Miles 4 Melanoma

A special Thank You to the Cleveland Hiking Club for including us in the August 2008 issue of their monthly member newsletter, Newsteps:

Kevin Madzia, a resident of Peninsula and a 3-year CHC member, along with his friend and co-worker Ray Query, who lives with his wife in Lakewood, will be starting an 8-month-long bicycle trip this month. They will depart from Cleveland on August 24, 2008, during a kick-off party held in conjunction with the Walk+Roll Cleveland event at Rockefeller Park. They hope to complete their trip by April of 2009 in Tierra del Fuego, Argentina, at the southern tip of South America.

The two cyclists are doing the trip to raise awareness of melanoma, the most deadly form of skin cancer, and hope to raise $20,000 for The Melanoma Research Foundation. Kevin’s father passed away from melanoma in 2002. All funds raised through the event are tax-deductible, and go directly to support the Melanoma Research Foundation’s mission of Research, Education, and Advocacy.

More details can be found at their web site at http://www.miles4melanoma.com. Online donations can be made on the web site, or donations may also be mailed to: Kevin Madzia, PO Box 546, Adena, OH 43901.

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From the July 8, 2008 edition of the Plain Dealer:

Matt Underwood, 40, is a play-by-play announcer for the Cleveland Indians telecasts on SportsTime Ohio. He was diagnosed with melanoma in October 2005. Here’s his story, as told to Plain Dealer reporter Angela Townsend.

I always looked at skin cancer as something that wasn’t really cancer. If you found that you had it, it was something you had taken care of and it was no big deal. But I got a kind of wake-up call about how dangerous they can be, how frequently diagnosed they have been in the past five to 10 years, and that if you don’t catch it in the early stages, it could be deadly serious.

I’m 50 percent Greek and have fairly tolerant Mediterranean skin. I never was the kind of person that really worried about skin cancer. But that doesn’t mean anything. Just because your skin doesn’t burn doesn’t mean you can’t get skin cancer.

My case is also something where people who are in the service industry — a hair stylist, massage therapist, etc. — take it as their response to check somebody out.

I’m not going to look at my scalp very often. You’re not going to turn around the mirror and check out your backside a lot.

I’ve been going to my barber, Steve Averill, since 1993. He’s right downtown on Lakeside Avenue. He was the one that saw something on my scalp and said, "You better have this checked out." A dermatologist removed it, and I didn’t think there was anything to worry about. I went back two weeks later to get the stitches out, and he referred me to (an oncologist) at MetroHealth Medical Center. They do something called "excise the margins," where they put you under (with anesthesia) and remove the cells in the surrounding area. I had the surgery in early December (2005). I was in the early stages, stage 2.

I go to the dermatologist twice a year and my oncologist twice a year. I’m seeing somebody every four months. I’ve had at least four other suspicious moles removed, and they all came back normal. If you’re diagnosed, especially in the early stages, the chance of the cancer returning at the same spot is (rare). And if your tests come back negative, they keep lowering the bar (of the chance of a recurrence) every time.

I’m the only one in the family who has had melanoma.

My wife is extremely cautious. She slathers up the kids (two sons, ages 6 and 9) with SPF when we go to the pool in the summertime. She’s got them trained to the point that they ask for it before they go out.

I wouldn’t say that I have become 100 percent diligent, but I don’t go out in the sun and bake all day at the beach. If I’m going to play golf, I’m wearing a hat. On TV, I can’t wear a hat. But I’m not going to be out there four, six hours at a time. I take it in very small doses.

I think about the fans in the bleachers every day who take their shirts off, and they’re bright red by the end of the game.

It’s nice to know that my story resonates with people. I just hope — if one person hears about it, and it causes them to make an appointment — that’s great.

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From the July 8, 2008 edition of the Plain Dealer:

by Angela Townsend
Plain Dealer Reporter

For many of us, summer wouldn’t be summer without a beach vacation.

Or a tan.

Or both.

Most people are well aware of basic moves (avoid direct sunlight at peak hours, wear sunscreen and a hat) to keep from getting a sunburn and lessen the risk of skin cancer.

But there’s a lot more that you need to know. Here are some common myths.

Myth: Sun exposure is the only determinant of skin-cancer risk.

Truth: Genetic risk is an important factor, especially for melanoma, the deadliest form of skin cancer.

More than 62,000 cases of melanoma will be diagnosed in 2008, the Skin Cancer Foundation estimates. More than 8,400 people will die this year. Melanoma accounts for about 3 percent of skin-cancer cases but more than 75 percent of skin-cancer deaths. According to the American Cancer Society, melanoma most often starts on the torso of fair-skinned men and on the lower legs of fair-skinned women, but it can begin on other parts of the body as well.

Public-service messages focus so much on sun avoidance that family history often is overlooked, said Dr. Stephen Somach, president-elect of the Cleveland Dermatological Society.

"People with a family history of melanoma need to be checked carefully," he said. "With melanoma, they should be checked annually starting in the teenage years."

Most nonmelanoma skin cancers are associated with exposure to ultraviolet radiation from the sun. Other risk factors include a weakened immune system, chronic exposure to some chemicals and radiation for cancer treatment.

Myth: Tanning beds do not increase the risk of skin cancer.

Truth: Data suggest that tanning beds increase the risk of all skin-cancer types.

A 2002 study by Dartmouth Medical School found that people — especially young women — who used indoor tanning lamps increased their risk of developing skin cancer. Tanning lamps give off intense ultraviolet rays just like the sun does and can give people sunburns as if they were on the beach. The same risk exists for developing basal-cell, squamous-cell and melanoma skin cancer.

Each year, there are about 1 million cases of basal-cell carcinoma, the most common form of skin cancer. While rarely fatal, it can be highly disfiguring. Often misdiagnosed as a pimple, it’s most commonly found on the face and neck.

Squamous-cell carcinoma is often found on the lips, scalp and ears and is often misdiagnosed as a scab. About 250,000 people are diagnosed with this each year, with men diagnosed twice as often as women.

Myth: Faithfully using sunscreen will make skin cancer unlikely.

Truth: Sunscreen reduces the amount of penetrating ultraviolet radiation, and most sunscreens are formulated to protect you from burning. But sunscreen does not eliminate all UV radiation from damaging the skin, especially when there is excessive exposure to sun. Many people are unaware that sunscreen must be reapplied every two hours to remain effective.

"I think there’s a misconception that as long as one wears sunscreen, you can go out into the sun with impunity," Somach said. "People will spend more time in the sun because they feel protected."

But man, woman and child cannot live on sunscreen alone. It’s still crucial to cover the skin (the average cotton T-shirt has an sun protection factor of only 5 to 10) and to limit the time spent in direct sunlight during the peak hours of 10 a.m. to 4 p.m.

Myth: If you have dark skin, or it’s an overcast day or it’s sunny but cold outside, then you don’t need sunscreen.

Truth: Dr. Gisela Torres, a dermatologist at MetroHealth Medical Center, doesn’t mince words.

"You need sunscreen," she said.

"People of darker skin colors can and do still burn," Torres said. While black people, Latinos and other darker-hued folks are less likely to get severe or frequent sunburns, they shouldn’t go outdoors unprotected, she said.

"We may not need as high SPF as people with a fair skin type, but SPF protection is also important [in terms of] photo aging," she said. That’s a fancy way of saying wrinkles, dark spots and uneven skin tone that plague many people over 50. Sun damage is the main culprit.

Don’t let the absence of a typical summer-feeling day fool you.

Anyone who is outdoors for extended periods of time — golfers, gardeners, bikers, cyclists — needs SPF protection.

"The clouds are not a good cover or blocker for the sun," Torres said. Up to 80 percent of all UV radiation penetrates cloud cover, she said.

And in the winter? Skiers and other outdoor enthusiasts, take heed. Sun rays reflected by snow are intense enough to cause damage, she said.

Myth: As long as you don’t burn, your risk of skin cancer doesn’t increase.

Truth: A person’s skin-cancer risk is largely determined by cumulative UV light exposure, regardless of whether burning occurs, Somach said.

"If you’re disciplined and careful enough not to burn, that’s great — but your risk is dependent on total exposure," he said. So if you think you’re home free because you’ve never had a sunburn in your life, think again.

Between 40 percent and 50 percent of Americans who live to age 65 will be diagnosed with a type of skin cancer at least once.

The incidence of both melanoma and nonmelanoma skin cancer continues to increase. As a practicing dermatologist and dermatopathologist (one who is specially trained to interpret skin biopsies), Somach said it is not uncommon now to see skin cancer occurring in people in their 20s, 30s and, occasionally, in teenagers. That’s a big shift from years ago when skin cancer in people younger than 40 was rare.

Myth: Skin cancer occurs only in sun-exposed skin.

Truth: Skin cancer, especially melanoma, may occur anywhere on the body.

Somach tells the story about a man who developed melanoma in his armpit. "He had a family history of melanoma, but he thought it only occurred with sun exposure," he said. "The melanoma wasn’t diagnosed until it was too late." The man was in his early 30s when he died.

People may be fastidious about shielding their skin, but they often forget about their scalp and ears, Torres said.

Because baseball caps don’t cover the ears, that location is an especially high-risk area for skin cancer, she said. Like other squamous-cell carcinoma, it easily can spread to other parts of the body.

The ABCDE rule for early warning signs of melanoma:

A for ASYMMETRY

B for BORDER IRREGULARITY

C for uneven and multiple COLORS (tan, brown, black, red)

D for DIAMETER 6mm or greater

E for EVOLUTION, meaning significant changes in elevation, contour, or color

Look for moles that look or feel different from other surrounding moles. If you fell that something has changed, call a dermatologist.

What you should know about ultraviolet rays, sunscreen and sun protection factor, or SPF:

Sunscreen is chemically absorbed into the skin and works by reacting with skin cells. Sunblock contains zinc oxide to mechanically block the sun. Because it has fewer chemicals, dermatologists prefer sunblock for babies, young children and people with highly sensitive skin.

Either way, pick something that protects against both Ultraviolet A and Ultraviolet B rays. Apply sunscreen at least 15 minutes before sun exposure, then reapply every two hours. Dr. Gisela Torres, a dermatologist at MetroHealth Medical Center, recommends looking for products that have the following chemical agents she feels are most effective for blocking rays: avobenzone (or Parsol), Mexoryl, titanium dioxide or zinc oxide. The last two are physical barriers against the rays and are recommended for babies and people with sensitive skin.

Torres tells her patients to use an SPF of at least 30. For patients with a family history of skin cancer, she advises and SPF of 45 or higher with UVA protections.

Ultraviolet A, or UVA, rays: Longer and less intense waves than UVB but can penetrate glass and clouds. Penetrates more deeply into the skin, causing wrinklilng, leathering and sagging. Tanning beds use UVA, which is also a part of natural sunlight.

Replace sunscreen that is a year old or more because it becomes less effective with age.

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