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You NEED to read this! It can save your life.
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I'll try to keep this brief because the longer it is, the less likely you are to read the whole post- but please read the whole thing. Oldman's question the other day about training with cancer brought this issue to the forefront of my mind again, so I wanted to take a minute and pass along some information that may hopefully save some lives regarding skin cancer in general and specifically malignant melanoma. I am now cancer-free for the last 4 years after being treated for malignant melanoma, and the only thing that saved my live is the fact that I caught it early.

The American Cancer Society estimates that there will be 47,700 new cases of melanoma in the US, with 7,700 deaths. People most at risk are:
  • Individuals who are age 50 plus
  • Individuals with a personal or family history of melanoma
  • Individuals with excessive exposure to ultraviolet radiation
  • Individuals with blond/red hair and/or fair complexions
  • Individuals with a large number of moles or freckles


I will add (and mind you, I'm not a doctor) that by definition triathletes are at high risk by virtue of the amount of time we spend in the sun.

Malignant melanoma, if caught early, has a >90% cure rate. However, if it spreads to lymph nodes or distant organs the odds drop drastically. Furthermore, while there are promising new treatments for melanoma vaccines, none are yet in widespread production (that I know of. I participated in a clinical trial for one myself 4 years ago which has not yet been released).

What can you do? It's actually quite simple- there are 3 things you can do which could save your life. 1) perform routine monthly self examinations. You'll probably need the help of a partner to check your back and scalp and other areas you can't check yourself very easily. 2) See a dermatologist every 3 months for a complete examination, and 3) wear sunscreen EVERY time you go outdoors.

What are you looking for in a self-examination? The American Cancer Society's ABCD rule can help distinguish a normal mole, spot, or freckle from a melanoma. Any change in size, shape, or color of a mole, spot, or freckle, or a sore that does not heal should be considered a warning sign.
  • Asymmetry: One half of the mole does not match the other half
  • Border irregularity: The edges of the mole are ragged or notched
  • Color: The color of the mole is not uniform, areas are brown, black, red, blue, and/or white
  • Diameter: The mole is wider than six millimeters


You can see examples of what to watch for here (I'll also give this site credit for some of the cut and paste I did in my post): http://www.jwci.org/...cerSkin/Overview.htm

Other things to be aware of:
  • a melanoma will not necessarily only form in areas that were previously sunburned. The skin is one big organ, and a bad sunburn on your legs can easily lead to a melanoma in a place that has never seen the light of day, so don't only check the parts that are exposed to sun.
  • Any sunscreen needs to be re-applied periodically. There is no such thing as a totally waterproof, all-day sunscreen.


Thanks for reading, and train safe.

-John
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Re: You NEED to read this! It can save your life. [jkatsoudas] [ In reply to ]
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I would add if there is something that you think should be biopsied but the Dr's dismiss it, be VERY persistant until it's done. My wife had amelanotic melanoma which is quite rare, colorless and doesn't fit the usual diagnostic criteria and it took 5 years before it was diagnosed and it has now spread so she is now in the 9 month mean survival time group.

Unfortunately most of the vaccine trials have failed to show any benefit compared with standard treatments. Even IFNa-IL2 treatment which is the current gold standard at least at some centers only adds around 12 months to survival time, so melanoma is definitely not something to mess around with.
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Re: You NEED to read this! It can save your life. [mises] [ In reply to ]
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mises, I'm really sorry to hear that.

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Re: You NEED to read this! It can save your life. [mises] [ In reply to ]
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Mises, I'm very sorry to hear about your wife. That's terrible. Best wishes to both of you.
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Re: You NEED to read this! It can save your life. [jkatsoudas] [ In reply to ]
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The information presented here about skin cancer is very valuable and I would encourage everyone to print it off and paste it at their desk and at their home. Skin cancer is no joke and it's not a cancer to be treated lightly. It might not seem as tragic as lung or prostate cancer, but don't be fooled - it is just as deadly.

I have so many friends that disregard it. "I'm too pale." "It's not sunny outside, it's cloudy (Oregon)" "A little color is good." Blah, blah, blah. Every excuse in the book. The fact is, color is not good. When your skin obtains color from the skin, it is because damage has been done to the cells. Sure, darker skinned people might have less risk, but that doesn't mean "no" risk.

Remember, the ozone is not getting stronger. It's getting weaker and allowing more "bad" ray's to get through to us. As triathletes we spend a large amount of time outdoors (and how many of you can realistically say you're not training between the peak sun hours of 10-2).

I get checked very frequently by the dermatologist. If it even looks slightly suspicious, I'm on his calendar. I would much rather have a small scar than cancer. I just recently had four removed from my back (thankfully all checked out okay). The downside - I was out of the pool for two weeks. The upside - I have my life and I'm healthy. My Dad has had it, his brother and sister, my uncle ... the odds for me are not "if", but "when". I grew up surfing on the Texas Gulf Coast and I got my share of really bad burns. Back then, suncreen was Coppertone Tanning OIL #4. Basically I would have been better being a piece of bacon lying in a frying pan.

If you have kids, protect them. Never let them go outside without sunscreen. Make them wear good protective hats. And for god's sake, keep your teenage son's and daughters out of the cancer coffin's at the tanning booths. Acne for most kids in the future will be a blessing compared to getting any form of skin cancer.

While this may sound so gloom and doom, just go back and read "mises" email and see what his wife is enduring. It's nasty stuff, so the main thing is - be aware of it and be proactive about covering up.

Dennis
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