By Robin Hutchinson
Special to The Free Press
May was skin cancer awareness month in Canada, and the heat of the summer will soon be upon us.
It was estimated by the Canadian Cancer Society in 2016 that 6,800 people in Canada will be diagnosed with melanoma and 1200 will die from it every year.
The statistics in the US are 13 times that number and growing every year. It is estimated that one person in North America will die from melanoma-skin cancer every hour. One in 63 people will be diagnosed with skin cancer in their lifetime.
Melanoma is the seventh most diagnosed of all the cancers and holds one of the fastest rising rates of cancer in Canada.
The rapidly rising statistics of skin-cancers and melanoma are shocking, preventable, and educable.
It is estimated that 90 per cent of skin cancers are associated with exposure to UV radiation from the sun or tanning beds.
Tanning beds provide a sense of false security; more than 419,000 cases of skin cancer in the U.S. each year are linked to indoor tanning, including approximately 245,000 basal cell carcinomas, 168,000 squamous cell carcinomas and 6,200 melanomas according to the Skin Cancer Foundation.
Individuals who have used tanning beds 10 or more times in their lives have a 34 per cent increased risk of developing melanoma compared to those who have never used tanning beds. People who first use a tanning bed before age 35 increase their risk for melanoma by 75 per cent. Having used a sunbed even once is associated with increased risk of melanoma by 15 per cent reports the Skin Cancer Foundation.
Individuals may also have genetic risk factors such as fair skin/hair, multiple moles, or a first-degree family member with a previous diagnosis.
Skin damage may have even occurred in our adolescent years when we were carefree, invincible and uneducated about the dangers of the sun. Many of us likely had sunburns, lacked sun awareness, and never thought much about the initial damage or discomfort of a seasonal burn. All of these things can increase your risk of being diagnosed with melanoma or other skin cancers in later years.
Melanoma is usually aggressive, fast growing, and unforgiving when it metastases (spreads to other parts of the body). More often than not, this requires a wide excisional biopsy in the local area and a removal and biopsy of lymph nodes to properly assess the systemic involvement of the metastasis, and to determine the optimal treatment plan. Early detection is the key to a successful survival rate.
On May 29, 2015, I received a diagnosis that changed my life. I was diagnosed with Invasive Malignant Melanoma (IMM), the rarest & deadliest type of skin cancer.
It was a serendipitous moment of fate. On an unrelated medical visit, the area in question was shave biopsied. It was located in a spot on the underside of my forearm, not often associated with IMM or exposure to the sun. It was a small, inconspicuous itchy rough patch without any strange coloration. It was nothing that would have set off warning bells or urgency in getting it looked at. That’s how melanoma can be tricky; the lesions aren’t always the obvious ugly duckling, or unusual in appearance.
I remember hearing the Drs. words “I’ve got some news for you and your not going to like it…You have invasive malignant melanoma,” clearly and reacting with shock and questioning denial. A hundred thoughts flooded my mind all at once and suddenly I was no longer in control of my life. What followed was a lightening chain of doctor visits, excisional biopsies, and educational information in preparation for what could possibly be a worst-case scenario.
A second excisional biopsy was scheduled immediately as it was the 1st line of defence in tackling what at that moment was unknown. This biopsy was wide and invasive; the size of an IPhone 4 screen, a half-inch deep and 19 stitches long leaving a three-and-a-half inch scar of honour resembling a shark bite due to the huge indent it left behind.
Those five days of waiting for the results were the longest I think I ever lived. My melanoma was in a rare category; it had not metastasized beyond a small margin of the original biopsy and the wide excision had confirmed it was contained. No sentinel lymph node biopsy was necessary.
I had found photos containing proof that the melanoma had been there for over three years, unnoticed, lurking, growing and waiting. Yet it had chosen not make me a statistic, and for this I am eternally grateful.
I have had and will have many more biopsies of suspicious lesions. Most are simply burnt off with liquid nitrogen without further testing, as they resemble pre-cancerous lesions. I take false solace in the fact that they are gone and what I cannot see cannot hurt me but yet I know that they are still there, quietly resting and waiting.
I have learned much through this journey and have certainly gotten better at practicing safe sun techniques. But being human, I still have days where I forget my sunscreen, sunglasses or forget to cover up well.
But I know that I am in charge of my life, the skin cancer isn’t.
My journey with skin cancer will likely never end; having not only an invasive malignant melanoma but also basal cell skin cancer in less than two years makes my odds higher than average of having more cancerous lesions in future. The odds are not forever in my favour.
When I look at my skin I see it all clearly because I have lived it. I see every scalpel cut, every stitch, every scar, and every reason I have to be thankful to still be here. And if for some reason I become unmindful, the pictures from each surgery will always serve to remind me that skin cancer never lurks far away.
My hope today by sharing this is that people will be more skin aware, more sun aware and more importantly, body aware. Use sunscreen, cover up, and please teach our children to respect the danger of the same sun that makes some of our best summer memories!
Learn the simple ABCDE’s of checking your skin regularly; it might save your life or that of a loved one. Visit Canadianskincancerfoundation.com, Melanomanetwork.ca/ and
Cancer.ca/en/cancer-information/cancer-type/skin-melanoma for more information.