|Melanoma : A Most Deadly, but Treatable Skin Cancer|
Melanoma : A Most Deadly, but Treatable Skin Cancer
By Staff Sgt. Marcia Triggs, Army News Service.
Washington D.C. -- (ANS) June 27, 2001 -- Every hour someone will die from the fatal skin cancer, melanoma. Although some will get the disease genetically, health officials point out the best preventive measure is to avoid excessive sun exposure.
Avoiding the sun's rays is not possible for soldiers who are training for real-world engagements, but it is the commander's responsibility to make sure his soldiers are wearing sunscreen, said Lt. Col. George Turiansky, assistant chief of Dermatology Service at Walter Reed Army Medical Center, Washington, D.C.
Melanoma is the least common of three basic skin cancers - but the most deadly, according to the American Cancer Society, and it is treated by surgically removing it. While the number of soldiers who have been medically discharged because of skin cancer is low, this year's numbers have almost surpassed the number of soldiers discharged two years ago, despite six months remaining this year.
In 1999 there were six cases, last year there were 12, and this year five soldiers have been separated or retired from the Army after a medical board determined they were unfit for duty, said Dr. Charles Peck, senior medical adviser for U.S. Army Disability System at Walter Reed.
An estimated 51,400 new cases of melanoma will be diagnosed this year in the United States, that's a 9 percent increase from last year, according to the American Academy of Dermatology. It's unclear if soldiers are also increasingly being diagnosed with melanoma and other skin cancers because officials say the Army doesn't keep a database.
During the summer months many people spend hours relaxing, playing or training during the hottest times of the day. However, people who have excessive exposure to ultraviolet radiation are more at risk of being diagnosed with melanoma, Turiansky said.
"The beach is a beautiful place, but there are life-saving rules that need to be followed before going out there," Turiansky said. "You modify your lifestyle to do what's good for you and protecting yourself from the sun is good for you.
"One out of 71 Americans have a lifetime risk of developing melanoma, but I still see soldiers running in the sun without shirts and sunscreen use," Turiansky said
Excessive exposure to the sun should be avoided between 10 a.m. and 4 p.m. because that's when the rays are the strongest, Turiansky said. Sunscreen should be applied at least 15 to 30 minutes before going outside and it should have at least a sun protection factor of 15, he said. People should wear hats and clothing that will cover their skin, he added.
Tanning beds are also unsafe, Turiansky said, because any exposure to ultraviolet light is harmful.
There are many possible reasons melanoma incidences are increasing at alarming rates. One reason, Turiansky said, is that individuals are living longer, which may possibly result in more skin diagnosises with time. The ozone layer is thinning, and people are less protected against the ultraviolet rays, he said. Also, more people could be going to the doctor when they notice changes on their skin. He added that public awareness of the disease has increased with media attention.
However, it is very clear to health officials that the fatal skin cancer can strike anyone.
A fair-skinned major, who was at the peak of his Army career, noticed a mole on his body that started getting larger over time. Moles and skin growth that change in size and color may be the warning signs of skin cancer, Turiansky said. The major said he had never been one to spend a lot of time in the sun, but a doctor diagnosed the mole as malignant melanoma.
Twenty years and six melanomas later, now retired Col. Ralph Churchill, spends every six months in a dermatologist's office being examined for reoccurring or new melanomas.
"It was never really determined how I got it. Some attribute it to the sun," Churchill said. "But it's something that will be a part of my life for the rest of my life, and I have to deal with it."
Caucasians are 10 times more likely to be diagnosed than other races, according to the American Academy of Dermatology. Individuals with increased chances of being diagnosed are people who have fair skin, moles, freckles, blond or red hair. The risks increase if individuals have parents, children or siblings who have had melanoma and if a personal history of prior melanoma exists.
People like Churchill who have been diagnosed once with melanoma are nine to10 times more likely to develop another melanoma, but if the cancer is diagnosed in the early stages and confined to the upper layer of the skin it can usually be treated successfully, Turiansky said. However, if not detected in its early stages, melanoma is a very aggressive disease and can spread to organs inside the body, which leads to metastatic disease, he said.
Metastatic disease is melanoma that has spread beyond the skin. Surgery for patients with widespread metastasis is not an option and long-term survival is uncommon, Turiansky said.
When melanoma goes untreated it goes deeper in the skin and beyond to other organs and the prognosis gets worse, Turiansky said. This is the reason, he said, dermatologists stress the A-B-C-D rule, a way examining existing or new moles.
The A stands for asymmetry, which means if the mole is divided in half it should be a mirror image of itself. The B is for border irregularities. The C is for color variation, which means the pigmentation is not uniform. The D is for diameter. The width is greater than six millimeters.
"I recommend that people do self-examinations in front of a long-length mirror and with a hand-held mirror to get the back and other hard to see areas," Turiansky said. Melanoma can develop anywhere there is skin or mucos membranes. Most common sites are the upper back for both men and women and the legs for women."
Turiansky said there are a number of reasons more people are being diagnosed with melanoma every year, but the best way to combat the disease is to avoid excessive ultraviolet exposure, cover the skin with sunscreen and clothing, perform self-examinations, and report any changes to a doctor.