Basal Cell Carcinoma

By now, you’ve most likely seen this photo of Hugh Jackman.

 

The Wolverine himself announced to the world that he had skin cancer, basal cell carcinoma, removed from his nose.  The bandage wasn't because he had plastic surgery or was in a fight.  He had skin cancer.  This photo made it to all the entertainment news shows while the phrase “skin cancer” was simultaneously spoken.  That’s a good step to increasing awareness.  But what exactly is basal cell carcinoma and how serious is it?

Basal Cell Carcinoma (BCC) are abnormal growths from the basal cells of the skin, which are located in the deepest layer of the outer skin.   The very rarely spread to other areas of the body, but they can grow in size and become disfiguring if not addressed.

BCC usually occurs on skin that is exposed to the sun the most, such as on the nose, ears, face, scalp, neck, shoulders or back.  It can develop by other means (radiation exposure, contact with arsenic, tattooing, complications from burns, etc.) but UV radiation is the primary cause.

While anyone can get it, those with fair skin, red or blonde hair, and blue or green eyes are more likely to be diagnosed with BCC.  Treatments can range from topical medications, cryosurgery (“freezing it off”), radiation, or Mohs surgery.  Basal Cell Carcinoma is rarely fatal, but again, can become rather disfiguring and scarring, particularly if left untreated.

Skin cancer in general is diagnosed annually more than cancers of the breast, colon, lung and prostate combined!  BCC is the most common form of skin cancer with about 2.8 million occurrences diagnosed every year.

Basal Cell Carcinoma is very treatable and, unfortunately has led to the “simply cut out skin cancer” mentality.  But even if the treatment is that simple, multiple scars and potentially disfiguring surgery is never a preferred choice for anyone, particularly A-list Hollywood stars.  BCC can be quite serious, even if it is “just skin cancer.”

 

I invite you to visit the Skin Cancer Foundations website at www.skincancer.org for more information.

Thoughts on One Sibling's Passing

A few years after my mother passed away, I decided it was not healthy to “recognize” the anniversary of her passing.  You can’t really call it a celebration, but “honoring” and grieving over my mom’s death on the same day in January held me back.  Deciding to celebrate her birthday instead was a very healing decision.  I still note the day she died on my calendar, but over time, it’s simply become a date.  I’ve tried to do the same thing with my brother’s death.

My brother died on November 15…and his funeral was on November 18…exactly three years ago today.  It’s been hard to pass up his “death anniversary” this year because of another death that occurred around this time of year.  John F. Kennedy.  Obviously, the day JFK was shot changed this country, and that’s why we see so much coverage, especially on this 50^th anniversary of his death.  Having all the media and the entire country recall the death of one person can’t help but spill over and cause me to think a bit more about my brother’s death than I’d like.  Well, not about his death, but about the void left behind.

My mother’s death devastated me.  I’ve not admitted it before, but I had to take anti-depressants after her death to try to cope.  It turned out the treatment was far more damaging and I had to end up dealing with things on my own, resulting in the realization I mentioned before…to focus on her life and not her death.  Jeff’s death has affected me in a far different manner.  His illness leading to his death was far more painful.  His death was more of a message to me.

I guess we all expect parents to die before us, but most of us never want our mommy or daddy to go away.  (Yes, I have referred to her as “mommy” more so after she died).  It hurts when they’re gone, but it’s the natural progression of things.  But when a sibling dies, a piece of our own soul dies as well.

Jeff’s illness scared me on so many levels.  Having a sibling die forces one to face one’s own mortality.  We’re from the same generation, which means death can come knocking on my door at any time.  I’ll say it again…it scared me.

My brother and I weren’t incredibly close.  We weren’t the types to call daily or to keep in touch with every aspect of our lives.  We were seven years apart in age and that’s an eternity when you’re growing up…and it takes a lot of adulthood to start closing that gap.  We were JUST at that closure when he left.  That hurt.  It’s not his fault…but I felt that a life-long bond that had just formed was brutally ripped apart.  I’ll say it again…it hurt.

And then there was the realization that despite not being stereotypically close, we were indeed close.  So many times after he passed, I thought of calling him to ask about a family member, or to call him to discuss the latest WVU game.  When I would geocache and come across a little adventure I’d want to share, I would start to email him.  But he was gone.  I never knew how much of me was shared with my brother.  And now that was gone.

Every person has a unique relationship with his or her sibling.  My relationship with Jeff is far different that yours with your sibling.  My reaction to his death is different than yours will be…or was.

I’ve mentioned here before that Jeff’s death became an inspiration and that I started this blog and campaign in his honor.  That’s true.  But I also started it out of fear.  I had to know if I was at risk of a similar melanoma diagnosis.  I started it from the hurt because a bond between us was torn, and I hoped the campaign would somehow mend that.  I started it to keep my brother here, at least his memory.  While I receive compliments and assurance from others that I’m carrying out that mission successfully…and that he would be proud, I have so wished that I could hear that from Jeff.

I’m not an overly religious man.  I’m perhaps more spiritual than anything.  I also try not to be sappy.  But on Saturday, November 15 at about three years to the minute of his death, I was walking along the beach with my daughter.  It was a cloudy, gray day.  I looked out over the ocean and I saw a sight that gave me that assurance that Jeff was indeed aware…and was still here in spirit.  I saw a rainbow within the clouds.  (The photo I took doesn’t do it justice…the colors I saw were so vivid and bright)  Yeah, I know it’s a natural phenomenon related to ice crystals and light refraction…I’ve seen it many times before.  But for some reason, this sighting reassured me.  This sight said…everything.  This was Jeff.

I’ve felt scared, hurt and empty.  Now I feel assured and recharged.  November 15 will always be a date to mark the day my brother died.  But it’ll also be merely another day on the calendar…another day t o live.

Amanda's Story...Michael's Mission

It’s a story repeated all too often in “Melanoma Nation.”  A beautiful young woman finds that an innocent looking mole is actually melanoma.  She discovers that the melanoma is far more serious than “just skin cancer” and enters a fight for her life.  A few such women have been fortunate enough to fight their way to N-E-D status (no evidence of disease) while far too many passed away.  Such is Amanda’s story.

Amanda Faye Brown had a pencil eraser sized mole on her shoulder.  Her husband Michael thought of it as a beauty mark.  But eventually, Amanda saw a dermatologist and it was determined to be Stage I melanoma.  It was surgically removed with the assurance that it was all gone.

It wasn’t.

In November of 2004, a small nodule was spotted on the inside of her thigh as well as a couple on her abdomen.  The melanoma had been spreading within her body for the previous two years. She was diagnosed as Stage IV.  A dozen or so tumors were discovered on her lungs and she was given a few months to live.  She fought on for longer, but died on April 15, 2006 at the age of 31.

Amanda kept a journal of her fight so as to enlighten others of the horror of this extremely dangerous cancer.  Michael had vowed to educate others so as to prevent this same tragedy in other families.  He began speaking at local middle schools and high schools and sharing Amanda’s story.  A few months ago, he published a book called Finding N-E-D, No Evidence of Disease.  The book is a compilation of Amanda’s journal entries intermixed with Michael’s own thoughts and memories.

 

 

Tomorrow, on November 12, 2013, Michael embarks on a multi-city tour to speak with over 2,500 students nationwide. He calls the tour “Amanda’s Message Tour.”  He begins in Erie, PA at MacDowell High School.  Today (November 11, 2013), he visited the regional cancer center in Erie where he entertained and shared some fun moments.

You see, Michael is the saxophonist for the legendary rock group Sha Na Na.  He told me of today’s visit to the cancer center, “I played my sax and sang a few Sha Na Na songs.  We played ‘Name That Tune!’  It was a fun moment with awesome patients!”

Michael is doing a great thing…sharing Amanda’s story, helping to cheer up those who are fighting for their lives, and educating kids on sun safety and skin cancer.  But Michael needs some help.  He has a lot of heart to tackle this tour, but unfortunately he has limited funding.  He could use our help.

I know this is a big time of year for charities and holiday gifts, so it’s not always easy to give.  I know the Charlotte AIM for the Cure Walk is upon us on November 16, and so many of you are spending cash to participate or donate.  Still, I ask that you spread the word and continue making a contribution to Michael’s mission.  He had set a goal of $6000 to help pay for the expenses of the tour (he’s driving his own car and looking for modest priced motel rooms along the way).  So far he’s raised $530…not even 10% of his goal, and his tour starts tomorrow!

If you can help, thank you.  If you can’t with a donation, then please spread the word of Michael Brown’s mission and encourage others to make a contribution.  And if you live in any of the following cities, spread the word to local media and consider attending yourself.  Here are the tour dates:

Nov 12                  Erie, PA
Nov 13                  Mansfield, OH
Nov 14                  Cincinnati, OH
Nov 15                  Owensboro, KY
Nov 18                  St. Louis, MO
Nov 19                  Springfield, MO
Nov 20                  Mustang, OK
Nov 21                  Amarillo, TX
Nov 22                  Albuquerque, NM
Nov 25                  Winslow, AZ
Nov 26                  Kingman, AZ
Nov 27                  Las Vegas, NV

For more information on Amanda’s story and Michael’s mission, please check out some of these links:

News Broadcast of Amanda’s Story

Another News Story on Amanda and Michael’s mission

Reviews of Finding N-E-D No Evidence of Disease.

Where to Purchase the book.

Where to donate to help Amanda’s Message Tour.

Comparing Survival Rates of Breast Cancer and Melanoma

I posted a recent commentary article written by someone else on my Facebook page that had a remarkable statement. “The survival rates for stage II melanoma are the same or worse than for stage III breast cancer.”  That got my attention, so I decided to dig in a little more.

A survival rate tells you what percentage of people will survive a certain type of cancer after a specified number of years.  In most cases, the survival rate is measured for 5 years.  For instance, a survival rate of 80% means that 80% of the people with that cancer survived, or were alive, after 5 years.  Conversely, 20% of the people died.  This is calculated based on the study of hundreds or thousands of people who have been diagnosed with the various cancers.  As I mentioned in an earlier post, “surviving” may not mean you’re cancer free or not undergoing treatment.

As I see it, the survival rate of a cancer dictates just how deadly that cancer can be.  However, a cancer with a low survival rate might not be the more widespread killer.  As stated in the original quote, melanoma has a lower survival rate than breast cancer, but statistics also show that there are about 5 times more cases of breast cancer per year than melanoma cases.  Breast cancer is a grenade which affects many while melanoma is a stone cold assassin which targets a few with greater efficiency.

How do the different cancers compare?  I checked into the American Cancer Society’s website and found the survival rates for each stage for both breast cancer (obtained from the 2013 National Cancer Institute’s SEER database) and melanoma (obtained from the 2008 AJCC Melanoma Staging Database):

Breast Cancer		Melanoma
Stage	Survivor Rate	Stage	Survivor Rate
0	100%	Not reported
I	100%	IA	97%
		IB	92%
II	93%	IIA	81%
		IIB	70%
		IIC	53%
III	72%	IIIA	78%
		IIIB	59%
		IIIC	40%
IV	22%	IV	15% to 20%

 

As you can see, there are indeed levels of Stage II melanoma which have a lower survival rate than Stage III Breast Cancer!

So what does this say?  It implies that breast cancer research has been very successful in recent years, thus increasing the overall survival rates.  In fact, according to the American Cancer Society’s “2013 Cancer Facts & Figures” report, breast cancer has an overall (all stages together) average survival rate of 89%.  Melanoma’s overall survival rate is 91%.

Hmm... that is interesting.  Is research responsible for melanoma’s higher overall survival rate?  Most likely not.  These figures were taken in 2008…before incredible medical advances such as Yervoy and Ipi.  Melanoma has always had a high OVERALL survival rate because so many more people catch melanoma in the earliest stages as opposed to many other cancers.  Why?  Because we can see it on the skin!  While this seems like great information, it hasn’t been the best news for melanoma researchers.  After all, if a cancer has such a high survival rate, why pour money into researching a cure when other cancers need more desperate help?  I’m sure this has been the challenging argument for melanoma researchers for years.

It’s important for those donating money to understand the nature of advance stage cancers.  Stage II breast cancer has a 93% survival rate.  Stage IIC melanoma has a 53% survival rate!  That’s an alarming difference!  This gap can only be filled with additional research.

To me, this set of data tells demonstrates two things.  First, as I said before, advanced melanoma is a stone cold killer.  But secondly, and more importantly, melanoma can be defeated if detected early.  There have been great things happening to further successful melanoma treatments, but so much more needs to be done.  The greatest weapon against this assassin is you!  Get your skin checked annually by a dermatologist and check your own skin monthly.

 

Post script:

As I reviewed the data found in the American Cancer Society report, “Cancer Facts & Figures 2013,” I noticed the survival rates of other cancers.  In particular cancers of the lung and pancreas have remarkably low overall survival rates.  Compared to melanoma at 91%, lung cancer comes in at only 16% and pancreatic cancer at 6%.  Stage IV rates for each respectively are 4% and 2%.  More people will die of lung cancer this year than any other cancer.  Cancer of the pancreas is statistically the deadliest of all cancers.

November is the awareness month for both Lung Cancer and Pancreatic Cancer.  The pink ribbons and football cleats have been put away now that October is over.  No one will likely be wearing white (lung) or purple (pancreas) in November…at least not for awareness.

Please continue your support for melanoma awareness and research, but take some time this month to lend your heart and hand to pancreatic cancer and lung cancer…the latter which took my mom’s life in 2005.