Yes. Isn’t the answer obvious? Doesn’t everyone know that the sun causes melanoma? Not so fast.
There are many people who think we dermatologists are needlessly frightening everyone. They argue that the sun is good for you because it boosts your vitamin D levels and that dermatologists are subsidized by the sunscreen industry. They argue that melanoma can occur in places that are not sun exposed (like the bottom of your feet), that sunscreens have never been proven to prevent melanoma, and that people who get sun every day, like farmers, are actually less likely to get melanoma. They’re right.
So, then does the sun cause melanoma? Yes. Melanoma is a potentially deadly skin cancer. Like other cancers (breast, lung, colon), there are many risk factors. Think of melanoma as a destination — the hell of skin cancer. There are many roads to that destination even though the final resting place is the same.
People who have light skin or a family history of melanoma have a much shorter route to arrive at melanoma. It takes less time and less environmental factors for them to get melanoma. People who have very dark skin have a very long road to melanoma; it is unlikely that they will arrive there in their lifetime. Older people are much more likely to develop melanoma than younger people (they have been travelling the road for much longer). Sun exposure, especially sun burns, pushes you farther down that road.
Brilliant research from people like Dr. Michael Stratton in the United Kingdom has shown that most of the mutations found in melanoma tumors are unquestionably the work of ultraviolet radiation damage to the DNA. We also know that people who use tanning beds before the age of 30 are 75% more likely to develop melanoma that those who do not.
The sun does have health benefits, but unfortunately it also is the main driver pushing us down the road to melanoma. Each person has to think about how far along the road to melanoma he or she is starting at to determine how careful to be with the sun.
Everyday in dermatology we see people who unexpectantly find themselves in a place they did not think possible — they have melanoma. Many don’t understand how they got there; it has been a long road. Stop and think about where you are along that journey. What are your risk factors of melanoma? It is never too late to stop and turn around.
Photo: Eduardo Amorim