Menace of melanoma Posted Wednesday, July 21, 2004 by arjuna
By Jen Waters THE WASHINGTON TIMES Published July 20, 2004

Henry Lichtenstein of Forestville survived the wrath of Adolf Hitler. Now he is working on defeating skin cancer. During World War II, Mr. Lichtenstein, 82, who is Jewish by heritage, was imprisoned in several concentration camps, including Auschwitz, Mauthausen and Birkenau. Originally from Lodz, Poland, he also suffered in the Lodz ghetto at the hand of the Germans. While under the oppression of the Nazi regime, he was forced to work outdoors in scorching weather, and he suffered several severe sunburns. About 55 years later, Mr. Lichtenstein developed melanoma, a form of skin cancer. The growth on his back was removed surgically in March 1998. He also has developed non-melanoma skin cancers and pre-cancerous tissues that have been excised. "In the concentration camp, you would stay in the sun all day long," he says. "When it got hot, you would take the shirt off. ... Yesterday, I was cutting my grass, and I wore long sleeves, and I have a nice little hat." The number of people developing melanoma is increasing faster than the number for any other form of cancer, according to the National Cancer Institute. In 2003, the American Cancer Society estimates there were 54,200 new cases of melanoma in the United States and about 7,600 deaths. Melanoma accounts for about 4 percent of skin cancer cases but causes about 79 percent of skin cancer deaths. Excessive exposure to sunlight doesn't account for all melanoma, however, says Dr. Gary Peck, director of the Melanoma Center at Washington Hospital Center's Cancer Institute in Northwest. Although medical professionals haven't identified the other causes, Dr. Peck says, doctors are sure they exist. The cancer can occur anyplace there are pigment cells, such as on the genitals, in the anal canal, inside the nose or sinuses and inside the eyeballs. "One patient treated for sinusitis wasn't responding to treatment," Dr. Peck says. "Finally, they did an X-ray and found a tumor, and it was melanoma." Until researchers discover other reasons why people have melanoma, the best way to lower the risk of its occurrence is avoiding too much sun exposure and ultraviolet light, says Dr. Catharine Lisa Kauffman, chief of dermatology at Georgetown University Hospital. If people must be in the sun, she says, they should apply sunscreen with at least 30 SPF before going outdoors and reapply it every two hours, more when perspiring. Further, she says, there is no such thing as a "safe" tanning bed. "Try not to be outside unless you absolutely have to between 10 a.m. and 4 p.m.," she says. "You need to wear a hat, preferably with a 4-inch brim. Wear sunglasses with proper UV protection. ... You need to wear sun-protected clothing. Toss Rit Sun Guard in the wash with clothing to increase its SPF." Factors that increase the risks of melanoma are having more than five serious sunburns as a child, red hair, pale skin, blue or green eyes, freckles, lots of atypical moles, an outdoor occupation, and relatives with melanoma. "To a certain extent, we're a slave to pop culture," Dr. Kauffman says. "If we could get Britney Spears to go pale, we'd be doing great. Nicole Kidman is a good dermatological advertisement." If melanoma is found, patients should return to their doctor for checks every three to six months until the doctor says otherwise, Dr. Peck says. He thoroughly examines Mr. Lichtenstein for new lesions, including on his lips, his scalp, his ears, under his toenails and on the bottom of his feet. The doctor uses a dermascope to examine moles and dark spots on his body. In addition to melanoma, Dr. Peck also searches for other malignant patches, such as basal cell skin cancer and squamous cell skin cancer. "I had one patient where the hairdresser found the tumor," Dr. Peck says. "Sometimes, the part in the hair line can have melanoma; sometimes, under the hair." On other patients, such as Riaz Latifullah, 47, of Northwest, Dr. Peck uses mole mapping, a procedure in which he takes pictures of the skin and magnifies them to analyze skin cancer risk. The images are stored in a computer and are used for comparison during future visits. "I know that melanoma can kill," says Mr. Latifullah, who visits Dr. Peck every six months. "I know that if you catch something that might be cancerous early you can treat it. Given that I have more moles than the average person, it makes sense for me to do it. As a child I ran around in the summer without a shirt on and got very tanned. Now I'm persistent about wearing a wide-brimmed hat." Adults also should make sure to protect their children. Sunburns in the first 10 years of life are the most critical, says Dr. Peck, who has two dozen young patients with melanoma, the youngest of whom is 10. Because there is no known cure for melanoma, early diagnosis is key. Finding a way to thwart the growth of melanoma has been the goal of much of the research funded by the National Cancer Institute in Rockville, says Dr. Scott Saxman, senior investigator in the cancer therapy evaluation program. Recently, scientists have identified a mutation -- a place in the cell where the DNA has changed, often in a bad way -- in one of the signaling pathways referred to as the BRAF gene. A pathway is a mechanism by which cells decide when to grow and divide. Because skin cancer probably has something to do with normal cells undergoing a transformation to malignant cells, finding the mutation has been a significant discovery, Dr. Saxman says. "If we understand better the abnormalities in the cell that have made them a cancer cell, that gives us better information to target the abnormalities," he says. "There is a big emphasis on learning more about the biology of melanoma and how it undergoes the process of being malignant, why it spreads from one space to another, and why it doesn't seem to be sensitive to chemotherapy, like some diseases." More doctors and scientists need to study melanoma and work together effectively, says Bill Marsch, acting executive director of the Melanoma Research Foundation in Princeton, N.J. The organization gives several research grants each year. The association also helps existing melanoma research communities share information through the Society of Melanoma Research, which consists of scientists from around the world. The next meeting will take place in Phoenix in November. "Melanoma has never been attractive to young scientists," he says. "Our goal is to provide grants to encourage young researchers to go into melanoma research." The ABCD Rule for Early Detection of Melanoma Almost everyone has moles. The vast majority of moles are perfectly harmless. A change in a mole's appearance is a sign that you should see your doctor. Here's the simple ABCD rule to help you remember the important signs of melanoma and other skin cancers: A is for ASYMMETRY: One-half of a mole or birthmark does not match the other. B is for BORDER: The edges are irregular, ragged, notched, or blurred. C is for COLOR The color is not the same all over, but may have differing shades of brown or black, sometimes with patches of red, white, or blue. D is for DIAMETER: The area is larger than 6 millimeters (about 1/4 inch -- the size of a pencil eraser) or is growing larger. Other important signs of melanoma include changes in size, shape, or color of a mole or the appearance of a new spot. Some melanomas do not fit the ABCD rule described above, so it is particularly important for you to be aware of changes in skin lesions or a new skin lesion. Other warning signs are: A sore that does not heal A new growth Spread of pigment from the border of a spot to surrounding skin Redness or a new swelling beyond the border Change in sensation ? itchiness, tenderness, or pain Change in the surface of a mole ? scaliness, oozing, bleeding, or the appearance of a bump or nodule.
Source: http//www.fightcancer.org/ACSWW