Skin cancer is still a risk for the black community

As I sat in my office in December 2019, I received a call from my dermatologist. She had performed a last minute biopsy on me just two days earlier. I wasn’t prepared for the news I was about to receive.

“You have skin cancer,” she told me. Within just a few minutes of that call, I was diagnosed with Dermatofibrosarcoma Protuberans (DFSP).

My body felt hot with shame. It had been probably over a year since I noticed an oddly shaped, raised bruise on my torso. I had let too much time pass before going to a dermatology consultation as recommended by my GP.

I was also shocked that I, a black woman, could even be diagnosed with skin cancer.

The black community rarely talks about skin cancer and how it affects us. Despite the massive production of T-shirts and clothing that boast of our “sun-kissed skin,” our melanin won’t save us from a skin cancer diagnosis. Melanin is a dark pigment found in the skin, eyes, and hair that gives them color and can protect them from the harmful effects of UV light. While it offers protection, it does not promise immunity against skin cancer.

And it wasn’t sunbathing that led to my diagnosis.

While black people can still develop skin cancer as a result of exposure to direct sunlight, there are many other types of skin cancer that are not a result of UV rays. DFSP is a rare form of soft tissue sarcoma – a group of cancers that affect tissues such as skin, fat and muscle. DFSP is not due to sun exposure, and researchers are still investigating what causes the tumor.

My dermatologist recommended Mohs surgery, which I underwent in January 2020 to remove the tumor. The process would be quick and recovery wouldn’t take long. However, my journey took a sharp turn when my post-operative pathology report came back. The tumor had penetrated the deep layers of my skin and was growing like the roots of a tree trunk. I would have to undergo an additional operation.

Research shows that Black people who develop skin cancer are often diagnosed at a late stage. This makes treatment difficult.

Postponing your visit to the dermatologist can lead to a late diagnosis, but even being diligent and making an appointment can lead to the same consequences. Many dermatologists are unfamiliar with black skin and/or are aware that black people are less likely to develop skin cancer than other people. Because of this, some dermatologists may miss the opportunity to diagnose a person with skin cancer early.

For people with melanoma, a delay can be fatal because it can spread quickly.

While blacks are less likely to be diagnosed with melanoma compared to whites, they are also at a much greater risk of death. Barriers to supply and a lack of representation in dermatology only compound the inequalities and institutional racism faced by the black community.

I’ve had three surgeries in total and now have to visit my cancer center every six months to make sure the tumor doesn’t come back. As I share my journey with others, I have found that there is a lack of skin cancer education that is causing misunderstandings to spread within the black community.

Here’s how you take charge of your skin’s health

Here are four things we should do as African Americans to make sure we don’t ignore what our skin is trying to tell us:

Check your skin

This can be done before or after you shower and should be done at least once a month.

With melanized skin, you want to identify anything that might look like:

• New dark spot (or one that changes shape and/or size)
• A wound that doesn’t heal (or heals and returns)
• A rough patch of skin
• A dark line under or around a fingernail or toenail.

Use a mirror or the help of a partner to examine your body for any unusual patches of skin, bumps, or bruising.

Apply sunscreen daily

As a community, we recognize that our melanin remains our greatest protector. Despite this natural protection, we still need to protect our skin from the power of UV rays.

According to the Skin Cancer Foundation, you should wear broad-spectrum sunscreen (SPF 15 or higher) every day. You should also try to stay out of the sun between 10am and 4pm, do your best to avoid sunburn, and cover up. You can check this Advisor to the Skin Cancer Foundation for more helpful tips on protecting your skin.

Schedule an annual visit to a dermatologist

When planning your yearly check-ups, be sure to schedule a visit to your dermatologist.

These doctors are qualified to diagnose and treat skin conditions. Ask them to check your skin if you haven’t done a thorough skin test yourself. Be sure to use your visit to address any concerns you may have.

If you notice anything on your skin, you should specifically ask for a biopsy. This is the only way to diagnose skin cancer and can be done during your visit.

Stand up for yourself

There is still a lack of diversity in the medical field. Many dermatologists are unfamiliar with black skin. Do your research and find a dermatologist that you think will best meet your needs. For black people, this can mean finding a dermatologist who looks like you.

If that’s not possible, it’s important to find someone who knows about melanized skin. If your dermatologist doesn’t take your concerns seriously, find one who does.

Above all, early detection is crucial and crucial. If we love our melanin, we must take great care to protect it.