Monday, November 25, 2013

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.

Monday, November 18, 2013

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 50th 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.

Monday, November 11, 2013

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:





Friday, November 1, 2013

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.

Wednesday, October 16, 2013

Giving...for the Magic

Last week (in October, 2013 for any historians that find this blog post in the future), I attended the MRF Miles for Melanoma Raleigh Walk (the 3rd Annual Amanda Wall – Corey Haddon Memorial Walk).  The event had a near miraculous feel about it.  Nearly 225 walkers participated and over $45,000 dollars was raised!  That is so many more people and so much more money than any of us expected.  While the majority of walkers were local, several traveled many miles from Northern Virginia and Charlotte.  Compared to last year’s Amanda-Corey Walk, this had a much more “Big Event” feel.

Last year in November, 2012, I participated in the Charlotte AIM for a Cure Walk.  That event raised a lot of money as well plus also had many walkers.  Right after the walk, I wrote a blog post reflecting on the event.  My closing paragraph read as such:

 This AIM walk is one of many…and AIM is one of several organizations that host such events.  EVERY walk is special.  Each event raises funds and awareness. Don’t let all the blogs and Facebook posts make you think that this was the ONLY event in which to participate.  Hardly.  It’s one of many, and I encourage everyone to find such an event near you.  AIM.  MRF.  Miles Against Melanoma.  Outrun the Sun.  Each one helps our campaign to raise awareness.

I have the same thought today.

I guess what I’m trying to say is…walk.  Attend an event.  Go to a golf tourney that raises funds for melanoma awareness or research.  Attend a free MRF or AIM seminar and give yourself the gift of knowledge.  Teach a middle school class about sun safety.  If you participate in an event with others, even stranger and particularly with survivors and warriors, you won’t regret one second.

In this day and age, it’s hard to give.  Money is tight (boy don’t I know that recently) and time is tighter in our busy schedules.  But I encourage you to make a moment available to give something.  Save 25 cents a week to donate some day in the future.  Pencil in one weekend out of the year to give time for a walk.  Spend 5 minutes of your Facebook time each night sharing articles on awareness.  Send a “thinking of you” text to a survivor/warrior.

Give.  Not “til it hurts,” but until you can’t stop smiling.

 
Postscript:

I have many friends walking in the 2014 Charlotte AIM for a Cure Walk next month.  I won’t be able to attend this year (which is why I pour so much of myself into the MRF Walk), but I ask that you support one of the AIM walkers.  It doesn’t matter which…the money will go to the same place.  Click here for the donation page.

There is also another event in North Texas affiliated with the Miles Against Melanoma organization.  Click here for their donation page.

I invite you to check out my “Melanoma Awareness and Fund-RaisingEvents” link for many such events.  I’ll be adding 2014 events soon, but there are still plenty of 2013 events scheduled.  Look for one near you!

Saturday, October 12, 2013

The Speech


I was nervous.  I don’t like being out of my comfort zone and public speaking qualifies as being WAY out of my comfort zone.  But I had a message I wanted to share, so I spoke.  I shared Jeff’s story and message to a crowd of around 200 walkers who were anxious to start walking.  I wondered if I would be heard…if the message would be heard.  I wondered if I would pass out.

But Timna spoke before me and did a fabulous job.  And I knew she was nervous…beyond nervous.  But she shined and thus gave me confidence to speak.  (Thank you Timna!)  

I wish I had my speech on tape.  There was a camera crew on site to film a video about the entire Amanda Wall – Corey Haddon Memorial Walk experience, so perhaps one day I’ll have it to share.  Such a tape would catch the adlibs while the train whistle blared behind me…and when I challenged anyone to debate on the (lack of) health benefits of tanning.  Oh, and I was wearing a tutu the entire speech.  But until I have such a video, I’ll share what I wrote for the speech instead.

One more thing the copy below doesn’t share is the joy I felt when someone approached me afterward, promising to make an appointment for the dermatologist on Monday morning.  That, my friends, is exactly why it was worth stepping far from my comfort zone.

The Speech:

A little over a year ago, I was fortunate enough to meet Don, Rebecca, Chap and Diane.  I never met Amanda or Corey, but through their family and friends, I discovered that both were amazing girls that were taken from us far too early by melanoma.  Like many of you, I walk here today in their honor.  But I also walk in honor of my brother Jeff.

In 2004, Jeff had a large ugly mole on his back.  His wife convinced him to see a dermatologist.  He diagnosed it as early stage melanoma and had it surgically removed with clear margins.  That means the melanoma was completely removed.  But that was to be expected…after all, it was just skin cancer, right?  I mean, you just cut it out and go on with your life…no big deal.  At least that’s what everyone thought…me included.

But Jeff knew it was a big deal…he knew the seriousness of melanoma.  He knew that he dodged a bullet.  He knew he had a new lease on life, and he started to live more healthily.  He lost weight, got his diabetes in check, exercised more, and stopped smoking.  He encouraged others to be sun safe and convinced many to see their dermatologist…including me.  He became involved with the Special Olympics and Relay for Life.  But at the Relay for Life, he’d never visit the survivor’s table to get a special ribbon or t-shirt.  Jeff felt that he wasn’t worthy of being called a survivor because he hadn’t undergone the radiation or chemotherapy that so many others had. But he was wrong.  He was a survivor because he suffered the mental anguish of knowing he had cancer.

In 2010, Jeff visited his general practitioner for a physical.  The doctor said Jeff was in the best health that he’d seen in years, and he asked Jeff if he had any questions or concerns.  Jeff responded that he felt great, but that he had some dizziness, that letters would seem to move as he was reading, and that he was having memory lapses.  The doctor joked that it was probably due to getting older, but decided to order an MRI to make sure things were okay.

What they found were three one-inch tumors in Jeff’s brain and numerous tumors in his lungs.  The melanoma was back.  You see, for anyone that has had melanoma, there is a one in three chance that it will reoccur.  This is exactly what happened with Jeff.

So in August of 2010 after an otherwise healthy check-up Jeff was diagnosed with Stage IV melanoma.  In November, three months later, Jeff died.

I visited with Jeff in September, only one month after his diagnosis.  His health has deteriorated quickly.  He was bloated from the steroids, his hair was gone, and he was using a walker because he was rapidly losing his motor skills.  When he talked with you, he would stare through you…partially because he was slowly going blind and partially because he had trouble recognizing people.  I had to remind him who I was several times.  But we still had some good conversations about our childhood and other misadventures. 

He told me a story about how he went to the University of Pittsburgh Cancer Center for cancer treatments.  He visited the gift shop to look for anything related to melanoma.  Because the color for melanoma is black, he sought out black ribbons…black wristbands…black car magnets.  But all he could find was pink.

Jeff and I both have family members and friends that have battled breast cancer, so we had nothing but respect for the pink breast cancer awareness campaign.  But Jeff told me that he was SO disappointed that there was nothing black at all.  Jeff said to me, “Alan, I wish that just once, black would be the new pink.”  I have a blog for melanoma awareness and that’s what I named it to honor my brother…Black is the New Pink. 

But I’m not here to promote my blog, I’m here to share Jeff’s message which was the next thing he told me in our conversation.  Jeff said, “People need to know.”  That’s all he said, but I knew what he meant.

 People need to know about melanoma.  People need to know that one person dies from melanoma every hour in the U.S.  People need to know that 1 person out of 5 is diagnosed with potentially disfiguring skin cancer, and 1 out of every 50 will be diagnosed with melanoma in their lifetime.  People need to know that melanoma is the number two cancer killer for people ages 15 to 25…so it’s not just an old person’s disease.  People need to know that Bob Marley died from melanoma on his toe…so it’s not just a fair-skinned person’s cancer and it can occur anywhere on the body.

But people need to know that you CAN go out and enjoy the sun.  Jeff loved the outdoors.  He hiked, geocached, golfed and worked in his garden.  He wanted people to know how to be safe in the sun.  People need to wear sunscreen…every day…even on cloudy days.  People need to wear hats.  People need to wear sunglasses, because melanoma can occur in the eye!  People need to stay away from tanning beds because there is not one healthy benefit to using a tanning bed…period!  But most importantly, people need to know to see their dermatologist.

Your skin is your largest organ!  Your skin is you most exposed organ!  Your skin is your most damaged organ!  You visit your dentist once or twice a year... you visit your family doctor once a year, so it only makes sense to visit your dermatologist once a year.  If you haven’t seen your dermatologist in a while, I encourage you to call and make an appointment Monday morning!

People need to be aware of melanoma.  But people also need to take action against melanoma.  You are taking action today by participating in this walk.  Please continue to take action after today by sharing the stories you hear today.  Take action by wearing sunscreen, avoiding the tanning bed,  and visiting the dermatologist, and encouraging others to do the same.  If you have to wear a black tutu to get their attention, please do it!  Do so in honor of Amanda, Corey, Jeff, and the many thousands who are touched by melanoma every day.

Thank you.

Wednesday, October 2, 2013

No Man is an Island


It’s hard to believe that it's been three years since I last hung out with my brother.  I shared that weekend with you before.  And I’ve certainly shared this photo with you many times:


There are several reasons I’m so attached to this photograph.

  • It was the last photo taken of just me and Jeff.
  • It’s a damned good photo of us both.  Jeff doesn’t look like a man who only had three months to live.  Despite the cane, he looks strong and happy.
  • We’re hugging.  That might be the only photo of us hugging…ever.  I think that act alone was a wordless way of saying we knew this photo was to be the best one.
  • We were geocaching together…something we both shared a joy for at the time.  (I’ve rarely been caching since his passing.  One’s passion lacks, well, passion when the person you enjoyed it with has passed on).
  • I like where it was taken.
Back to the caching.  We were on a quest to make my 300th cache find the one he had placed for other to find.  I wanted the milestone to be his cache.  However, I had about 293 cache finds thus far, so we had to grab a few before his.  Number 299 was this one.  Here’s an aerial view of the location:

The island of No Man is an Island
 
 

I had taken photos of other cache finds that day, but something told me that I needed to take our photo here.  On this island was a picnic table on which to place my camera at the perfect angle.  It was like the photo was meant to happen.  After the photo, we found the cache in the lone tree on the island.  We read the title.  “No Man is an Island.”  I smiled and said to Jeff, “kind of appropriate, don’t you think?”  He responded that he agreed, and we did an awkward one-armed hug as I stabled his stance as we turned around to leave.

I reminisced about this day and decided to check in on this geocache on the official website.  It turns out that mere weeks after we found this cache, the tree was cut down and the cache disabled.  We were nearly the last to find it.  It’s as if the geocache location remained just long enough for us to find it and have out last photo taken. 

Postscript:

I wrote this piece on September 26, but wasn’t able to share my thoughts with you until tonight.  Since then, my wife Kim and I shared our 17th wedding anniversary.  The best man at my wedding was Jeff:
 
Jeff choking me..."Don't do it!"  :)


Kim and I spent our anniversary (with the kids in tow) with a weekend at Myrtle Beach, South Carolina.  While there, we had the good fortune to meet up with my sister-in-law Debbie, Jeff’s wife.  Debbie took Jeff’s death very hard…VERY hard.  But I’m happy to say that she is well and loving life again.  She’ll always love and miss Jeff…as we all will.  I hope that Debbie realizes that no man is an island, and we’re here for her.
 
Kim to my right and Debbie to my left.