Love the skin you’re in: Protect it from cancer

Sun-Safe Measures and Early Detection Make a Difference

Jean Tayntor is sometimes called the Cookie Lady because of the cookies she passes around while volunteering at the Lakeland Regional Cancer Center. But 72-year-old Tayntor serves more than tasty treats— she offers hope.

Tayntor is a cancer survivor. Diagnosed 10 years ago with melanoma, the most viral of the skin cancers, Tayntor is tangible evidence of promise for the future. “It seems to perk up patients that somebody could tell them it wasn’t all gloom and doom,” she says. “It’s easy for me to be upbeat because I don’t have any side effects. I know the side effects can be devastating.”

The Facts

There are an estimated 13.7 million people alive diagnosed with cancer; approximately seven percent of them diagnosed with melanoma, according to National Cancer Institute data for January 1, 2012.

In Florida, the incidence of melanoma was 17.8 to 20.3 per 100,000 in 2009, according to adjusted data from the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and the National Cancer Institute. It ranked lower than the southern states of Georgia, Alabama, South Carolina, and Tennessee, with 20.4 to 23 per 100,000, and the northwestern states of Washington, Oregon and Idaho, with 23.1 to 32.6 per 100,000.

The melanoma death rate in Florida for 2009 was 2.7 to three per 100,000, the figures show, which was equal to Tennessee’s rate, lower than Alabama’s 3.3 to 3.9, and higher than Georgia and South Carolina’s 1.5 to 2.6. The rate was the same in Washington state, but higher in Oregon and Idaho, which logged 3.3 to 3.9 deaths per 100,000, the figures show.

Beyond the Facts

Tayntor’s circumstances are unusual. She receives chemotherapy every third Tuesday as a part of a clinical trial for a chemotherapy drug manufactured by Indianapolis, Indiana-based Lilly Pharmaceutical. The thing is— she’s the only one left in the clinical trial. The others dropped out for a variety of reasons.

The fate of the drug, whose name cannot be disclosed during the clinical trial, will not be decided until Tayntor quits taking it, explains Robin Stewart, the center’s manager of clinical research. “Right now,” Stewart continues, “she is using what is left in a stockpile.”

“It is a clinical trial that I think has saved my life,” says Tayntor, who volunteers at the center along with her 74-year-old husband, Phillip. “I’m not in pain. I’m not sick to my stomach. I get tired easily, but then I’m 72 years old.”

Lakeland Regional Cancer Center is actively working to defeat cancer by early detection though screening programs offered through employers. A common treatment is surgery, offered by Drs. Helen Chan, Manuel Molina, and Solange Pendas, all surgical oncologists. “It [melanoma] has been likened to an iceberg,” says Kim Walker, cancer center administrator. “It goes deeper underneath.”

Dr. Molina advises regular checkups at least once a year to avoid a problem. Skin lesions should be checked by a dermatologist, he says. When in the sun, people should follow “sun safety measures,” he adds. “Living in Florida, nobody can avoid the sun. You need to take precautions.” That means avoiding stronger rays between 10 a.m. and 4 p.m. and applying sunscreen correctly— something many people don’t do. The sunscreen needs to be put on 20 to 25 minutes before sun exposure, so it will have a chance to soak in. It also needs to be reapplied every two hours. He recommends 30 Sun Protection Factor (SPF) for Florida, or higher when rays are more intense.

“It’s important to protect the kids,” Dr. Molina cautions, saying cancers in adults build from childhood. A decrease in the ozone layer means a little more UV exposure and an increased risk for skin cancer, the most common type of cancer.

He suggests wearing sunglasses with ultraviolet (UV) protection, plus big hats and UV-protected clothing. “You shouldn’t be exposed all the time,” he says. “The way the sunscreens work— they delay the damage of the UV rays.”

While people in Florida tend to be aware of the potential to develop skin cancer, they obviously aren’t the only ones affected. “Snow reflects 90 percent of the UV rays,” Dr. Molina points out. “If you see people that go skiing that come out with a tan, it’s bad. All of the rays are reflected.”

Cancer Types

A mole that changes in size or shape, or starts itching or bleeding, should be checked for possible melanoma, Dr. Molina says. What makes it more dangerous is that it has the tendency to spread to the lymph nodes, internal organs, and brain.

Squamous cell cancer is more locally aggressive, although it also can metastasize. A warning sign is an ulcerated lesion, he says. A sun mole, or pearly white nodule may be a premalignant lesion that can turn into squamous cell. The lesions can be frozen off with cryotherapy, or removed with chemotherapy creams. “Some people watch them,” he observes. “If you get more sun exposure, it’s not going to make it better.”

Lesions may be benign, but it takes training to know the difference. “Any lesion that is changing needs to be biopsied,” he advises.

Basal cell carcinomas are usually pearly nodules that are more locally aggressive. Very similar to sun moles, that may be depressed in the center and can look like a red, flaky patch. The carcinomas tend to appear in areas of direct sun exposure. “Usually the best treatment is to remove them,” Dr. Molina says. Radiation therapy is an option when there are cosmetic reasons.

Taking Comfort in Solutions

The good news is that there have been improvements in cancer treatment. Immunomodulars have offered good results while surgery has become minimally invasive. There have been new strides with radiation therapy, chemotherapies, and biological therapies, Dr. Molina adds.

“There’s always something new coming right around the corner. There’s no complacency in cancer care,” Stewart says. “In the last two years, they’ve actually added three new drugs for melanoma that came out of clinical trials.” She says clinical trials offer a “wonderful option” for patients. “It gives them an opportunity to try something that already has shown benefit,” she adds.

A good candidate may be someone who has had a melanoma removed and wants to prevent a new cancerous growth. It also may be someone whose cancer has spread, making surgery impossible. “In those cases,” Stewart continues, “a clinical trial is a great option.”



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