Melanoma is a very hot topic and well covered in most magazines at one time or another. Currently with the new healthcare system looming a new tax is going to be imposed on Tanning Salon businesses. You may ask why a tanning salon would be taxed under this new Healthcare plan? Well these places are “Hot Beds” for the development of these cancers. The direct UV light often unprotected in such high concentration really is like putting yourself in a cancer machine, and although I am not here writing as an activist, I would only say that they should be avoided, and buyer beware.
So where can this deadly cancer rear its ugly head. It is a skin cancer so obviously it occurs on the skin. What is not so obvious is what people perceive as skin.
The definition of skin is “the body’s outer covering. It protects us against heat and light, injury, and infection. It regulates body temperature and stores water, fat, and vitamin D. Weighing about 6 pounds, the skin is the body’s largest organ. It is made up of two main layers; the outer epidermis and the inner dermis. The epidermis (outer layer of the skin) is mostly made up of flat, scale-like cells called squamous cells. Under the squamous cells are round cells called basal cells. The deepest part of the epidermis also contains melanocytes (the cells that cause Melanoma). These cells produce melanin, which gives the skin its color. The dermis (inner layer of skin) contains blood and lymph vessels, hair follicles, and glands. These glands produce sweat, which helps regulate body temperature, and sebum, an oily substance that helps keep the skin from drying out. Sweat and sebum reach the skin’s surface through tiny openings called pores.
So this is a rather broad definition of our largest organ, but it does illustrate that in addition to the skin that we all try to tan, and reduce wrinkles on and tattoo, our skin is also those linings of our body that we do not readily expose to the sun. This includes our oral mucosa, scalp, vaginal lining, nail beds (highly deadly location). It is my hope that this information will save a life. Hold your doctors to a higher standard and they will respect you for it. The Dermatologist is certainly the skin expert, but your other doctors, including Dentists, Podiatrists, Gynecolgists, Proctologists, need to be checking for these skin cancers regularly, and you as the patient should also be aware that melanoma can be found on any skin surface, not only sun exposed area (although they are certainly the most common)
I recall a patient of mine, who presents with a “wart” that she had present for many months on her heel. She had been through many topical treatments at various doctors before she presented to my office. Not wanting to reinvent the wheel, after looking at this “wart” it appeared to have some abnormal pigment, I felt that a biopsy was prudent as her other treatments were unsuccessful in clearing the lesion. When the pathology came back Malignant Nodular Melanoma, I was glad that I did. The patient was informed that she had this very aggressive skin cancer and that it required removal. She was subsequently operated on which required a large amount of tissue to be removed from the back of her heel, as well as a skin graft to cover the area.
The tumor was staged, which requires both pathologic and surgical evaluation of the patient as well as the skin specimen. Luckily this melanoma was caught in its early stages prior to it entering the patients blood stream. It has been 5 years since that operation and I recently saw this patient in the neighborhood pushing a stroller with her 3 year old son, I felt great knowing that I had not only saved her life but, that I played a part in allowing this new life to come into the world. Check yourself monthly for Suspicious Moles using the ABCDE Characteristic Method. If you find any of these characteristics on your skin, make an appointment for evaluation by your doctor.
- ASYMMETRY; one half unlike the other half.
- BORDER; irregular, scalloped or poorly defined border.
- COLOR; varied from one area to another; shades of tan, brown, and black; sometimes white, red, or blue.
- DIAMETER; melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, but they can be smaller.
- EVOLVING; a mole or skin lesion that looks different from the rest or is changing in size, shape, or color.