KINGSTON, Jamaica (CARIBUPDATE/NOV 21, 2016) - WHEN Robert Nesta ‘Bob’ Marley died on the 11th of May 1981, it was a very sad day for Jamaica, and indeed, the world. He had fought a long, hard battle against cancer but had finally succumbed to it. This cancer had begun as a malignant melanoma underneath his toenail.
Many patients that I see know about Bob’s story and are fearful that they might have the same condition.
This article will clarify what this type of malignancy is and create more awareness regarding the condition.
Acral lentiginous melanoma (ALM) is a rare type of skin cancer that is not attributed to sun exposure, like most other types of skin cancer.
It is most commonly located on the hairless parts of the body, like the palms, nail beds and the soles of the feet, with the vast majority found on the latter.
Usually it first appears as a dark brown spot or streak on the skin or nail.
It is important to note that most people of colour will have benign dark lines underneath their nails and hyperpigmentation on their palms and soles.
This does not mean that they have skin cancer.
This type of skin cancer is far more common in people of African and south- east Asian descent.
In fact, just over a third of all skin cancers found in people of colour turn out to be ALM.
Most people with the disease are diagnosed around the age of 60 or older.
Older people are not as mobile as younger folk, so are unable to check their feet regularly and notice changes.
Men tend to have a lower survival rate.
This is thought to be because women are more likely to seek medical help during the early stages of disease and therefore access treatment.
When assessing a potential cancerous lesion, dermatologists will apply the ‘ ABCDE’ rule.
A is for assymetry, where one-half of the lesion does not match the other.
B indicates that the border is irregular.
C is for colour that ranges in tone and is not uniform.
D is for a diameter greater than six milimetre.
E stands for evolving in shape, size or colour over time.
ALM lesions can remain in situ or in the epidermis (outer layer of skin) before crossing into the dermis (lower layer of skin) and spreading to other parts of the body.
Survival rates are closely related to the thickness of the tumour at diagnosis.
To carry out diagnosis a series of excisional biopsies will be carried out and treatment will be based on the findings.
Sadly, the prognosis for ALM is poor compared to other cutaneous malignant melanomas.
As this is a rare cancer, very little research has been carried out regarding it.
If ant new lesion appears on your skin or in your nails, you should consult your dermatologist as soon as possible.Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.