Steamboat Pilot & Today

Steamboat Springs — A few months after relinquishing the race for the Republican presidential nomination, John McCain was back in the spotlight with the chilling news that he has melanoma again. According to reports, his second go-round with this deadly form of skin cancer disease was detected before it had spread to his lymph nodes.
Malignant melanoma, a cancer of the pigment-producing skin cells, is the deadliest form of skin cancer. Although it's responsible for only 5 percent of reported skin cancer cases, the American Cancer Society reports that malignant melanoma causes up to 85 percent of skin cancer-related deaths about 7,300 a year.
Dr. Sandra Eivins, a Steamboat Springs dermatologist, says residents of Colorado are particularly at risk. "The new state of Colorado statistics are alarming," she said. "For men in Colorado, the risk of melanoma is one in 39; for women, it's one out of 58. The national rate is one in 80. Colorado numbers are approaching the statistics for Australia, where melanoma is an epidemic."
The best way to reduce the possibility of getting melanoma is to limit your sun exposure and thoroughly check your skin for melanoma's warning signs.
When the sun's ultraviolet rays penetrate the top layer of your skin, cells called melanocytes are stimulated. These cells release a brown pigment called melanin, which helps protect deeper layers of your skin from sun damage. Sun exposure can transform melanocytes into cancer cells, or turn a previously normal mole or freckle malignant. In fact, about half of all melanomas arise from previously normal moles or freckles.
When a physician diagnoses malignant melanoma, the growth and sometimes nearby lymph nodes will be surgically removed. If the primary cancer has spread, chemotherapy or radiation therapy may be necessary.
According to the American Cancer Society, the five-year survival rate for patients with localized malignant melanoma is 94 percent. However, if the melanoma has metastasized (spread to other parts of the body), the five-year survival rate drops to 16 percent.
The earlier the melanoma is detected, the better.
Excessive exposure to harmful ultraviolet-A and ultraviolet-B sun rays can cause melanoma. Although darker-skinned people aren't immune, those who have fair skin and red or blonde hair are most often affected by melanoma. Having a family history of melanoma or having had three or more blistering sunburns puts one at increased risk.
Eivins recommends avoiding sun exposure, especially during the peak hours of 10 a.m.-2 p.m.
If you must be in the sun, liberally apply a sunscreen with a sun protection factor of 15 or higher to all areas of exposed skin, then wait 15 minutes before going out. Reapply sunscreen at least once if you're spending a good portion of the day outside.
Look for a broad-spectrum product that protects against both ultraviolet-A and -B radiation). Pay special attention to your face, nose, neck and rims of ears. Wearing a long-sleeved shirt and hat will also decrease your risk.
Most people have a variety of moles, freckles and birthmarks that are harmless. Some moles may become malignant due to sun exposure or genetic factors. To detect melanoma in its most treatable stage before it spreads Dr. Eivins encourages regular monthly self-examination of moles.
"Someone can come to me for a yearly check-up and everything is fine, but two weeks later a mole can start changing," Dr. Eivins said. "It's so important to see a doctor immediately when you notice a change. That's why the Skin Cancer Foundation strongly endorses monthly self-exams."
Know your ABCs
Consult a physician if a growth appears suddenly, or if a mole begins to ooze or bleed, or becomes itchy, tender or painful.
Any of these "A, B, C, D" warning signs would also warrant a trip to the doctor's office:

• Asymmetrical: One half of the mole doesn't match the other half.
  * Border: An irregular border, with edges that are ragged, notched or blurred.
  * Color: Varied shades of tan, brown and black are present.
  * Diameter: Extending diameter greater than 6 millimeters.

Christine McKelvie is public relations director of Yampa Valley Medical Center.