Melanoma Awareness Month in 2020

I am writing this on May 1, 2020.  Today is the first day of Melanoma and Skin Cancer awareness month.  May is typically a month where you’ll see news stories on skin cancer awareness and sun safety.  You’ll often see a charity run or walk occurring on the weekend.  It’s a good chance such an event is held to raise money for the Melanoma Research Foundation, AIM for a Cure, or some other melanoma organization. 

However, this year, the medical news is dominated by COVID-19…the pandemic sweeping the world.

There will be no gatherings for a walk.

There will be no gala.  In May, we are slowly trying to reopen the world, but it’ll be a slow and cautious process.  People are not so concerned about skin cancer.

Usually, I would point out that people die of melanoma at a rate of greater than one person an hour. That’s over 9,000 people who will be lost this year.  However, the virus has claimed nearly 63,000 U.S. citizens at the time of this writing within the last 3 or 4 months. 

These deaths do not reduce the significance of the melanoma fatalities by any means. Still, it’s easy for the general population to miss during these times.  I hope that all other deaths outside of the virus will not be forgotten.  The families affected by a death from melanoma, any cancer, heart disease, or any other fatal illness grieve as much as anyone.  This year it might be even harder because the families are not allowed to visit the sick in the hospital.  COVID-19 is killing not only those it affects directly but kills the opportunity to pass on with family near them in the hospital.  Afraid and alone.

2020 is not a typical year.

Please keep all who suffer in your thoughts this year.  Keep those who are trying to keep our sick comforted in your thoughts.  Keep in your thoughts those families who can’t say goodbye, or can’t attend the funeral.

It’s still Melanoma Awareness month, and I plan to post a few more thoughts and reminders.  I encourage you…beg you…to wear sunscreen. I still encourage you to visit your dermatologist on at least an annual basis.  And while you can’t walk or run in a charity event, you can still donate money to the melanoma organization of your choice.

Be safe out there.  And be sun-safe as well.

She Got What She Deserved…?

Earlier this week I shared an article on my Black is the New Pink Facebook page.  It was written by April Pulliam who shared her life-long experience with tanning which ultimately led to her diagnosis of melanoma.  She admitted that her excessive tanning led to her skin cancers.  “I worked so hard for this damage,” she wrote.  “I paid big bucks for years, but it’s nothing compared to the price I am paying now and will continue to pay for years to come.  A tan was never worth it.”  Obviously this is wisdom based upon a difficult experience and poor decisions.

During the last 6+ years of reading and sharing thoughts about melanoma, I have been exposed to many such stories of tanning leading up to a diagnosis of skin cancer or melanoma.  Some former tanners have died as a result.  Some have survived with minimal scarring.  Many experiences lay somewhere in between the two extremes.   April’s story is not new, nor is it unique.  But it’s a story that should be shared as often as possible so that people understand the impact of tanning.  I applaud April sharing her story and for warning others to not make the same mistake.

The day after posting the article, I stumbled upon a video that April had appeared in which she shared her experience.  Despite the same story, the video had much more impact.  The skin on her face was raw due to the annual application of a chemo-cream that wards off pre-cancerous spots on her skin.  (My brother had used the same cream with the same results at one time during his years-long fight).  Not only was April sharing her story, her appearance conveyed the true struggle in living, red color.  Once again, I decided to share her story on my Facebook page.  The first comment posted to the video was this:

“This story pisses me off.  She got what she deserved.  Myself I NEVER EVER willingly went into the sun without sunblock and I got skin cancer.”

Needless to say, her comment inspired many to respond with angered tone.  I’ll admit that I was quite shocked at the statement as well.  Actually, I shouldn’t say I was shocked…I was disappointed.  As social media becomes an engrained part of everyday life, negativity and insensitivity seems to grow by leaps and bounds.  What people state online is often far more harsh than what one would say to a person to his or her face.  With that in mind, this woman’s statement shouldn’t be shocking at all.  But again, it’s disappointing.

My mom smoked.  She died of lung cancer at the age of 70 years old.  Her health suffered.  But she lived a pretty good life.  I’m biased because she was my mom, but I recall so many more good things about her than bad.  She deserved a quiet, painless death at the end of a longer life.  I wish she would have chosen not to smoke, but she didn’t deserve lung cancer even if she did.

My brother died of melanoma at the age of 55.  He never visited a tanning bed that I know of, but he certainly tanned at the pool in the summers.  Baby oil was his “lotion.”  At the time, sunburns were the enemy which we treated with Solarcaine and aloe.  Once the peeling and pain were gone, the issue of damaged skin was never thought of again.  It’s just how it was.  He led a very successful and happy life with his wife Debbie.  He had a great job which made him happy and they had many good friends.  He deserved to be alive today.  He did not deserve melanoma even if he did get some dark tans.

It seems that the lady that responded to the video did everything that she could to not endure sun damage.  Despite her efforts, she got skin cancer.  Perhaps that’s where her anger grows.  I have a cousin who had mouth cancer, despite never having smoked or chewed tobacco or any other “vices” associated with mouth cancer.  He often questioned why chain smokers would live cancer-free yet he had to suffer.  While most melanomas can be attributed to UV exposure, many cases cannot.  It just happens.  Redheads are predisposed to have a higher risk just because of who they are.  It’s not fair.  But redheads don’t “deserve” skin cancer any more than someone who tans.  No one deserves cancer.

I’ve kept the woman’s comment on my page along with the rebuttals and her counter-arguments.  I want there to be a voice…a dialogue.  I seriously doubt that this lady will take back her words in that her anger seems pretty deep.  I’m not a therapist, so perhaps my assumption about her anger is completely off the mark.  Maybe there is some other reason for her anger.  Or maybe she’s just an ass.

Regardless of who she is, she was diagnosed with skin cancer.  I applaud her efforts to fight off the ill-effects of the sun with sunblock.  I am sorry that she was diagnosed anyway.  I hope she doesn’t have melanoma or that she doesn’t have to suffer as April has or as my brother did prior to his death.  She may have pissed off a lot of people with her remarks, but even she doesn’t deserve the skin cancer she got.

Tanning is Not a Game!

I don’t shock easily.  I may find some things in this world upsetting or confusing or whatever, but rarely does something shock me.

Today, the Facebook Page “Pull the Plug on Tanning Beds” shared a children’s computer game called “Sophia the First Tanning Salon.”  Sophia the First is a popular cartoon princess who appears on the Disney Channel.  If you have any preschool daughters, you have undoubtedly heard of this little princess.   Anyhow, apparently the game allows the user, intended to be a small girl, to learn remedial computer skills by selecting items with the mouse through a tanning process.  “Pull the Plug” was livid and encouraged followers to write to the game company, and to Disney, to complain about this game.

I wrote the following:  "You have GOT to be kidding! The FDA has issued a warning against all minors from using tanning beds as a result of the increased risk of skin cancer and melanoma. And now you're teaching kids that tanning beds are fun? When will you come out with Sophia the First Humidor to teach kids the fun with smoking? How about Sophia the First Binge Drinking? Please take this game down now!"  Others sent similar messages.

But in all honesty, this didn’t shock me.  It surprised me because, while I knew the peer pressure to tan was evident in high schools, middle schools, and perhaps even elementary schools, I never suspected there to be such influence towards preschool girls.  Disappointed?  Yes, but not shocked.

It then occurred to me that Sophia the First might not be the only children’s character to fall to the seductions of tanning.  So I Googled “tanning games.”  I was quite surprised by the number of websites with similar games as Sophia…aimed at preschoolers and girls of all ages.  Again I was surprised and I browsed the many games.  And then…I was shocked:

All images from ogigames.com

Yes, what you see above is the beginning of a girls game called, “Cinderella Pregnant Tanning Solarium.”  I kid you not…this is real!

Per the introduction, “the sun is not strong enough for a tan and Cinderella cannot go to the beach, especially since she is pregnant.  (We’ll assume that she married Prince Charming before she got knocked up.)   She decided to go to the salon and get that perfect summer tan that will perfectly match her beautiful hair. First of all she must prepare for the solarium by choosing a nice bathing suit shave her legs and apply sun lotion for protection.”  (Um…if you’re using a tanning bed you ain’t gonna use sunscreen!)

So, I decided to play the game.  A guiding hand showed the young girl (me in this case) where to move the cursor and click the mouse.  First, one must select a swim suit.  I chose this frilly pink and blue striped bikini:

Next I used bolt cutters to remove any jewelry from Cindy’s body.  This included her necklace, bracelets and ankle bracelet.  Apparently this is to advise that it’s important not to wear metal in the tanning bed.  (I didn’t notice a wedding band either…hmmm)  And yes, I said bolt cutters:

Next I put a comb in her hair to make sure her neck would be nice and exposed to the rays, and then I shaved her legs:

I have no words.

Afterwards I applied “protective lotion.”  If you look carefully you can see the letters UV on the bottle.  They probably printed it so small so as not to lessen the tanning fun with pesky UV statistics.

Finally I gave Cindy her eye protection and it was off to the tanning bed!

Notice that there is a choice of a light, medium or dark tan.  The latter suggests a tanning time of 60 minutes.  Even though tanning salons are sleazy, I’m sure even they agree that poor Cinderella will turn into pumpkin bread after 60 minutes laying in the bed!  But what the heck, I chose dark.  After applying some “After Tan” spray plus a Pumpkin Carriage belly tattoo,  Cinderella was a new tanned (pregnant) princess!

Speaking of princesses, the player can opt for others to partake in this tanning pampering session, including Elsa, Ariel and the aforementioned Sophia.  Neither of the other princesses appears pregnant, but Barbie does indeed show up after having spent a careless night a few months ago with Ken and/or the Toy Story crew.

The point of this message is not to shock you with the story line of the game, but to be shocked that tanning influence exists when our kids are barely out of diapers!  We all know of the “dangers” of what may be online …but this is a different and unexpected kind of danger.  Please speak with your children and teach by example.  Wear your sunscreen, check your skin, and for goodness sake, stay out of the tanning beds!  Tanning is a game you will lose!

Are Tanning Beds Still A Thing? Sadly, yes

John Oliver is a British comedian who had appeared many times on “The Daily Show” with Jon Stewart and who now has his own show on HBO called “Last Week Tonight” which airs on Sundays.  He has a segment called, “How is this STILL a thing?” featuring funny bits on stupid or seemingly impractical practices that continue today.  Examples have included “Pennies,” “Daylight Savings Time,” and “Dressing up as other races.”  Last night he posed the question to tanning beds.  Have a look at the video…

I shared this on my Facebook page and it’s already been seen by many.  It’s refreshing to see a comedic take on the stupidity of using tanning beds.  But at the same time, the question remains, “how are tanning beds still a thing?”  The answer may lie within the video above.

There are organizations listed in the video that support the tanning industry including the Indoor Tanning Association and the American Suntanning Association.  These groups might support a stupid, vain and proven dangerous practice, but they are smart and savvy.

A few years ago, the ASA actually supported the North Carolina bill to ban tanning beds for those under 18 years of age.  Yes, they SUPPORTED the ban.  At the time, I was skeptical of their claim, wondering if they might not be realigning their tanning strategy from targeting high school kids to soliciting the college-age crowd.

I was right.  In the past couple of years, tanning salons have cropped up all over college campuses and some tanning beds are appearing in private and university-owned dormitories as part of an amenity package.  Luckily, there are folks trying to discourage colleges and universities from endorsing tanning businesses.  However, despite increased broadcasts of sunscreen importance and UV ray dangers, more and more “educated” college kids are seeking that golden tan.

But it’s not just the college crowd.  Blatant ignorance still exists in blue collar America.  Despite the warnings…despite the deaths…despite ample information, adults are still choosing to visit tanning salons.

A 34 year-old co-worker who recently started where I work announced last week that she was looking forward to hitting the tanning bed.  Having made the statement in front of me and  having not known my stance, other colleagues backed away as if Clint Eastwood was about to have a shootout.  As expected, I pretty much laid into the otherwise nice and sharp lady about her absolute stupidity at visiting a tanning salon.  Her arguments included, “I’ve been going for years and I don’t have cancer,” “But I never burn,” “My skin is too ugly unless it has some color,” and the classic “I need a base tan for when I’m outside this summer.”  Yes, I rebutted each point (“Each time you go you increase your chances and it’s a cumulative effect,” “Tanning is a sign of skin damage, not just burning,” “Your skin color is beautiful but you will get more wrinkles and sun damage if you continue tanning,” and “Bullshit!”)  Still, she hasn’t changed her mind and despite being older than an over confident college kid, she still approaches tanning with an exuberant ignorance.  It’s really frustrating. 

And yes, tanning beds are still a thing.  Just not a good thing.

<sigh>

Melanoma Does Not Discriminate

In this day and age, the term “discrimination” gets discussed more and more.  It seems like not a day goes by where there isn’t some public policy or some celebrity statement that gets labeled as discriminatory.  It’s true that we all have some bit of prejudice within our personalities.  Whether it be an opinion offensive to many or a private irritation with someone who differs from you in some way, we humans all discriminate on some level.  It’s true. 

There are, however a few things in this world that do not discriminate.  The weather.  Aging.  Hunger.  But of course there is one thing in particular I need everyone to understand that does not discriminate.  Melanoma

My Facebook page is approaching 6,000 likes.  I have been followed by people in all 50 states as well as 69 countries…from Algeria to Zimbabwe.  Each one, I assume have been somehow touched by melanoma.  Believe it or not, I have opened the profiles of every person that has followed the “Black is the New Pink – Fight Melanoma” Facebook page.  Every.  Single.  One.  And while not each one allows access to personal information, most share a photo or two that depict not on what is important to each one’s life, but a bit of their personality.  I can assure you that melanoma does not discriminate.

It is true that melanoma is more prevalent in people with lighter toned skin and blonde or red hair.  But there have been many followers of all skin colors all the way to the darkest of dark.  In fact, since it’s harder to detect melanoma on darker skin, the cancer is usually detected at a much higher and deadly level when ultimately found.  It’s true; people of dark skin should wear sunscreen and see the dermatologist as often as someone with pale white skin like myself.

Religion?  No discrimination there as well.  Christian, Muslim, Buddhists, Hindus, Atheists…you name it and someone from each religion has been touched by the black cancer.  No matter the name of your god or spiritual guide, you flesh is as susceptible as the person’s next to you.  Protect yourself!  Especially you sun worshipers!

Politics?  Whether you “feel the Bern” or “Trust Ted,” your political beliefs have no effect at rejecting melanoma.  Democrats, Republicans, Libertarians, Independents, Socialists, Communists, Anarchists…I’ve had them all stop by my Facebook page.  They’ve all been touched.

Do you preach the moral high ground?  DO you work in the adult film industry?  Are you fighting of an addiction?  Do you work as an executive for a Fortune 500 company?  No matter your social or economic status, you all share in that 1 in 50 chance of getting melanoma, and 1 in 5 chance of being diagnosed with skin cancer.

Do you live along the equator?  South Africa?  Iceland?  Certainly, the more exposure you have to the sun, the greater your risk of melanoma.  However, there are melanoma warriors on every continent at every latitude and longitude on the globe.

No, melanoma does not discriminate.  But it can be resisted.  As stated countless times, protect yourself by wearing sunscreen and protective clothing and gear.  Stay out of the sun at peak times and seek shade.  Wear sunglasses and hats.  And perhaps most importantly, check your skin!  Check it yourself at least once a month and monitor any changes.  Visit your dermatologist at least once a year!  Prevention and detection are the best ways to fight melanoma.  No matter who or what you are.

FDA Proposal and the Need for Continued Education on Melanoma Awareness

Today, December 18, 2015, the Federal Drug Administration announced a proposal of new rules that would ban anyone under 18 from using tanning beds or tanning booths.  In addition, they would require that tanning facilities obtain a client’s signature that he/she acknowledges the risk to one’s health when using such devices.  They also propose that all tanning devices be labeled with a warning that UV radiation can cause skin cancer, skin burns, premature skin aging, and eye damage (both short- and long-term).  This is an effort by the FDA to “improve consumers’ understanding of the risks related to UV radiation exposure.” ¹ 

The primary resource for the FDA’s decision is a 2012 publication by the British Medical Journal (“Cutaneous Melanoma Attributable to Sunbed Use: Systematic Review and Meta-analysis”) which concludes that “sunbed use is associated with a significant increase in risk of melanoma.  This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years).  The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.”²  The study cites well-documented statistics such as tanning beds may emit 10-15 times stronger UV radiation that the sun, UV radiation is classified as a carcinogen, and tanning bed use results in a 75% increase in risk of melanoma (from 40% to 228%) when indoor tanning starts during adolescence or young adulthood.   

The public (including up to 19,000 tanning salons) has 90 days to share comment on the proposal.

This is indeed a great day in the fight against skin cancer and melanoma.  For years, the FDA has been asked to take more action against the use of tanning beds.  Citing the administration’s bans and warnings on tobacco use, the argument was made that more cases of cancer were caused by tanning beds than cases of lung cancer caused by cigarettes.  Today’s action by the FDA is a long time coming.

But this does not close the book on skin cancer prevention.  While there will be harsher warning labels attached to the equipment, the age restrictions apply only to facilities that offer tanning services, such as tanning salons and “health” clubs.  The restrictions do not apply to personal tanning beds.  Additionally, once an individual reaches the age of 18, tanning bed use will be allowed, although the FDA proposal requires disclosure of health risks before allowing an individual to use such a device.  The only real weapon against such use will be in public education.

There are efforts and organizations that are devoted to educating the public on the risks of UV radiation, both from tanning devices and from the sun.  One such organization is the Melanoma Education Initiative.  Founded in 2011, the MEI has been raising awareness about the dangers of melanoma by visiting middle schools with an interactive presentation, visiting high schools and colleges with harder-hitting presentations including first-hand and graphic accounts of melanoma, distributing educational material at community health fairs, and participating in health and wellness events for companies and organizations.

When asked why founder Beth Mancini didn’t just join forces with existing organizations such as the Melanoma Research Foundation, AIM at Melanoma, or others, she responded that “many organizations out there raise money for research which will benefit patients down the road, but we wanted to save lives in a more immediate way by educating people about early detection and prevention. We couldn't find an organization … educating in the way we wanted to, thus, Melanoma Education Initiative was born.”  The MEI was founded and continues advocating near Akron, OH, however Beth. Mancini and her family now reside in North Carolina.  She hopes to expand the MEI efforts within the Tarheel State and beyond.

Much like the aggressive anti-tobacco “truth” campaign to curb youth smoking in the US, the MEI and other organizations hope to equally educate teens and young adults about the dangers of UV radiation.  I encourage you to offer your support to the MEI, or any such educational group in your area as they are in desperate need of volunteers.  While today’s FDA announcement is a red-letter date in skin cancer awareness, the real work of education the public needs to continue.

For more information on the Melanoma Education Initiative, visit their website at http://www.melanomaeducationinitiative.org/.  You can also contact Beth Mancini directly at ewmancini@melanomaed.org.

1.          DEPARTMENT OF HEALTH AND HUMAN SERVICES; Food and Drug Administration; 21 CFR Parts 1002 and 1040 [Docket No. FDA-1998-N-0880 (formerly 1998N-1170)] RIN 0910-AG30 Sunlamp Products; Proposed Amendment to Performance Standard.
2.           Boniol, M., P. Autier, P. Boyle, and S. Gandini, “Cutaneous Melanoma Attributable to Sunbed Use: Systematic Review and Meta-analysis,” British Medical Journal, 345:e8503, December 2012.

Jimmy Carter's Cancer and a Guilty Thought

I had a thought this morning for which I’ve felt a bit guilty all day. 

As I was getting ready for work, I saw the story on television where former President Jimmy Carter was going to share more details about his cancer later in the day.  I couldn’t recall such an event before regarding cancer.  Usually, one announced their cancer diagnosis right away…there was no waiting for an announcement of the specific details later.  “Steven Jobs announces that he has pancreatic cancer.”  “Shannon Doherty reveals breast cancer diagnosis.” “Jimmy Carter has….cancer to be revealed next week.”

I wondered what type of cancer he might have, and it occurred to me that whichever cancer he has will get a real boost in awareness and publicity.  I stopped short of it, but I came damned close to wishing that President Carter would announce that he has melanoma.

All of you should know that I would never ever wish cancer, especially melanoma on any person…not even my worst enemy.  Still, there’s always been this near desperation to have a celebrity representative for “our” cancer.  Bob Marley has been our go-to guy…the perfect example of how melanoma can attack the young and those with darker skin.  However, we still lacked a mainstream face, and don’t think that we didn’t search for one.  Remember how we all shared that Hugh Jackman had skin cancer?  Sure, it was basal cell carcinoma (BCC), but it was skin cancer and a celebrity was talking about it.  We were so “happy.”  And yet, none of us are really ever happy for anyone diagnosed with cancer, even BCC.

As it turns out, Jimmy Carter did indeed announce that he has melanoma that has metastasized to his brain and liver.  I feel awful for him and his family.  While there have been many who have survived a Stage IV melanoma diagnosis, the survival rate is still only 15%.  Many have beaten the odds.  More have not.  This includes my brother Jeff.

It was 5 years ago…almost to the day….that my brother announced that he had Stage IV melanoma that had metastasized to his brain and lungs.  I recall talking to him and he stated how he actually felt quite healthy.  He had plans to go to work for a few months and take some time off whenever the treatments made him feel sick.  He simply couldn’t believe he had cancer, especially cancer in his brain.  Less than a month later, I visited him and he could no longer go to work.  He needed a cane to walk.  His memory and brain functions were diminishing.  He, frankly, looked like he had cancer.  Two months after that, he was gone.

While the prognosis remains dim, President Carter has a much better shot at survival than did my brother.   He is being treated with an immunotherapy drug called Keytruda.   This and several other drugs simply didn’t exist five years ago.  Amazing research has occurred.  However, what remains relatively low on the radar is awareness about melanoma.

The public continues to see melanoma as just another skin cancer.  Just like Hugh Jackman’s BCC, many people think that melanoma can be cut out and all that remains is a large bandage on the nose.  This is simply not the case with melanoma.  As with Mr. Carter, melanoma can form inconspicuously on the skin and spread to other parts of the body if it remains undetected.  It can spread to the liver, the lungs, the brain…anywhere!  It can start anywhere on the skin, including places that never see the sun.  (Yes, even “those” places).  It can start in your eyes or in your mouth.  It is simply one of the nastiest and sneakiest cancers there is.  But make no mistake, no matter where it might occur, it’s still melanoma.

One of my good friends and fellow melanoma awareness advocates (Respect the Rays) posted the following on Facebook today:

“I really hope the media starts calling Jimmy Carter’s cancer diagnosis what is it…melanoma.  It’s not liver cancer…or brain cancer.  It’s melanoma that has spread (metastasized) to his liver and brain.”

It’s a common misconception that melanoma in the brain is brain cancer, or that melanoma in the lungs is lung cancer.  It’s not.  It’s melanoma.  Even my brother had a tough time grasping that.  

When I last saw Jeff, we were playing cards.  When he lost the game, he joking said to me, “yeah…big deal that you beat a guy with brain cancer!”  He always looked at the lighter side of life.  Another time, we were discussing various cancer awareness colors.  “Black is for melanoma, white is for lung cancer, and gray is for brain cancer!  Could I have three more boring colors?”  Again, I loved Jeff's humor, but the fact is, he had only one cancer, and that was melanoma. 

The same is true of President Carter.  He has melanoma.  As a result, the world might learn a little about the disease.  And despite my early morning thought, I really wish he didn’t have it. 

I wish there was no melanoma at all.