Young people feel invincible. They spend hours at the beach in the summer without a care. They bake in tanning booths on a regular basis year ’round. And most of them — 66 percent of teens — don’t use sunblock, says the U.S. Food & Drug Administration.

The result of their nascence is tragic. Young adults are being afflicted at an alarming rate from a cancer that is one of the most preventable: Melanoma.

“Melanoma is the most common form of cancer for young adults 25-29 years old, and the second most common cancer in adolescents and young adults 15-29 years old,” said Dr. Sherri Vazales, of Bay View Dermatology in Petoskey.

When melanoma is detected in the early stages, before it reaches the lymph nodes, it has a 99-percent five-year survival rate. Left undetected, it’s a deadly disease, a diagnosis Vazales has had to deliver more and more frequently in recent years.

Several cases stand out in her mind, like the woman in her early 40s who found a suspicious spot on her nose and for months thought it was a pimple or cyst. It had no color to it, but it wouldn’t go away. By the time she went in to see Vazales, the young woman was diagnosed with melanoma which had metastisized to her bones, and within the year she was dead.

Three of Vazales’ current melanoma patients are in their 20s and 30s, all with moles that changed; all were determined to be melanomas that have spread to their lymph nodes. “So far they’re doing OK,” Vazales said, of the two men and one woman who are receiving a type of chemotheraphy treatment.

They all, she added, had significant sun exposure through their lives.

Emphasis on early detection

It’s not just the young who feel invincible. Middle-age men are also a common victim of melanomas, because they don’t have as much physician contact as do women, Vazales noted. To wit: One of her patients is a male who found a spot on the bottom of his foot. By the time he came to Vazales, it had metastasized into his liver and lymph nodes.

Vazales’ examples paint a picture of how deadly melanoma can be, and why early detection is paramount. Where to start? First, begin doing regular skin exams, including in hard-to-see places (enlist a friend/spouse/child/parent) like behind the ears, scalp and backside (a mirror helps).

Skin cancers of all types — basal cell, squamos cell and melanoma — take time to develop and spread, five to 10 years or longer perhaps. The sun is an added danger because it can damage DNA, which is necessary for a properly functioning immune system to fight off the cancer in its early stages. “(Sun damage) effectively paralyzes the immune system,” Vazales said.

Advancements in treatments are improving the outlook for cancer patients, though there’s still a long way to go. Among the new treatments is a topical ointment that can be applied to cancerous and precancerous spots. It acts as chemotherapy, attacking the spot without side effects.

Photodynamic therapy is another method; it utilizes a light source to kill off cancer cells after applying a topical treatment, Vazales noted.

Also, an oral herbal supplement, polypodium leucotomos (one brand name is Heliocare) has been found to help maintain the skin’s ability to protect against sun-related effects and aging. And sun-protective clothing (Solumbra is one brand Vazales recommends) is a growing area for adequately covering adults and children while out in the sun. (FYI: an average white T-shirt has an SPF of just 3, Vazales noted.)

Lotion sunblock remains a leading way to avoid damage from the sun in the first place, and Vazales said an SPF of 15, when applied correctly and regularly, is sufficient to prevent damage.

“People don’t apply enough,” she said, offering an example: A one-ounce application should cover a person for up to two hours. An eight-ounce bottle should have six to eight applications in it. But many people still have the same bottle from last summer laying around when it could’ve (and should’ve) been used up in a day or two.

Vazales’ final message: “If you notice anything that’s changing, get yourself in to see your doctor.”

Topical treatment offers new approach to killing cancer

HOUSTON (AP) — A topical treatment for certain types of skin cancer means that some patients won’t have to worry about scarring, say dermatologists at Baylor College of Medicine in Houston.

While a topical treatment for precancerous cells has been around for more than 30 years, it was only in the last five to 10 years that a topical cream was developed for cancerous lesions.

"The cream, called Aldara, only works for certain types of skin cancer," said Dr. Ida Orengo, professor of dermatology at BCM and director of the Mohs Surgery Center at the Baylor Clinic. "You simply rub it on the area, usually at night, and after about four to six weeks, the cancer is gone in about 80 percent of the cases."

It is FDA approved for superficial basal cell and actinic keratosis but has shown good results for squamous cell carcinoma in situ, she said.

"It works by turning on the body’s immune system," said Orengo. "Your body starts to recognize those cancer cells are not normal and kills them off."

Skin cancer is typically removed by scraping and burning or cutting the area. This can leave a scar or even multiple scars since superficial basal cell carcinomas can appear in several spots close together, but not connected. Orengo said the cream allows for a larger area of coverage and usually heals without leaving behind scars.         

"While the cream works the area can look raw and begin to scab," she said. "But when treatment is over it heals beautifully."

Melanoma on the rise

Local numbers of melanoma patients in Northern Michigan have continued an upward track over the last several years. Doctors are required to report melanomas to a database at Northern Michigan Regional Hospital; those figures show:

2006: 40 cases in the registry
2007: 60-plus cases
2008: Over 100 cases

Roughly 116,500 new cases of melanoma are diagnosed in the U.S. each year, and more than 8,400 people die from it annually.

Source: Dr. Sherri Vazales, Bay View Dermatology and the American Academy of Dermatology

Risks you need to know

While melanoma can strike anyone, there are certain factors that increase the risk, including if you:
Are Caucasian;
Have substantially many moles, large moles or atypical moles;
Have a blood relative who has had melanoma;
Are a Caucasian with fair skin, blonde or red hair, blue or green eyes;
Have had a previous melanoma or a basal cell or squamos cell carcinoma.

Learn your ABCs

If you notice a mole on your skin, you should follow the ABCDE rule which outlines the warning signs for melanoma:

A: Asymmetry, one half is unlike the other;
B: Border, irregular or scalloped or poorly defined;
C: Color, varied from one are to another, shades of tan and brown, black, sometimes white, red or blue;
D: Diameter, larger than 6 mm (the size of a pencil eraser);
E: Evolving, changing in size, shape or color.

Melanomas most frequently appear on the upper back, torso, lower legs, head and neck. In females 15-29 years old, the torso is the most common location, due to high-risk tanning behaviors.