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Men often ignore moles until it's too late

| Thursday, April 26, 2001, 12:00 p.m.

Fair-skinned J. Robert Stemler spends a little more time in front of the mirror than most men, checking for morphing moles that could signal a return of his melanoma.

His diligent skin care is not the norm among his peers.

Men are less likely than women to visit dermatologists or perform regular self-examinations for signs of melanoma such as a mole that has changed color or shape, according to a study presented Wednesday at a conference of the American Academy of Dermatologists in New York City.

'Twenty-five percent of the people who came to the cancer screening were men over age 50 and over 44 percent of the melanoma was found in that group,' said Dr. Barbara Gilchrest, the study's lead researcher and chair of the Department of Dermatology at Boston University.

Of the 242,374 people in the study who were screened for cancer, men age 50 and older were four times as likely to develop melanoma, the deadliest form of skin cancer, Gilchrest said. Experts say men are less likely to seek early treatment, making the chances of the disease becoming fatal even higher.

Stemler, 70, of Export, Westmoreland County, has twice had melanoma. His dermatologist, Dr. Larry Cohen, has detected it early enough that it could be treated before it spread to other organs, when it can be fatal.

Cohen, chief of the section of dermatology at Forbes Regional Hospital in Monroeville, said, unlike Stemler, most men will ignore a mole that has changed color or started to bleed until they are sent to a dermatologist by a higher power.

'Men will come in and say they are here because their wives sent them,' Cohen said.

This tendency to ignore moles that change color or grow larger is precisely why older men are more prone than women to develop melanoma that requires radical treatment, said Gilchrest.

Risk factors for melanoma include genetics, exposure to sunlight and moles that change shape, size or color.

Melanoma can suddenly appear, but in 95 percent of the cases melanoma arises from a previously existing mole and, if left untreated, can spread to the brain or lymph nodes, according to the American Academy of Dermatologists. It is an uncontrolled growth of pigment-producing cells and causes six out of seven deaths from skin cancer.

Treatment is usually surgery or surgery coupled with a form of chemotherapy. Cohen said melanoma is not sensitive to radiation.

Why melanoma is more common and more severe in men may have something to do with machismo, experts believe.

'Women are much more likely to use sunscreen, to wear a hat,' Gilchrest said, pointing out that there is a correlation between exposure to sun and skin cancer. 'Women do things that protect their skin and men don't. Teen-age boys refuse to sunscreen. It's just not macho.'

Five years ago, a surgeon cut out a cancerous, palm-sized patch of skin on Stemler's back, and two years ago he had a small, cancerous lesion on his cheek removed.

The retired Alcoa manager said he has a family history of skin cancer, has moles covering his arms and back and also enjoys activities in the sun such as going to the beach and gardening.

'I've been going to (Cohen) for regular examinations several times a year for about 15 years,' Stemler said. 'I guess I had some suspicions about the lesions on my body. The one on my face, I saw it change, but I guess I didn't think it was serious. That one sneaked up on me.'

Marc Lukasiak can be reached at mlukasiak@tribweb.com or (412) 320-7939.

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