Skin cancer that affects more black people cannot be prevented with sunscreen

“Sunscreen. Never stop using sunscreen.” That’s how the song began in which Pedro Bial lined up advice on how to live well. “The long-term benefits of using sunscreen are proven and proven by science,” the letter read. And it’s true. In addition to preventing skin aging, the protector is recommended by dermatologists in the prevention of skin cancer – but not all types of the disease can be prevented this way.

This is the case with acral melanoma, a subtype of cancer that occurs mainly on the palms of the hands and soles of the feet, regions that are usually less exposed to sunlight. It was this type of illness that killed Bob Marley at age 36. Even if he had followed Pedro Bial’s advice, the singer would not have saved himself.

Seeing a black spot under his big toe nail, the Jamaican thought it was an injury caused by football, not an aggressive type of cancer much more common in people of African descent. As there is little attention focused on this type of disease, the main tool to prevent it from spreading is impaired.

“Early diagnosis is the great secret, as in any type of cancer”, says Guilherme Gadens, a member of the SBD (Brazilian Society of Dermatology).

Deusmira Rodrigues, 64, did not imagine that the mole on her heel could be melanoma. “She’s been there for years and it never bothered me.” Until the stain began to change shape, grow and accumulate blood. Rodrigues then went to the doctor.

At the first consultation, the specialist said it was a benign tumor, but the recommended treatment had no effect. After a biopsy, the diagnosis was the same as Bob Marley’s: acral melanoma. This delay made the treatment more complex. Rodrigues underwent surgery to remove the compromised tissue and then had to undergo a graft.

Before receiving the diagnosis, Rodrigues had not heard about this type of cancer. “I never thought I could have this melanoma, because I only heard about melanoma in white skin.” For her, who is black, this lack of information can cost lives.

“And I think it’s a disregard, you know? Society and those who work with it”, he points out when criticizing campaigns on skin cancer that do not mention this type of disease. “Acral melanoma is super dangerous. It’s a life that’s at risk.”

She claims that if she had seen information about the disease earlier, she would have found out sooner. Rodrigues recovered well from the surgery and, for 4 years, she has been cured.

To make an early diagnosis, dermatologist Guilherme Gadens says that the black population should be attentive to signs of the disease such as dark spots on the palms of the hands, on the soles of the feet or under the nails.

“For example, a very dark band on the nail, which we call melanonychia, can be a problem.”

There is yet another reason that delays the diagnosis of skin cancer in black people: a false sense of security.

According to dermatologist Katleen Conceição, head of the Black Skin Outpatient Clinic at Santa Casa de Misericórdia in Rio de Janeiro, what causes this feeling is the natural protection provided by melanin.

“People think that those who have black skin are not at risk of skin cancer and that is a mistake,” he says.

Although less common, skin cancer manifests itself and causes the death of black people. Between June 2021 and June 2022, according to information from DataSUS, 1,221 Brazilians died from the disease. Most were white (702), followed by brown (331), black (40) and yellow (7). The other 141 deaths are not detailed in color.

Although it does not protect against acral melanoma, sunscreen is effective in protecting against other types of melanoma and carcinomas, which are the most common form of skin cancer.

In addition to using the product and focusing on physical barriers such as hats, caps and long clothes, Conceição says that people who are often exposed to the sun should pay more attention to their own skin and seek medical attention if they notice spots on their body.

The diagnosis of skin cancer is made through clinical examinations and biopsy.