
Breast cancer, colon cancer, and prostate cancer all top the list of diseases African-Americans are told to be on the look out for and to take aggressive measures to prevent. But skin cancer -- usually associated with people with fair skin -- is not on that list and many blacks believe they are automatically protected against it.
Think again.
Individuals with dark skin are not immune from sun-inducing skin cancer, said, Dr. Frank Barone, a Toledo area plastic surgeon who also performs medical skin care.
"It's true that darker pigment protects skin from harmful rays, to some extent," Dr. Barone said. "Sun is still the primary cause of skin cancer in African-Americans."
Skin cancer in blacks isn't nearly as common as it is in other ethnic groups. It comprises just 1 percent to 2 percent of all cancers among blacks. But the fatality rate for African-Americans with melanoma, the most dangerous type of skin cancer, is almost double that of Caucasians, Dr. Barone said.
The Centers for Disease Control and Prevention reports the survival rate for African-Americans with melanoma is 77 percent, compared to 91 percent for Caucasians.
Protection
Sunscreen is the first layer of defense against sun-inducing cancers. Experts recommend using a broad spectrum sunscreen with SPF 15 or higher.
The summer is not the only time you are at risk for damage from the sun. Apply sunscreen year-round, even on cloudy days and reapply throughout the day on sunny days. Don't forget your head, neck and ears.
Avoid intense sun exposure between the hours of 10 a.m. and 3 p.m. when the sun's rays are most harmful.
Source: Drs. Frank Barone and Adnan Amkhalil.
What to look for
Melanoma usually starts as a mole that changes colors, has an uneven border, irregular shape or is raised.
Basal cell carcinoma/skin cancer begins as a light pink or red raised lesion on the skin's surface. It may have a crusty layer, bleeds and won't heal. The cancer could appear in the form of a sore with a depressed or sunken center.
Squamous cell skin cancer usually occurs on the face, ears, neck, hands, or arms. It may occur in other areas. The main symptom is a growing bump that may have a rough, scaly surface and flat reddish patches.
Source: U.S. National Library of Medicine National Institutes of Health
"Melanoma is not picked up as early in African-Americans," Dr. Barone said. "Once it's diagnosed, it's usually in the later stages and more likely to be fatal."
In 2006, the CDC reported that of the more than 53,000 people diagnosed with skin cancer, only 311 were black. Of those 311 blacks, 126 died from melanomas.
In one of the most notable cases of skin cancer in the black community, reggae legend Bob Marley discovered a type of malignant melanoma under one of his toe nails. The cancer spread to his lungs and brain, causing his death at age 36.
Not all skin cancers are fatal. Basal and squamous cell skin cancers develop in sun exposed areas of the skin. The cancers are slow growing and less likely to spread than melanoma.
Darico Willis remembers putting on sunscreen as a child, but abandoned the practice once he was older. The 18-year-old Toledo man, who often works outdoors, said he didn't understand the purpose of sunscreen.
"My mom used to make me wear it," said Mr. Willis who is of mixed race. "I never knew why she made me wear it, so once I was older, I stopped."
Sidi Shabaa, Mr. Willis' co-worker, said despite working outdoors, using sunscreen has never crossed his mind.
"I never thought [black people] needed it," said Mr. Shabaa, 21, of Toledo. "I've never seen anyone use it."
Sherie Moore works out four to five times a week outdoors at Wildwood Park. The Toledo woman, 40, is aware of the possibility of skin cancer, yet she's never worn sunscreen.
"I used to think that [black people] couldn't get it, but I know that's not true," Ms. Moore said. "Other than when I'm working out, I'm not usually outdoors. Wildwood is pretty shady, so I figured I didn't need [sunscreen]."
Genetics also plays a role when it comes to melanoma in African-Americans, accounting for many cases of melanoma in the black community, said Dr. Adnan Amkhalil, an oncologist at Mercy Cancer Center.
"If someone in the family has had it, it's possible for others to develop it," Dr. Amkhalil said. "You can't change genetics."
Skin cancers develop over time, Dr. Amkhalil said. The more exposure to sun on unprotected skin overtime, the higher the risk of getting cancer.
"Intense exposure, starting in childhood, leads to increased risk" Dr. Amkhalil said. "The damage can start at any age and for anyone."
Contact RoNeisha Mullen at rmullen@theblade.com or 419-724-6133.
First Published August 6, 2012, 4:00 a.m.
