Skin deep

More than 20 people die each day from skin cancer, primarily melanoma. With early detection, the survival rate for patients is a very promising 99 percent. Nearly 24 years ago, not a lot was known about skin cancer, but early detection still probably saved Nancy Carlson’s life.

Then 37, Carlson was a single teacher in Princeton enjoying her summer vacation. She spent those warm months with friends, out in the sun, wearing shorts and no suntan lotion.

Carlson had never paid much attention to the mole on her lower right calf. It had been there all her life, after all. It wasn’t until July 1983, when a friend noticed the mole and said she thought it looked a little strange.

Carlson’s twin sister, who’s a nurse, also noticed the mole and asked about it.

“She said ‘has your mole changed?’ and I, of course, didn’t think anything of it,” she said. “Then my dad, who doesn’t notice anything, mentioned it. So after three people said something, my sister said I should go to the doctor.”

On July 27, 1983, Carlson went to Dr. Richard Corley in Peoria, who specializes in cosmetic surgery.

“I was planning on going on vacation, and I said ‘oh, I’ll just make it after my vacation’ and of course my sister thought I should go right away, but I waited,” she said.

Corley said he’d like to get a biopsy of the mole, and the results surprised Carlson, who was sure the test would probably turn up nothing.

“As soon as he had taken it out he starts rattling this and that, and running around like a chicken with its head cut off. He said ‘we’re scheduling you for surgery on Monday’ and he said he thought it was cancerous, but said ‘we’ve got it,’” she said.

“Finally, it just dawned on me, and I said ‘are you saying I have cancer?’ and he said ‘yeah, but I think we’ve got it. I’m 95 percent sure it’s going to be OK,’” she added.

She was diagnosed with Stage 2 superficial spreading melanoma, the most common type of melanoma, which usually begins from a previously benign mole.

On Aug. 1, Carlson had the mole and an area 5.6 by 4.5 centimeters on her calf removed, leaving a large hole in its place. Doctors took a portion of skin from her buttocks to be used as a skin graft to cover the area.

“I had to stay in the hospital seven to nine days, basically just for the skin graft to take. I’ve never looked back since,” she said.

Carlson underwent a bone scan and a lymphangiogram, but the tests found the cancer was still encapsulated and had not spread anywhere else in her body.

After it was removed, she went back to the doctor for a yearly check-up, but all these years later she’s healthy and cancer free.

“I learned that melanoma spreads very quickly. It starts at the skin but goes in vertically, so you have to worry about lymph nodes, and you have to worry about blood vessels and organs. It’s one of the fastest spreading cancers,” she said.

Carlson admits when she was younger she wished she could tan, like her darker-skinned sister, and had lain out in the sun during college without putting sunscreen on. In fact, she said she actually used baby oil to enhance the tan.

“I did go out during the summer and try and tan, and do it slowly, but it was really an effort for me. I went through that phase,” she said.

More than likely, Carlson wasn’t alone in her desire for bronzed skin. Had she tanned in recent years, she would have had a lot of company.

According to The Skin Cancer Foundation, nearly 30 million people tan indoors annually in the U.S., and 2.3 million of them are teens.

People who use tanning beds are 2.5 times more likely to develop certain types of skin cancer, including squamous cell carcinoma. Even occasional use of tanning beds almost triples the chances of developing melanoma.

“My mother also had a light skin. She was always on me to be careful; she didn’t want me going out in the sun. I really didn’t break down and do it until I was in college. Just because I was so vain, I wanted to have a tan,” she said.

There are four types of melanoma:

• Superficial spreading melanoma is the most common type and travels along the top layer of the skin for a fairly long time before penetrating more deeply. It is a flat or slightly raised discolored patch with irregular borders, somewhat geometrical in form. It varies from tan, brown, black, red, blue or white. It can occur in a previously benign mole and is found almost anywhere on the body. It is likely to occur on the trunk in men, the legs in women, and the upper back in both.

• Lentigo maligna remains close to the skin surface for quite a while, and usually appears as a flat or mildly elevated mottled tan, brown or dark brown discoloration.

It is found most often in the elderly, arising on chronically sun-exposed, damaged skin on the face, ears, arms and upper trunk.

• Acral lentiginous melanoma spreads superficially before penetrating more deeply. It appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands. It is most common in African-Americans and Asians, and the least common among Caucasians.

• Nodular melanoma is usually invasive at the time it is first diagnosed. It is recognized when it becomes a bump and is usually black, blue, gray, white, brown, tan, red or skin tone.

The most frequent locations are the trunk, legs and arms, mainly of elderly people, as well as the scalp in men. This is the most aggressive of the melanomas, and is found in 10 to 15 percent of cases.

By Jessica Gray
Source: www.bcrnews.com