June 12, 2015
By Dr. Kwame Williams
Many African-Americans and other people with dark skin believe they face lower risk for skin cancer than light-colored people.
And while that is true, complacency surrounding that fact often leads to late detection of cancer among patients with dark skin, which means their cases are often more deadly. Moreover, many may not be aware that one form of cancer – acral lentiginous melanoma, or ALM, which often occurs in the feet – is more common among darker people.
According to the American Cancer Society, melanoma, a serious cancer that starts in the skin’s pigment cells, has become more common in the United States each year for at least 30 years. The lifetime risk of getting melanoma is about 1 in 40 for whites, and only about 1 in 1,000 for blacks and 1 in 200 for Hispanics.
However, the ACS also reports that the survival rate for melanoma is much lower among blacks – just 73 percent, vs. 91 percent among whites. Doctors say that could be because cases among African-Americans get detected later, when chances for survival are lower.
People with darker skin are more likely to be afflicted with ALM, a rare and aggressive cancer that is often found on the soles of the feet, palms of the hands and beneath toenails and fingernails. These are areas that many people ignore.
We don’t hear much about ALM, but it caused the 1981 death of Musician Bob Marley at age 36. The melanoma that started beneath his toenail was originally thought to be a bruise from playing soccer.
ABCS of melanoma
The bottom line is this: No matter what color your skin is, you need to regularly look for, keep an eye on and ask your podiatrist about unusual moles, bumps or patches on your feet.
Here are what podiatrists call the “ABCs of melanoma.”
- Asymmetry – When a lesion is divided in half and the sides don’t match.
- Borders – Borders look scalloped, uneven or ragged.
- Color – There may be more than one color. These colors may have an uneven distribution.
- Diameter – The lesion is wider than a pencil eraser (greater than 6 mm).
To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or “donut-shaped” edges, or scaly areas.
Preventing skin cancer on the feet and ankles is similar to doing so with any other body part. Limit sun exposure and be sure to apply sunscreen when you’re outdoors and your feet and ankles are exposed.
For more information on skin cancer in the feet, visit this article on the American Podiatric Medical Association website.
For more on ALM, check out this article from the Washington Post.