Deadly Skin Cancer Strikes Older Men More

New study: Melanoma is more common among men over age 50—and more dangerous.

April 24, 2009

Spot check: Skin cancer on the back tends to be deadlier, unless an exam catches it early.

RODALE NEWS, EMMAUS, PA—Even though most of us associate skin cancer with tanning-bed addictions and the pursuit of a summer glow among teens and younger women, it’s actually middle-aged white men who make up 50 percent of all melanoma-related deaths in the U.S. “Young women are more likely to be diagnosed with melanoma, and at ages 40 and 50, [diagnosis for women and men] starts to equalize. But after age 50, the disease is much more common in men,” says Alan Geller, MPH, RN, a senior research scientist at the Harvard School of Public Health and author of two studies published in the April issue of the Archives of Dermatology that called attention to this disturbing trend. “What we’re even more concerned about is that when you look at men who are diagnosed compared with women, men tend to do worse.”


THE DETAILS: Geller and his colleagues surveyed men between 40 and 88 years old who had been recently diagnosed with melanoma, the most deadly form of skin cancer. After asking the men questions about how their tumors were discovered, about their awareness of the disease, and how frequently they were examined (either by themselves or a doctor), researchers found that less than 20 percent were aware of the warning signs and less than 50 percent did self-examinations. The experts also found that the men who were more educated about the disease had thinner tumors, meaning that the disease had been detected in its earliest stages. Geller notes that early detection can lead to a 5-year survival rate of almost 100 percent. In a separate survey, he found that men whose tumors had been detected by a physician (rather than by themselves or a significant other) were also thinner and therefore more easily treatable.

WHAT IT MEANS: Be pushy when it comes to asking your doctor for skin examinations. “The squeaky wheel gets the oil,” he says. adding that it doesn’t necessarily mean making an appointment with a dermatologist. Geller points to studies that show men who were diagnosed with melanoma had actually visited a doctor at least once in the year prior to diagnosis. Simply asking their family doctor for a full-body skin exam could have lead to earlier detection, he says.

Here are some strategies for reducing skin cancer risk:

• Demand a skin check. “Every single person who has light skin or a number of moles should be asking his doctor for a full skin exam,” Geller notes. Risks are higher among Caucasians, but he particularly stresses the risks among people with a high number of moles, whatever their skin type. “Patients often have to ask doctors to give them an exam. They need to be encouraged,” he says.

• Watch your back. “The worst thing for a man is to be diagnosed with melanoma on his back,” says Geller; that’s where nearly a third of the skin cancer cases occur in men. Because they’re hard to detect, back tumors usually lead to higher rates of death from the disease. He’s even launched a “Watch Your Back” campaign to urge men to ask their doctors and significant others to pay more attention to this part of their bodies.

• Keep up the self-exams. Just because men whose tumors were detected by physicians tended to have smaller tumors, that doesn’t discount the importance of self-checks. In fact, one of Geller’s surveys found that more tumors, regardless of size, were detected by either the individual or his significant other than by a doctor. “Download off the Web pictures of what melanoma looks like,” says Geller, and then hand them to someone who can check your back and other hard-to-see places on your body.

• Wear sunscreen. You’ve heard it a thousand times. But unfortunately, “There’s very good evidence that men are less likely to use sunscreen than women,” says Geller. Use as much sunscreen as it takes to fill a shot glass in order to cover your whole body and reapply it every 2 hours, or after toweling off if you’re swimming. All areas of your body are susceptible to cancer, Geller warns, but men in particular should pay attention to their backs and the tops of their ears.