Globusz^® Publishing 

vidence from many sources suggests a steadily rising incidence of malignant melanoma in the past few decades accompanied by a rising death rate. The recent concern about Senator McCain has led people to worry more and more about this deadly skin tumor. The mortality rate in the United States from this lethal growth is now over 9,000 a year, accounting for most of the deaths from skin cancer. Sam Donaldson and Troy Aikman have also been afflicted with these deadly tumors.

What is this malignant growth that seems to appear suddenly out of nowhere and quickly invades not only adjoining tissue but also distant organs, spreading via the blood and lymph channels?

Malignant melanomas are usually black lesions of the skin that arise in a pre-existing, dark, hairless mole - hence the epithet “black cancer.” While occurring primarily on the skin surface, melanomas, which can also be pale and non-pigmented, can appear in the eye, on mucous membranes, and elsewhere. No portions of the body and no organs are immune from this deadly tumor.

Unlike the other cancers of the skin – the basal cell and squamous cell carcinomas – the melanoma has a striking tendency to spread to other parts of the body. Once melanoma cells extend to vital organs, they are much more difficult to treat.

While it can develop at any age, melanoma is seen most commonly in people between forty and seventy. While the current ballpark figure is that it will strike about 50,000 men and women in the United States this year, this figure is greatly underestimated. As a result of gross underreporting by many general physicians and some dermatologists who read their own pathologic slides, it is believed that there are closer to 100,000 cases of melanoma a year in the United States. In fact, malignant melanoma is increasing worldwide faster than any other cancer. One of the latest figures is that 1 in 70 Americans will develop melanoma at some time in their lives, and by the year 2010, the melanoma risk will rise to 1 in 50. A sobering thought . . . .

No one has as yet discovered a single cause for melanoma, but some of the following factors appear to play a role:

• There is a higher incidence of malignant melanoma in summer climates.

• Many dermatologists believe that excessive sun exposure at an early age, and severe blistering sunburns at any age, will predispose to malignant melanoma.

• There is a greater frequency in whites as a result of the superior ultraviolet screening capacity provided by black skin.

• People who develop melanoma are likely to have light-colored eyes, light complexions, light hair color and seem to sunburn easily.

• Although melanomas are uncommon in blacks, they can arise on the more lightly pigmented portions of the skin: the palms, soles, the nail beds, and mucous membranes of the mouth.

• If your parents, children, or siblings have had a melanoma, you have a much greater risk of developing one.

• More melanomas develop on the legs of women than men. This phenomenon is attributed to the greater exposure to sunlight as a result of women’s habit of dress.

• Women taking oral contraceptives run a far greater risk of developing these black cancers than those women who have never taken birth control pills.

• Injury may also play a role in the development of melanoma. In the barefooted-African Bantu, melanoma of the sole is more prevalent than in those who wear shoes, and in Ugandans the most common site of melanoma is on the sole.

Bleak as this picture is, malignant melanoma can be cured surgically in over fifty percent of cases. The key to success is prompt therapy. One can never be certain, however, that a melanoma has actually been cured, particularly those tumors that have penetrated the lower layers of the skin and subcutaneous tissue and have spread to involve the lymph glands.

A new vaccine, being tested in Canada, is now being developed that promises a modicum of encouragement for those with early melanomas. It is still too early for any definitive results, but the companies are optimistic.

How do you know whether to worry about existing moles? Suspect a mole if it had undergone any change in size, shape, color, or texture. The A, B, C, D danger signs of melanoma are as follows:

A	B
C	D

1. Asymmetry. If one half of a mole is unlike the other half.

2. Border irregularity. A scalloped or poorly circumscribed border should alert one.

3. Color varies from one area to another. Look for shades of red, white, or blue. Black should make one suspicious.

4. Diameter is larger than a quarter of an inch.

Moles that itch, crust, bleed, change texture or ulcerate also point to a possible malignant change. See your physician at once if you notice any of these changes. He or she will more than likely recommend surgical excision of the worrisome mole followed by microscopic analysis of the tissue.

For more information on melanoma, log on to: www.melanoma.com or www.aad.org or phone: 1-888-462-DERM x22

RECAP

• Evidence from many sources suggests a steadily rising incidence of malignant melanoma in the past few decades accompanied by a rising death rate.

• Unlike the other cancers of the skin the melanoma has a striking tendency to spread to other parts of the body.

• If your parents, children, or siblings have had a melanoma, you have a much greater risk of developing one.