Take a good look at yourself: skin cancer can hide in plain sight. Blistering sunburns, especially in children, increase the risk of subsequent skin cancer

Paul SerVaas

If detected early, the deadly melanoma skin cancer can be completely destroyed. Once it spreads beyond the skin, however, melanoma turns into a relentless killer. Unlike deadly cancers that strike without warning, melanoma at least gives vigilant victims a window of opportunity to insure survival. This “window,” however, is measured in mere months.

There is a chance that you will be one of the 50,000 Americans who will develop melanoma lesions this year. What you do (or don’t do) in the months after these lesions begin to grow will help determine whether you join the approximately 8,000 Americans that die of melanoma each year.

It will always pay to remain familiar with the skin you’re in. You will never grow too old to benefit from such monitoring. After all, even if melanoma were to rob you of just one of your two remaining years on this earth, that theft would still represent ha/f of your remaining lifetime. The past is the past. It’s your future that needs to be protected.

You simply cannot afford to let these cancerous lesions spread. The trick of “saving your own skin” is simple. Make skin examinations a habit. Depending on your melanoma risk factors, you should examine your skin every one to three months (see the accompanying guidelines). The key is to become familiar with all of your existing skin lesions (a catch-all term covering almost any skin imperfection). Once you truly know your own skin, it will quickly become apparent if (1) an existing lesion has changed, or (2) a new lesion has appeared.

The devil is in the details. It is not easy to spot small changes in lesions based on memory alone. Furthermore, it is highly likely your back has lesions that can only be seen by using one or more mirrors. Such lesions can be hard to scrutinize even for those blessed with perfect eyesight. The old joke about the guy who decides to look for his lost car key only under a streetlight because the light is better is not funny when it comes to searching for melanoma.

Even a melanoma that has grown 50 percent can be hard to see with the naked eye–especially if it is on your back. If a mole grew from being a quarter inch in diameter to being three-eighths of an inch in diameter, it grew 50 percent. In absolute terms, however, its diameter only increased by a hardly noticeable one-eighth of an inch.

Technology to the Rescue

If you don’t already own one, consider purchasing a digital camera that has the ability to take “macro” photographs. Digital cameras are good investments. They don’t require film, plus they allow photographs to be stored, viewed, printed and e-mailed via a computer. Cameras that can take macro photographs will allow you (or a loved one) to take excellent close-up photos of your skin.

Make it a family affair to photograph each other’s skin at least four times a year (e.g., at the beginning of each season). Doing so will have the added benefit of educating any children or grandchildren you recruit to assist you. (Imagine being able to write on a medical school application that you found a melanoma lesion on your grandmother when you were only ten years old!)

There is an old saying that “the weakest ink is better than the strongest memory.” Armed with photographs, family members can accurately compare skin lesions from one season to the next. If growth, discoloration, or a change in texture occurs, the possessor of this new worry can mail (or e-mail) the troubling images to a doctor for an opinion. In turn, these same digital photos make it possible for your family doctor to quickly consult a dermatologist about your case. “Before and after” photos may enable you to get a quicker appointment with a specialist–especially if they show a lot of change in a short amount of time.

Once again, the devil is in the details. Photographs of lesions begin to look alike if not carefully numbered and dated. Devise a numbering system before you accumulate a lot of photographs. Imagine the needless worry you may cause yourself if you somehow compare the wrong photographs!

In addition to a numbering system, some idea of the size of each lesion is necessary. Otherwise a lesion that has not changed may appear to have grown simply because of how it was photographed.

To solve these problems, the Post has developed a peel-and-stick sticker (shown below) that can be placed on the skin to bracket each lesion before being photographed. This sticker does three things. It provides a metric ruler (the kind used by doctors) to determine size. It provides a color bar so that the lesion’s colors in the photograph (or on the computer screen) can be compared to true colors. Lastly, the sticker provides a line so you can fill in the date and lesion ID number prior to taking the photograph. (If you are interested in obtaining these stickers, please call 1-800-558-2376.)

The advantage of using your children, nieces, nephews, or grandchildren to assist you in photographing your lesions is that they will certainly come away from these sessions knowing that melanoma is a disease to be feared, and hopefully prevented. To be seen by these children “monitoring for melanoma” will give you credibility when instructing (and otherwise cajoling) them to (1) slip on a shirt, (2) slap on a hat, and (3) slop on the sun block lotion before venturing out under a hot sun. For it is now known that children who suffer three or more blistering sunburns prior to age 20 have saddled themselves with an additional melanoma risk factor.

Melanoma is a flaw in humankind that vigilant people can try to intercept. In a way, so is terrorism. While looking for melanoma on your skin, there is a slight chance you could help your neighbors and your country by identifying an infectious disease spread by a terrorist.

Out of the 12 “category A high-priority biological agents” that terrorists might spread, only botulism toxin and Lassa fever virus do not cause skin lesions. The remaining ten pathogens (anthrax, smallpox, plague; tularemia, Ebola fever, Marburg fever, and the four South American viral hemorrhagic fevers: Guanarito, Junin, Machupo, and Sabia) each cause specific skin outbreaks. This important observation was first pointed out by Dr. Thomas W. McGovern in his excellent 2001 article “Can Derm Warfare Fight Germ Warfare?” published by Medscape.com. God forbid you should ever get one of these ten terrible diseases, but if you do, you can do well for yourself and our country by quickly making images of the resulting lesions available to your doctor.

Accurate and timely self-reporting of unusual health problems is exactly what our public-health officials need from us if they are to limit outbreaks. We are all canaries in the coal mine in this regard.

What are the risk factors in developing skin cancer?

People of any age may develop various types of skin cancer, although it is rare in children. It tends to occur more frequently in people with fair complexions and with light-colored hair and eyes. Sun exposure is a major risk factor in the development of skin cancer. The damaging effects of the sun are cumulative. Even if you stay out of the sun now, you may be at higher risk for skin cancer because of sun exposure you have had in the past. Blistering sunburns, especially in children, are also a’ risk factor. Skin cancer is more likely to develop if there is a family history of the disease.

RELATED ARTICLE: The ABCD’s of melanoma.

Most people have a number of brownish spots on their skin-freckles, birthmarks, moles. Almost all such spots are normal, but a few may be skin cancers. Key warning signs of melanoma are shown below. Be alert to irregularities in shape, edges, color, and size. The ABCD’s of melanoma are: Asymmetry, Border irregularity, Color variability, and Diameter larger than a pencil eraser.


Most early melanomas are asymmetrical: a line through the middle of it would not create matching halves. Common moles are round and have a symmetrical shape.


The borders of early melanomas are often uneven and may have scalloped or notched edges. Common moles have smoother, more even borders.


Common moles usually are a single shade of brown. Varied shades of brown, tan, or black are often the first signs of melanoma. As melanomas progress, the colors red, white, and blue may appear.


Early-stage melanomas tend to grow larger than common moles–generally to at least the size of a pencil eraser (about 6 mm, or 1/4 inch, in diameter).

–The Skin Cancer Foundation

COPYRIGHT 2003 Saturday Evening Post Society

COPYRIGHT 2003 Gale Group

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