By Dr. W. Gifford Jones
July 19, 2004
Ask Wayne Gretzky if you want to know about hockey. But ask Australians if you want to know about malignant melanomas, a deadly form of skin cancer. That country has the highest rate of this skin malignancy in the world. And studies show that in North America melanomas are becoming more common every year. We would all be dead without the sun's energy. But being a sun worshiper is one easy way to leave this planet prematurely.
Every year over 50,000 new cases of malignant melanoma occur in North America. According to the American Academy of Dermatology one person dies every hour from this malignancy on this continent. Today, skin cancer is the most common malignancy in women between 25 and 30 years of age.
Dr. Joanne Aitken, a researcher at the Queensland Institute of Medical Research, in Australia, says that 75 percent of malignant melanomas are first noticed by patients or their partners, rather than by doctors. This should send an important message to us on the other side of the world. Being your own doctor is rarely a wise move. But in this case self examination of your skin could save your life.
The study involving 2,800 Queenslanders showed that many patients delayed too long in seeking medical advice. Just 60 percent were seen in the early stages of development. The average delay was three months. This procrastination could be lethal as melanomas can worsen significantly over this length of time. And men were the worst offenders.
The hesitancy to seek attention was often due to the misconception that melanoma is a disease of the elderly. But skin cancer can strike any age. White people are at greater risk than blacks, but it can occur in any race.
How to diagnose a malignant melanoma is the $64.00 question. It should be as easy as rolling off a log. After all, we can all examine our skin. But diagnosing a malignant skin lesion is not as straight-forward as most doctors would have us believe.
For instance, surgeons and dermatologists have a less than perfect record in diagnosing melanomas. One authority at The University of Toronto claims that even dermatologists miss spotting a melanoma 30 percent of the time even when it's staring them in the face. And it comes as a shock when an innocent looking mole is removed for cosmetic reasons, then later is reported as malignant by the pathologist.
So what should you look for when examining the skin? Melanomas come in a variety of colours. Some are the shade of the skin. Others coal black or darker around the outside of the mole. Still others contain a mixture of white, purple, blue and red.
Nearly all dangerous moles develop irregular or indefinite margins. A red inflamed area is often present around the periphery of the mole. And in some cases there may be small satellite moles in the immediate vicinity.
A red light should flash if moles develop a tingling sensation or become itchy, grow larger, tender, ulcerated and bleed easily. See your doctor immediately even if there's only a slight suspicion that an innocent looking mole is changing in any way.
An old surgical saying says "when in doubt cut it out". No doctor of course wants to remove a normal appendix. But it does no harm if a suspicious mole is removed, then is subsequently declared benign.
A colleague often reminds me of an embarrassing incident. I had an innocent looking mole at my waistline and thought it prudent to remove it. But like many patients I waited for too many tomorrows to have it done.
One day I decided it was time to practice what I preach. But I couldn't find a surgeon with time to remove the mole. So I went to the emergency, picked up a scalpel and proceeded to cut it out myself. Just as I was putting in the final sutures a colleague unexpectedly arrived, saw what I was doing, and shouted so all could hear, "How can you be so cheap!" Migawd! How cheap can you get?"
Remember this summer that less prolonged exposure to the sun, along with sunscreen, will decrease the risk of developing a malignant melanoma.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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