"God Made The Sun...Man Made The Chemicals"

A couple weeks ago, I read an online article about a local 22 year old girl who had been diagnosed with malignant melanoma.  Within the article, she was quoted as saying, "they called me about a week later and told me it was melanoma, and I had no idea what melanoma was."

As with most online articles nowadays, there was room for public comment.  One of the first comments was “I'm just amazed that a 22-year-old wouldn't know what "melanoma" was.”  Unfortunately, the girl’s statement didn’t surprise me as I’ve been reading of the ignorance that many people have regarding skin cancer and melanoma.  So I wrote a comment of my own stating that thought.

Other comments were added, but then there was one that simply floored me.  It read, “Skin Cancer does not come from the sun... It comes from all the chemicals you put on your body daily.  (body wash, soaps suntan lotion cologne).. God Made the sun.... Man made the chemicals.”

While I’m sure there are topical products that could in fact contribute to skin cancer, there are literally volumes of research that shows UV radiation from the sun is a primary contributor…if not THE primary contributor.  How anyone can blatantly state that the sun does not cause cancer because it’s made by God is beyond me.  I responded…but only with “whatever you may believe causes skin cancer, it’s still important to see a dermatologist for a check-up.”

The person never posted again, so I have no idea if they read my words or not.  But this really enlightened me about a major obstacle in any awareness campaign.  There will always be people that simply will not listen.  Or, they’re so grounded to their own opinion that no amount of information or pleading will get them to change their mind.  But I’ve decided not to let such attitudes anger me.  Instead, I’ll gladly respect their right to not listen and simply move on to those who might.  And I still hope this guy gets his skin checked out, no matter the cause.

Time To Increase My Own Awareness

I grew up in a time and place where we dealt with sun damage relief rather than prevention.  We had plenty of Solarcaine in the medicine cabinet, but hardly a drop of sun block.  I remember many a night receiving a dose of the cold medicated spray on my back before bed, only to slide under the sheets in burning pain and stickiness.  It was a rite of passage…it was growing up in the summer.

I first encountered true sun BLOCK when my mom was diagnosed with Lupus.  She was pretty much “allergic to the sun” and was told to wear long sleeves and apply a prescription SPF-grade lotion to her exposed skin.  Yes, prescription-level.  So of course, I figured that sunscreen was for sick people…and I kept burning.

Skin cancer was an unknown to me.  Many things that are bad in this world were unknown to me, as were with many kids of my day.  We had no multichannel cable or internet to let us know what was going on in the world.  We simply went outside and played from dawn to dusk.  And when my family joined the local swim club, we spent the entire day there.  And each night, we slid into our sheets, sore and sticky.

I guess my first encounter with melanoma was when my brother told me he had one found on his back about 7 years ago.  I pictured a “bad mole” and when he mentioned it was successfully removed, I figured that was pretty typical…no big deal.  Then he showed me what they cut out.  It looked like a golfer took a divot off his back.  I was amazed by the size of what was cut.  This opened my eyes enough to start seeing a dermatologist every year to have myself checked.  But honestly, I still wasn’t fully aware of it all.

I’ve told the story of my brother several times here, so you know that the melanoma returned last spring, then metastasized in the summer and the took my brother in the autumn.  Now…now I was aware.  And scared.  I started to scan my skin almost daily.  I became intimately aware of every mole and freckle on my body…and I have a lot.  I started to read about melanoma and eventually started this blog and awareness campaign.  I wasn’t sure (still not) if I’ll ever pay for my days in the sun as a child, but I wanted to make sure other people were aware of the dangers.  One would probably think that I became overly aware.

This past weekend in North Carolina, we had temperatures in the mid-80’s and plenty of sun.  It was really the first “shorts and t-shirt” day we’ve had since this past winter.  It was a beautiful Easter morning and my daughter was anxious to go out and play.  Apparently our neighbor just installed a new trampoline, so immediately my parenting mode went into gear about being careful and making sure there was an adult around and blah, blah, blah.  She rolled her eyes and said she’d be extra careful, and out the door she went as I finished my morning coffee.  When my wife came into the room, I told her where our daughter had gone and that I hoped we wouldn’t have to venture to the hospital on this holiday.  She looked at me and asked, “Did you put sunscreen on her?”

Damn.

So I got dressed and headed over after a short while, only to find that she had gone inside to play in her friend’s room.  She told me that it got too hot and, “besides Daddy, you forgot to put sunscreen on me.”

Ouch.

My lifelong habits still need fine tuning.  In fact, despite putting sunscreen on my arms and legs, and wearing a wide-brimmed hat during the Easter Egg hunt, I still found a small sunburn on my temple this morning where I forgot to apply some to my face.  But I don’t see this as a failure.  In all honesty, I’m just now starting this diet of awareness after gorging in ignorance for decades.  So having dipped into the cookie jar this once...and probably another time or two…won’t detour me from continuing my goal of increased awareness.  I need to work on my self-awareness of course.  But I still have to smile, because obviously, my message has made it to one very important little girl.

Can Two Causes Be Supported?

A couple of weeks ago, I made a deadline to make my new prototype “Black is the New Pink” t-shirt.  My family and I were planning to walk in the annual MS Walk for Multiple Sclerosis in support of my father-in-law who has this condition.  A comment was made that I was trying to overshadow one cause with another…trying to trump MS with a t-shirt about melanoma awareness.  I didn’t see it that way.

I was accused of the same thing back in October of 2006 when I wrote a blog called “Not Just Breast Cancer Awareness…but ALL Cancer Awareness.”  I commented on how the pink ribbon campaign for breast cancer awareness surrounded us, but so many other cancers existed that also needed awareness.  My mother died of lung cancer, my brother had a bout of melanoma (I never thought it would return with a vengeance) and I had underwent two biopsies on my prostate due to a cancer scare…but there were no ribbons or campaigns to make others as aware of these “flavors” of cancer like there was for breast cancer.  Some people, including my brother, accused me of being jealous.  As I look back, I think it was more envy than jealousy.

There’s no doubt that the pink ribbon campaign has been very successful.  I can’t imagine anyone wearing or seeing pink without being reminded of the campaign.  And while not every cause can have such a following, I wished that people could become as aware of these other cancers.  Being aware of so many needs would make a person crazy I suppose…so we tend to focus on one.  Or sometimes two.

When I was working on my t-shirt, my thought was that it IS possible to convey one’s interest in more than one cause.  To display a t-shirt for Melanoma Awareness while walking in support of MS was my idea of supporting both at once.  Why can’t those walking also be enlightened to wear sunscreen as they do?

And then irony struck today.  There’s a person I’ve mentioned here before…she goes by “Melanoma Girl.”  I discovered her story and website while doing my own research, and felt compelled to reach out and ride her coat tails a bit as she blogged and shared so much about Melanoma Awareness.    She enthusiastically invited me along for the ride and I attribute the surprise following and success of this blog to her.  She’s done so much through different campaigns and t-shirt sales to promote Melanoma Awareness…her efforts continue to be an inspiration to what my campaign strives.

Anyhow, Melanoma Girl…or MG as she calls herself, announced last week that she had some “funky nodules” to be looked at, and had a biopsy done.  I, along with many of her readers were anxiously awaiting word…hoping above hope that her melanoma had not returned (as it had to my brother).  Today, she shared the news… 

“OK - so here is the news. Good and bad. The Good - no melanoma. The Bad - breast cancer. Can you believe it?  Still processing myself.  I said to the doc - breast cancer? MG can't have breast cancer! How am I going to get both on one T-shirt???? ;-)” 

You’ve got to love her humor and good spirit.

The good news is that the pink ribbon HAS been very successful and so much has been accomplished towards breast cancer awareness and research.  As a result, perhaps MG’s prognosis will be encouraging…much more encouraging than if she was re-diagnosed with melanoma.  And now she has a chance to wear that t-shirt in the MS walk…or in her case, perhaps the Susan B Komen Walk for the Cure.  Her mission has been to “create a local and national community, and partner with as many people and organizations as possible to help raise awareness about melanoma.”  I don’t see where this needs to stop.  It’s her time to ride the coat tail and partner with an incredibly successful campaign, and make her own success even brighter.  And as she does, she’ll continue to inspire little bloggers like myself to keep up the campaign.

She has a tough fight ahead as all do that face any type of cancer.  But in the little bit I'd read about her, she's tougher.

My thoughts and prayers…and respect…go out to MG.

Facebook.com/fightmelanoma

I’m no computer genius.   I’m sure I’ve not posted everything properly or set my links exactly right.  But amazingly, people have been reading my thoughts.  And I truly appreciate it.  My only regret is that I have a blog that is apparently difficult to post comments upon.  A couple of friends and readers have told me they’ve tried to make a comment or add some insight to my latest post, but the blog site I’m using requires a log-in that’s sometimes difficult to figure out.  My sister-in-law, Jeff’s wife, has encountered the same difficulty. 

Until I get the bugs worked out on this blog site, I encourage you to go to my accompanying Facebook page.  Either select the link to the left, or go to facebook.com/fightmelanoma.  Yep, I figured out how to create a URL for my Facebook page so that it’ll be easier to link.  And amazingly, “fightmelanoma” was an available name.  I guess that goes to show you that not enough people are putting up the fight, and that the need to increase awareness is more than ever.

Great Things Are Happening

“Great things are happening!”

I heard those words back in October, 2010.  My brother, Jeff, was in his second month after being diagnosed with Stage IV melanoma which had metastasized to his brain and lungs.  Jeff had a unique form of melanoma, leptomeningeal disease, which spreads inside the fluid cavities and spinal cord.  There really wasn’t much that could be done, and he passed away a month later.

Those words above were spoken to me by his doctor, Patrick Hwu, M.D., Department Chair, Department of Melanoma Medical Oncology at MD Anderson Cancer Center, Houston, TX.  Dr. Hwu called me from Texas while my brother was visiting, and to catch up on old times.  You see, Pat is an old high school buddy and worked with me as a lifeguard for a number of summers.  Yep, he and I sat in the sun for hours at a time, usually covered in nothing but baby oil and iodine.  It’s ironic that he’s now considered one of the leading tumor immunologists in the country.  When he heard of my brother’s condition, he jumped right in to help out.  But we all fear it was just too late.

When I talked to Pat, we obviously discussed my brother’s condition at the time.  I was hopeful for some miracle, as was Pat.  But at the same time, we both knew the prognosis of three months was probably close to the mark.  But Pat shared a couple of encouraging words.  First…”It takes just finding that one cell.”  Yes, a shot in the dark and a needle in a haystack, but that’s the hope every time radiation and chemo is involved…to find that one cell and kill it.  But it was the other words I think about more today.

“Great things are happening!”

At first, I thought this was just a kind statement from a caring friend to give me a bit more hope.  Sure, he knew about what was going on in research more than I, but were great things REALLY happening?

A few weeks ago, the FDA announced the approval of Yervoy as a treatment towards Stage III and Stage IV melanoma patients.  The drug will be used to treat melanoma patients whose cancer has spread to other parts of the body.  It is the first approved drug that has extended the lives of patients with advanced melanoma.

Last week, another medicine, Sylatron, was approved for Stage III patients…those found to have metastatic disease that has reached the lymph nodes.  While the test study showed no increased survival rate, patients taking Sylatron remained relapse-free for an average of nine months longer than patients not taking the drug.  This is a definite improvement and the first new drug for Stage III patients since 1995.

Today, researchers at Yale University announced that a blood test could be used to predict the risk of cancer spreading, or metastasizing, in people who have early-stage cancer.  Being able to use a blood test to predict the risk of metastasis in people with melanoma would be cheaper than the current method of monitoring, which includes periodic imaging tests, physical examinations and blood tests, the researchers said.

 It seems every week, or even every day, there is news about advances towards finding a cure or better treatment against melanoma.  The best fight against melanoma is awareness and prevention, but in the medical battle field, Pat was right…”great things are happening.”

My Visit to the Skin Cancer Foundation's Road to Healthy Skin Tour



4/13/11 - Road to Healthy Skin Tour



The huge, 38-foot long canary yellow RV drew plenty of looks.  It sat parked in the Rite Aid parking lot in Raleigh, and most folks just gazed at some of the messages printed upon.  “Don’t use tanning beds,” “Use sunscreen,” and “Examine your skin” were only a few of the many messages conveyed upon the vehicle.  Many folks walked on to their cars, or into the drugstore, but a few approached the table in front, full of pamphlets and information about skin cancer.  Clad in my homemade “Black is the New Pink” t-shirt, I walked up and started to browse the info (Yes, I picked up every brochure and will share much of the info in future blogs!)



Christie, one of the tour’s hosts greeted me and asked if I’d like a screening.  Yep, that’s what I came for.  As I filled out the form (and not a long form at all) we talked a little about the tour.  It seemed slow at the moment and I asked if they expected a larger crowd, or was a smaller crowd typical.  Christie responded that it all really depended on the time of day, and expected a bigger turn-out the next day when the RV would be available a good chunk of the day from 11:00 to 5:30.



I asked her what criteria determined the stops they would make.  After all, the big city of Charlotte was visited one day while Raleigh was lucky enough to host the tour for three days.  “Volunteer doctors determine where we’ll be.”  While Christie and her colleague Chris host the tour, it’s the volunteer dermatologists along the way that dictate where they’ll stop.  Today’s host doctor was Dr. Maureen Aarons of Blue Ridge Dermatology.  More on her later.



Christie returned inside the RV as I completed the paper work (and grabbed more brochures) and an older lady approached.  I asked her what brought her to the tour and she stated that she had to cancel a planned skin screening with her normal doctor earlier in the month due to a conflict, but felt it was important to “fit one in” while she saw the opportunity.  She went on to state that, when she was a kid, they used cooking oil on their skin to help enhance the tan.  “While I’ve not had any cancer, I’ve had plenty of pre-cancer removed.  It’s important to get checked now and then.”  Good for her.



Christie called me into the small waiting room…more like a bench in front of a small desk (after all, we’re in an RV).  Chris sat inside and talked a little about the tour.  It all started on March 11 in Florida and plans to end in New Orleans in September.  80 stops in 24 states…amazing…and the two of them are driving every mile.  I asked if they had any days off and he responded that they do, but they’re still with the RV.  “On our days off, we’ll take off and go bike riding.”  But since the RV is always promoting skin cancer awareness, it always gets attention.  “We were at a bike park earlier this week and had bikers knocking on the door asking for screenings.  Of course we’re not the doctors, so we invited them to our next tour stop.”



In the Exam Room



I finally went into one of the two small exam rooms.  It was remarkably equipped and comfortable for being a mobile unit.  I was given the option to have my full body screened, my arms and face only, above my waist, or just a specific area of concern.  I chose the full-body screening and disrobed (leaving underwear on) and put on the paper gown.  Dr. Aarons arrived very soon after...hardly a wait at all.  She introduced herself and described what she was looking for the entire time, putting me, the patient, at ease.  This was her first experience with the tour and she was as amazed at the facility as I.  Eventually, she found one spot of moderate concern…a dysplastic nevus.  This is basically a mole that needs to be watched, but no biopsy recommended.



I didn’t ask, but I don’t believe they performed any type of biopsies on the tour.  On the original form that one fills out, the doctor completes the bottom section and returns to the patient.  There’s a checklist for “presumptive diagnosis,” a diagram of the body to indicate the location, and two choices for recommendations: referred (to see a dermatologist for further examination) or biopsy recommended.  It’s up to the patient to take this information and go do something about it.  So far, as of 4/10/11, the various doctors on the tour have found 188 indications of Actinic Keratosis (the most common pre-cancer), 63 Basal Cell Carcinoma (the most common skin cancer), 26 Squamous Cell Carcinoma (the second most common skin cancer) and 11 Melanoma (the deadliest skin cancer).



Had I not been full of questions, the entire process would have taken less than 30 minutes.  Thirty minutes for a full-body skin screening…I believe time well spent.

Many thanks to Christie and Chris for answering my questions (and complimenting my t-shirt) and to Dr. Maureen Aarons for her volunteer efforts.  My only hope is that word gets out along their tour so that more folks can take advantage of this great service!  Please check their website for planned tour stops (http://www.skincancer.org/Tour/). If the tour doesn’t come to your town, please go see a dermatologist and have yourself screened.

Darker Skin is No Defense Against the Sun

“You don’t have a face!”  That’s what my friend said to me after I expressed my frustrations as to why so many people seem to think melanoma is no big deal.

“You don’t have a face…a famous face.  No one famous has had melanoma nor died from it.”  It was pointed out that breast cancer has many such faces (Melissa Etheridge for one).  Lance Armstrong is “the face” for testicular cancer and all cancer for that matter.  Dana Reeve and Peter Jennings died of lung cancer.  Patrick Swayze was a victim of pancreatic cancer.  While grim and macabre, my friend seemed to have a good point.  But then I mentioned the name of someone famous that died from the disease.

“Bob Marley?” exclaimed my friend.  “I never knew.  But…how did he die from melanoma?  He wasn’t white!” 

Melanoma has long been considered a white person’s cancer.  Those with darker skin and more melanin feel that they are immune to this disease.  There’s some truth to this in that darker skin has a natural SPF of about 13.  But if left unprotected, the skin of Hispanics, African-Americans, and all races with darker skin can indeed burn and thus develop skin cancer as easily as those with lighter skin.

Yes, Caucasians are much more likely to be diagnosed with melanoma…about 156 times more likely than blacks and 35 times more likely than Hispanics according to a 2009 study at Northwestern University.  But if detected early, their survival rate is about 91%.  For African-Americans, the survival rate falls to around 77%.  This is attributed to the fact that many general practitioners are not properly trained to discern the various types of moles, freckles and scars from those marks that are potentially life-threatening…especially in darker-skinned races where these marks blend in more easily.

Once again, the solution seems to be awareness.  Although darker skin is more protective from the sun’s rays, all people, regardless of skin color, can get a sun burn if they don’t apply sunscreen.  No one is immune from the sun.  And no sun tan is a healthy tan.

Make sure to spread the sunscreen.  And spread the word.

Cancer rates are down! But....

There are some interesting facts cited in a recent report from leading health and cancer organizations.  For men, incidence of new diagnosis rates have declined for cancers of the prostate, lung, oral cavity, stomach, brain, colon and rectum.  Cancer death rates are also down for each of these cancers.

New cases of Melanoma in men increased 3.1%.  And the death rate is up 2.0%

In women, incidence rates decreased for breast, colorectal, uterine, ovarian, cervical and oral cavity cancers.

New cases of Melanoma in women rose 3.0%.  And while the death rate of the other cancers improved, for women, the death rate remained unchanged…no improvement.

This data backs up the need to increase public awareness of Melanoma and Skin Cancer.  Protecting oneself from the sun with clothing or sunscreen; placing tougher restrictions on tanning beds; and encouraging annual skin exams by a dermatologist…these are the steps of which the general public needs to be more aware.

Please spread the word!