Every hour of every day, a patient succumbs to melanoma.
The statistics, bare and cruel, are the grim reality of this ferocious type of skin cancer.
Once the malignant cells penetrate the outer layers of skin, they can metastasize with little mercy. Melanoma cells invade other organs a
nd leave only a slim, 15 percent chance of survival.
A combination of genetics, too much sun and general exposure to ultraviolet rays are the primary risk factors for melanoma, experts say.
Most melanomas and other skin cancers, including the more common basal and squamous cell carcinomas, can be cured with a surgeon’s blade.
Tumors are sliced off, the patient is stitched up and the only follow-up treatments are regular visits to a dermatologist.
Early detection and good sun habits are the best ways to prevent complications, Dr. Craig Birkby said. He’s an educational spokesman for the Skin Cancer Foundation and a dermatologist at Swedish Medical Center in Seattle.
Birkby tells patients to check their birthday suits on their birthdays. That means a thorough look at moles that may stand out as different.
“If you take a look at all your moles and something just looks different, it just stands out as different, that is a mole that you should have looked at,” Birkby said.
People with suspect moles should check with a primary care doctor or see a dermatologist, a skin-care specialist.
Skin cancers are common and some, including melanoma, are on the rise. Each year, more than 3.5 million people are diagnosed with skin cancers in the U.S.
“The amazing thing is you can see the disease,” said Dr. Daniel Berg , a professor of dermatology and the director of dermatologic surgery at the University of Washington.
Unlike cancers of the liver, colon, breast or other areas of the body, patients can see changes to their skin.
While melanoma is the most deadly type of skin cancer, it’s much more common for people to have basal cell or squamous cell carcinomas.
Basal cell carcinomas often are slow growing and look like a pimple that refuses to go away, Berg said. Squamous cell carcinomas appear more rapidly and can look like psoriasis, but, similar to basal cells, it’s a rash or outbreak that doesn’t go away.
There are a number of treatments for these types of cancers. Doctors can prescribe a cream or use a type of surgery called Mohs, named for the doctor who developed the technique.
Mohs surgery allows doctors to carefully and meticulously remove small amounts of tissue, Berg said.
This helps reduce the amount of damage to the areas where the carcinomas often occur.
The biopsy is tested rapidly while the patient waits. If bad cells remain, the doctor keeps taking off small amounts of tissue until only healthy tissue remains.
When Mohs surgery isn’t a good option, patients with basal and squamous cell carninomas can be referred to a radiation oncologist.
Dr. Steve Adam has worked treating cancer with X-ray beams and other types of radiation for more than three decades.
He works in the high-tech halls of the Providence Regional Cancer Partnership on 13th Street in North Everett.
That’s where he uses a new, low-energy X-ray beam that can be programmed to target cancer cells in sensitive areas including eye lids, lips and the scalp.
“It’s ideal because you always have 100 percent of the dose you give right at the surface (of the skin),” he said.
Patients come to the lab daily Monday through Friday for treatments. It’s a painless, 20-minute process. The zap of radiation is applied in less than a minute, Adam said.
Results of the treatment typically are the same as surgery: Cured.
The radiation also can be better than surgery for people at with complicated medical conditions such as diabetes. Sometimes radiation is used in addition to surgery.
Some radiation clinics have been in the national news lately for reportedly delivering the wrong amounts of radiation. Adam said Providence avoids these problems by employing four physicists who maintain and calibrate the powerful radiation machines.
Doctors also supervise the procedures and special monitors are placed on the patient to record the amounts of radiation delivered.
Treating melanoma is more challenging.
When melanoma has spread below the surface skin layers, doctors first attempt to remove lymph nodes. They then move on to various chemotherapy treatments.
New therapies are emerging that can help extend patients’ lives. A drug called Yervoy was approved by the FDA earlier this year.
“It is exciting to begin to have new agents for metastatic melanoma that seem to prolong life, if even only by a few months,” Berg said.
Melanomas typically can be caught early.
The problem moles are asymmetrical, have jagged or uneven borders, often are deep in color or contain a variety of colors, are bigger than a pencil head in diameter, and appear to be evolving.
Doctors use the acronym: “A: Asymmetry, B: Borders, C: Color, D: Diameter, and E: Evolving” to help patients remember what to look for.
While scientists can’t determine the exact cause of melanoma, doctors recommend limiting exposure to ultraviolet rays.
Some doctors who work with skin cancer patients call getting a sun tan “a full-body radiation treatment.”
The sun’s powerful rays penetrate deep into cells and can change the cell’s DNA, causing problems years or decades later.
“There’s nothing healthy about a tan,” Birkby said.
He recommends liberally applying sunscreen and covering up whenever possible.
That doesn’t mean staying inside. Birkby encourages his patients to enjoy the outdoors.
“We need to take caution when we’re out there,” he said.
Give yourself regular check-ups
Early detection of skin cancers — particularly melanomas — is crucial to treatment. You can help protect yourself with regular at-home body inspections, says Dr. Melissa Schwarzschild of Richmond, Va. “You can be proactive and alleviate anxiety,” she says.
• Do regular inspections: Check all of your moles about every six months, especially if you have lots of them or have a personal or family history of skin cancer. See a dermatologist once a year for a routine full-body check.
• Get to know your moles: Know their location, size and color.
• Look for new or changing moles: It’s normal to develop new moles into your early 20s, but not beyond. Pay attention to any new growths or moles that have changed in size, color or shape.
• Take pictures: If you have lots of moles, keeping up with potential changes is difficult. One good idea: take photographs every six to 12 months; save and date the images on a computer and review as needed. You may find a “scary” mole has always been there, or that it is in fact new.
• Beware of pink or black: Normal moles and other benign skin growths typically are varying shades of tan to brown. Melanomas may be black or less commonly pink, while other skin cancers tend to be pink and are often scaly. See your dermatologist if you notice a pink or black lesion.
• Check “hidden” spots: Don’t overlook the soles of your feet or your genital area; ask a partner or friend to check your back and have your hairdresser inspect your scalp. Skin cancers can appear even in areas where the sun doesn’t shine.
Source: Newport News Daily Press
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