Sunny season is here, be mindful of melanoma
John Nasci noticed a tiny red spot on his right shoulder right by his “Nasci” tattoo.
The Jefferson resident visited his doctor to inquire about it. He was told not to worry about the 1⁄4-inch spot. But Nasci remained concerned and went to a dermatologist, who took a biopsy.
The biopsy showed he had malignant melanoma that was in its early stage..
Nasci had surgery at Allegheny General Hospital. Doctors made a large incision on his right shoulder and extracted the tumor and a lymph node.
“I was told if I didn't have surgery, I would die,” Nasci, 61, said. Since his melanoma surgery was five years ago, he undergoes a full body skin scan every six months and always makes sure he has sunscreen and a hat on when outside.
Melanoma is on the rise nationwide, said Dr. Mary Martini, a dermatologist at Allegheny General Hospital in Pittsburgh. About one in every 50 Caucasians will develop melanoma, she said.
“Years ago we went to the shore,” she explained. “We now go to places where there is poor ozone.” Australia and South America have ozone depletion.
The popularity of tanning beds has boosted melanoma rates by 2 percent, especially among females. Also, the population is aging and most skin cancer patients are 65 or older, she said.
Melanoma begins when the melanin cells, which give skin its color, become malignant. It is the third most common type of skin cancer and the most deadly. It accounted for more than 9,700 deaths in 2017, compared with more than 3,800 deaths from other skin cancers, the American Cancer Society said.
Melanoma should be taken seriously because it has the potential to spread to other parts of the body if it is not caught early. Unlike most cancers that need to learn to metastasize, melanoma can move quickly and attack other parts of the body, she said.
Also, quality of life and health care improvement have contributed to the rise of melanoma cases, another local dermatologist said.
“People are living longer,” said Dr. Brian Horvath, a dermatologist at St. Clair Hospital in Mt. Lebanon. “It also appears people have more leisure time and we're catching more melanoma at the early stage.”
Kelly Simmons, 45, of Freedom, always loved being in the sun. A red head with pale skin, she sought out the sun for tanning.
“When I was a teenager, people used to call me Casper,” she said. “It is a society thing. We believe tan is beautiful.”
Simmons said she had a spot on her biceps, but never thought a thing about it. A rash on her forehead sent her to a dermatologist, who wanted to biopsy the spot. It turned out to be early-stage melanoma. The rash was simply from stress.
The spot was removed, replaced by a four-inch scar. She usually wears shirts that have sleeves long enough to cover the scar. And Simmons, who was diagnosed in October 2015, sees Martini every three months for a check-up. A doctor formerly in Martini's practice group diagnosed Simmons.
“I was blessed to have caught it early,” said Simmons, who wears sunscreen and clothing with ultraviolet ray protection woven into the fabric.
“It is kind of strange to know you have something in your system that could kill you is pretty scary,” she said.
Changes in the skin, like a new mole, growth or sore that won't heal are common signs of cancer, the dermatologists said.
Also, use the ABCDE rule, when trying to decide if a spot may be melanoma and merits a trip to the dermatologist. This rule stands for the characteristics used by dermatologists to classify melanomas.
According to the Centers for Disease Control and Prevention, “A” stands for asymmetrical. Does the growth have an irregular shape with two parts that look different? “B” is for border. Is the border irregular or jagged? “C” is for color, is the color uneven? “D” is for diameter. Is the spot larger than the size of a pea? “E” is for evolving. Has the mole of spot changed?
“Hair dressers pick up a tremendous amount of melanoma,” Martini said.
She said men tend to develop melanoma more than women. The most common spots for melanoma in men are the neck, back, ears and the scalp. Women, meanwhile, tend to get melanoma on their legs, chest and face.
So what can be done to decrease the risk of melanoma? Wear sunscreen, protective clothing and be smart.
“The biggest thing is to wear sun screen and keep re-applying it,” Horvath said. “Be in the shade when you can and wear a hat that covers your ears.”
Martini said the hat should have a brim of at least three inches. Also, wear sun-protective clothing and be active because it helps the immune system. Nine out of 10 melanoma cases are caused by the environment, she said.