Wipe Out Melanoma - California
Changing the way our community faces melanoma
What is Wipe Out Melanoma - California? It is a way to engage our community in the prevention, early detection, and treatment of this serious disease. It is a research cohort, or group of people, who have a personal history of melanoma, are family members or are individuals interested in this topic. We hope to reach out to people who may not realize they are at higher risk for severe melanoma. We are gathering an impressive “wave” of community members and experts in melanoma treatment and prevention who can wipe out melanoma and help speed the progress of research and discoveries. Together, we can find answers and reduce the deaths caused by melanoma.
Why join? Melanoma can be deadly, and it has taken far too many lives. One person in the U.S. alone dies of melanoma every 52 minutes! Melanoma affects people of all skin types, even those with darker skin, and the disease is hitting our poorest neighborhoods hard. For researchers to make groundbreaking discoveries, they need people willing to respond to surveys and to join studies. With an engaged community, studies enroll more quickly, education spreads more rapidly, and public policy changes more effectively. This is a place where you can make a direct impact on this deadly disease.
Our plan. We want to increase melanoma awareness among all Californians. Our goal is to save lives by educating our community on how to prevent and detect melanoma. Our plan includes educational campaigns and interventions, research surveys and studies, clinical trials and opportunities for the community to engage, by providing feedback on surveys and speaking directly with doctors and researchers. There is much that needs to be done. Join us.
Surf the Seven C's!
1) COLLECT Information
The Melanoma Community Registry of California will allow us to collect information regarding your risk for melanoma: Skin type • Measure your exposure and reaction to the sun • Rate of melanoma within your community • Family history •
Hang Ten - The Ten Most Important Risk Factors for Melanoma
- Fair Complexion : Your risk of getting melanoma depends on your skin color/pigmentation, how your skin reacts to the sun (ultraviolet light) by either tanning or burning, and how much ultraviolet (UV) light exposure you have had. If you have light skin that tends to freckle and burn easily, red or blond hair, and blue or green eyes, you are especially susceptible to melanoma. People with darker complexions are at lower risk for melanoma and other skin cancers, though rates of melanoma in the US are rising in those of Asian race and Hispanic ethnicity.
- Family History of Melanoma: Your risk of melanoma is increased if you have a family member who has the disease. While less than 10% of melanoma cases are linked to an inherited genetic trait, families tend to have similar skin coloration and reactions to the sun, as well as shared environmental UV exposures.
- Exposure to Ultraviolet Light from the Sun: Ultraviolet-B (UV-B) radiation from the sun is the main cause of sunburn and skin cancer, although UV-A also plays a role. In people with very light skin, sunburn can occur after only a minutes of sun exposure. Having a history of five sunburns doubles your chances of getting melanoma. Sunrays that damage your skin can reflect off of water, sand and concrete and can penetrate windows.
- Exposure to Ultraviolet Light from Tanning Beds or Sunlamps: Indoor tanning beds emit both UV-A and UV-B rays with higher concentrations than natural sunlight. If you use a tanning bed for 20 minutes, it is like spending up to 3 hours at the beach with no sun protection. Your risk of developing melanoma can increase by 20% after even one indoor tanning session. If you use a tanning bed before you are 35, your risk of melanoma increases by 75%. Indoor tanning beds are banned in Australia and Brazil, with legislation in place to ban them in other countries. In the United States, 19 states and the District of Columbia ban tanning bed access to minors (under age 18) with state bills pending for more states to do so.
- Atypical or a Large Number of Moles: The most important clinical risk factor for melanoma is having a lot of moles, especially if these moles are larger (bigger than a pencil eraser) or look atypical. While most melanomas do not come from an existing mole, having lots of moles increases your risk of getting melanoma. A mole count of 50 or more is considered increased. People with an atypical mole pattern benefit from total body photography and routine skin monitoring by a dermatologist.
- Age: If you are between the ages of 25 and 29, melanoma is the most common form of cancer you might suffer. Melanoma is second only to breast cancer in women between the ages of 30 and 35. Your risk of melanoma increases with age, and it is most often diagnosed if you are middle aged. About 70 percent of melanoma cases are diagnosed in people age 55 or older. While new medications (immunotherapy and molecularly targeted therapy) have reduced death rates from advanced melanoma over the past 5 years, white males over the age of 50 have a higher risk of dying from melanoma, often related to later detection of more aggressive skin tumors.
- Employment Out-of-Doors: If you are employed out of doors, like a construction or agricultural worker, you are at more risk of developing melanoma since you will receive increased exposure to ultraviolet radiation. Some melanomas occur in chronically sun-damaged skin (face, ears, scalp, arms), while others occur in more intermittently sun-damaged skin (trunk).
- Recreation Out-of-Doors: If you recreate out of doors, like a surfer, hiker, swimmer or other athlete, you are at greater risk of melanoma due to your increased exposure to ultraviolet radiation. Sweating may also contribute to your risk of skin damage since it makes sunscreen less effective and may increase your sensitivity to the sun.
- Immune System-Suppressing Diseases or Treatments :If you’re immune system is suppressed due to medications you take after an organ transplant or have HIV/AIDs, you are more susceptible to melanoma and other skin cancers.
- Previous Skin Cancers: If you have had basal or squamous cell skin cancer or precancers called actinic keratosis, you are at higher risk of developing melanoma, since these lesions are all related to UV exposure. You are also at higher risk of developing another melanoma if you have already had a skin melanoma, especially in the first 3 years after your diagnosis.
Raise melanoma awareness among our community members and doctors • Learn how to reduce sun exposure and other unsafe behaviors that can endanger people of all skin shades • Promote policy changes to reduce harmful exposures • SUNSPORT
Hang Ten - The Ten Most Important Ways to Protect Your Skin from Melanomas
- Wear Protective Clothing When You Are Exposed to the Sun: Many comfortable clothes and hats are available with an ultraviolet protection factor (UPF) of 50 in the US. You generally don’t need to apply sunscreen under clothing when outdoors. It is best to wear a broad-brimmed hat that covers your ears and shades your face and neck. Wear sunglasses to protect your eyes from damaging UV radiation; wrap-around sunglasses are best, but make sure to look for a label that shows UV protection. Wear lightweight, long-sleeved shirts and pants with UV protection in the fabric, although any clothing is better than none for sun protection. Rash guard shirts are best while swimming.
- Use Sunscreen on All Exposed Parts of Your Body: You should use a broad-spectrum, water-resistant sunscreen that protects against both kinds of ultraviolet light (UV-A and UV-B). You should use a sunscreen with a sun-protection factor (SPF) of at least 30. If you have very light skin, are exposed to more intense sunlight (nearer the equator), or are going to be in the sun for a longer period, it is best to use sunscreen with a higher SPF (50+), as well as protective clothing, hats, and eyewear. For maximum protection, you should use a sunscreen containing UV filters that cover the entire ultraviolet light spectrum. Better UV filters in chemical sunscreens may be available outside of the US. Mineral sunscreens contain micronized zinc oxide or titanium dioxide, and higher concentration are needed for broad spectrum UV protection (at least 20%). The Food and Drug Administration does not question the safety of currently available sunscreens in the US. Further studies have been requested before approval of UV filters outside of the US.
- Apply A Sufficient Amount of Sunscreen Before Exposure: You should apply sunscreen about 30 minutes before going outside so it has time to take effect. If you are an adult, you should apply about one ounce (two tablespoons) of sunscreen to the exposed areas of the body.
- Ask Someone Else to Apply Sunscreen to Hard to Reach Parts of Your Body: You should apply sunscreen to your back and shoulders. Nearly 40% of people rarely or never apply sunscreen to their back, which is a common site of melanoma in men and women. If you cannot reach the areas, ask a friend to apply the sunscreen for you. Over 40% of people rarely or never ask someone else to apply sunscreen to their back.
- Reapply Sunscreen Every Two Hours and After Swimming or Excessive Sweating: Sunscreen effectiveness wears out after about 2 hours, so if you are in the sun longer, be sure to reapply. If you’re skin starts to get pink or red (sunburn), get out of the sun, cover up , and seek shade. Putting on more sunscreen won’t prevent you from burning!
- Avoid Sun Exposure When You Can, and Seek Shade Between 10:00 a.m. and 4:00 p.m when the Sun’s Rays are the Strongest: Even on a cloudy day, up to 80% of the sun’s ultraviolet rays can pass through the clouds.
- Create Your Own Shade if None is Available: You should use an umbrella to create shade.
- Take Special Precautions with Babies: You should keep infants, under six months of age, out of the sun by using protective clothing, hats, strollers or other coverings. It is best to avoid (or use only minimal) sunscreen use in babies less than 6 months of age and to seek shade instead. Sunscreen is safe to use in babies older than six months, either chemical or mineral brands. Be sure that your toddler wears sunglasses when outdoors.
- Use Extra Sun Protection During Childhood and Adolescence: If you are a minor, you should use extra sun protection. About 40-50% of total UV exposure through age 60 happens before the age of 20. In addition, the more sunlight you have as a child, the more moles and freckles you tend to develop as an adult, especially if you have lighter skin.
- Use Extra Protection if You are Near Snow, Water, Sand or Concrete Which Reflect and intensify the Damaging Rays of the Sun: UV-B intensity is greater with altitude, so don’t forget to use sunprotection while hiking or skiing at higher altitudes.
Hang Ten - The Ten Most Important Ways to Check Your Skin for Melanomas
- Look at your skin regularly to identify any spots that don’t resemble each other or are changing: Use the clinical warning signs below to spot any suspicious lesions on your skin. Perform self-exam of your skin once per month, especially if you have a lot of moles. Involve your partner or a family member to check your back. Examine your skin from the scalp to toes and most importantly, let your health provider know if you spot anything of concern.
- Look for spots that don’t match your usual mole pattern or look different from the rest: Most melanomas present as an outlier or “ugly duckling” compared to other moles on your body. This is one of the easiest ways to pick up an early melanoma.
- Use the ABCDE Checklist to identify a skin spot that may be melanoma:
- Asymmetry: One half of the lesion does not look like the other.
- Border Irregularity: The edge of the lesion is irregular or ragged in appearance.
- Color: More than one color is present, including tan, brown, black, red, blue, and/or white.
- Diameter: The size is greater than 6 mm in diameter (about the size of a pencil eraser). Most melanomas are about this size when diagnosed, but they can be detected when smaller in diameter.
- Evolving: The lesion is changing over time, such as elevating or growing horizontally on the skin. Any bleeding in mole should be promptly evaluated.
- Pay attention to spots that are pink or skin-colored: Melanomas are most often pigmented (tan/brown/black in color), but a small percentage are pink or skin-colored. Any changing lesion on the skin, especially a new pink or skin-colored lesion that is elevated, firm, and/or growing on the skin for over a month, should be evaluated by your health professional.
- Monitor Your Skin for Symptomatic Changes: Although a melanoma may develop from a mole, it most commonly arises from “clear skin.” You may notice that the appearance of a mole may change subtly as you get older (often becoming more “flabby” and lighter in color), but this is not usually a quick change. A mole or spot on your skin should not generally bleed or become suddenly itchy, painful or tender. If you have a sore on your skin, it should heal and/or go away and not keep coming back.
- Look for spots on your hands, feet and fingernail and toenails: If you have a brown or black streak under a nail, it may be a melanoma, particularly if you develop this in adulthood and only a single toenail or fingernail is involved. Since people with darker skin tend to get less melanomas on chronically sun-exposed sites, it is important to always make sure to look at the bottoms of your feet, palms of your hands and fingernails/toenails to make sure there aren’t any concerning pigmented lesions.
- Monitor Your skin for new moles if you are over fifty: Although it is normal for you to get new moles while you are younger, moles tend to develop less often by the age of 50. If any new concerning spots develop after age 50, make sure they are evaluated by a health professional.
- Check everywhere on your body: Although a melanoma usually will occur on an area of your skin that is exposed to the sun, it may be found anywhere on your body, including your eyes, genital area, mouth, and scalp.
- Watch your back, especially if you are an older white male: If you are male, you are most likely to develop a melanoma on your back and other areas of the trunk (from the shoulders to the hips), as well as the head and neck. If you are female, you are most likely to develop a melanoma on your legs or arms, though melanomas on the trunk are also common. Ask your health provider to look at your back during routine physical exams.
- Ask Someone Else to Help You Check Hard to Examine Areas of Your Body: If you can’t see any area of your body, you should ask someone else to do the examination. Spouses find about 16% of melanomas. Only about 35% of people ask someone else to help them examine hard-to-see areas for signs of skin cancer. Your hairdresser can also help to spot concerning lesions in the scalp. Less than 25% of people get a regular full skin examination by their primary health provider – so be sure to ask for a skin check during your visit.
Wipe Out Melanoma – California partners with the national War on Melanoma TM program to reduce melanoma incidence and mortality nationwide.
Hang Ten - Prevention-related Research Collaborations
- Stanford participates in a national Melanoma Prevention Working Group to promote early detection and prevention of melanoma.
- We are part of a Federation of States through the War on Melanoma™ that is working to promote increased health professional and public awareness of sun protection and clinical warning signs to detect melanoma when it is early and most curable.
- We participate in the National Cancer Institute-sponsored University of Arizona Cancer Prevention Clinical Trials Network (UA CP-CTNet) dedicated to conducting early phase therapeutic prevention (“chemoprevention”) trials in melanoma. Our hope is to find a safe, readily available medication, vitamin, or nutritional supplement that could prevent melanoma at the outset.
- We created an innovative education and research program to reduce skin cancer and sun damage among outdoor athletes. The Stanford University Network for Sun Protection, Outreach, Research, and Teamwork (SUNSPORT) initiative is designed to teach and engage athletic trainers and coaches to promote sun protective practices in college athletes.
- Through partnerships with the Stanford Institute for Human-Centered Artificial Intelligence, we are working to improve early detection of melanoma through novel imaging technologies, including artificial intelligence and machine learning, so that we can improve diagnosis and speed health care delivery to those who need it most.
- Our team involves collaboration with Stanford Dermatology, Center for Population Health Sciences, Office of Community Engagement, Stanford Cancer Institute Community Outreach and Engagement Program, and academic researchers across the state.
Empower people to ask their doctor or other health care provider for skin exams • Partner with community providers and lay health advocates to promote early detection • Help our community receive the care it needs
Help Us to Wipe Out Melanoma in California
The best progress in medicine happens in partnership with the community. If you, a family member, or a loved one have been personally affected by melanoma would like to join our efforts, please consider a contribution. With your generous support, we aim to save lives by educating and engaging the community in early detection and prevention, as well as speed the progress of research and discovery of novel treatments. Our goals are to reach those at greatest risk of developing melanoma and to use the latest technologies and medical advances to reduce the number of melanoma-related deaths in California. By investing in this initiative, your contribution will go directly to support our research, education, and community outreach efforts. You can make a direct impact on this deadly disease.
Hang Ten - The Ten Most Important Results of Finding a Cure for Melanoma
- A nationwide, comprehensive skin cancer prevention program could prevent 20% of melanoma cases from 2020 - 2030, corresponding to an average of 21,000 melanoma cases/year (total 230,000 cases from 2020 to 2030) and save $2.7 billion in initial year treatment costs.
- Melanoma can be prevented by reducing ultraviolet radiation exposure from sunbathing and indoor tanning and increasing the use of sun protection. These goals are particularly important in children and adolescents, who spend much time outdoors year-round, in one of the sunniest states.
- Despite advances in therapy for melanoma, including immunotherapy and targeted therapy against specific mutations in melanoma cells, about 50% of patients fail to respond.
- Melanoma accounts for 75% of all skin cancer deaths and is the 5th most common cancer among Caucasians in California.
- The rate of new diagnoses of melanoma in California has increased over the past decade, especially among Hispanics and Caucasians.
- Patients in lower socioeconomic groups and with lower education tend to present with more advanced melanoma at the time of diagnosis.
- An estimated 10,710 California state residents were diagnosed with melanoma in 2019, and 750 people died of melanoma (about 2 Californians each day).
- Detecting melanoma at its thinnest/earliest stages in the skin is still the best way to prevent deaths from disease.
- Preventing advanced melanoma not only saves lives, but spares people from needing more surgery and costly medications that can have long-term side effects, cause time off from work, affect quality of life and normal daily activities.
- We hope you join us in this effort.