“I liked the look of a tan and thought that maybe down the line when I was much older that I would have to deal with wrinkles and a few basal cell cancers, but at the time it seemed worth the risk,” says Fischer, who had no known family history of the disease.
But at age 27, she discovered a small, brown, flat irregular-shaped mole on her back with a tiny black speck on the edge. She asked her boss, Dr. Phillip Hall, to check it out.
Hall, a skin cancer surgeon at Dermatologists of Southwest Ohio in Kettering, diagnosed Fischer with melanoma, the deadliest form of skin cancer. Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old. One person dies of melanoma every hour.
“With blond hair, green eyes and fair skin, I was the perfect candidate,” says Fischer, now 38 and living with her husband and two children in Columbus. “Melanoma is currently on the rise and I don’t think young people really know what it is. It’s very important to realize that melanoma is not just skin cancer: melanoma is currently the leading cause of cancer deaths in women ages 25-30.”
While the incidence of many common cancers is falling, the incidence of melanoma continues to rise at a rate faster than that of any of the seven most common cancers. Melanoma is primarily a disease of whites; rates are more than 10 times higher in whites than in African Americans.
According to the American Cancer Society’s Cancer Facts & Figures 2010, rapid increases have occurred among young white women and white adults 65 and older. Men now have a one in 55 chance of getting melanoma, for women the statistic is one in 78.
About 68,000 new cases of melanoma are diagnosed each year, and about 8,700 people die, according to the American Cancer Society.
When discovered early, melanoma can usually be cured with surgery alone, but once it spreads (metastasizes) throughout the body, treatment options are limited. In March, the FDA approved a breakthrough melanoma treatment called Yervoy, the first melanoma drug to receive approval in 13 years and the first therapy proven to extend overall survival for advanced-stage melanoma patients.
Hall says a melanoma grows “like ripples in a pond.” He says it begins to grow in a radial fashion, then later grows vertically and “that’s when you get into serious trouble because it gets into your blood vessels.”
Hall believes many people have developed a false sense of security because they use sunscreen.
“There’s probably too much exposure because they feel so protected,” he says. “Good common sense trumps a good sunscreen.”
Hall, who trained in New Orleans, figured he would come to Ohio and “see nothing” in comparison to Louisiana fishermen when it came to melanoma. But that wasn’t the case.
“Ohio is filled with farmers and outdoor workers and these people work the land and come to my office extremely sun-damaged,” he says.
According to Ohio Facts & Figures 2010, Ohio has an average of 2,222 people diagnosed with melanoma every year and another 324 who will die from it.
A recent study at the University of California San Francisco and Stanford University Medical Schools found young women are at the highest risk for malignant melanoma if they live in neighborhoods that are both more well-to-do and sunnier. But the study also found that melanoma incidence increased at all rungs of the socio-economic ladder.
“It is disturbing because this is a fairly young population that doesn’t typically develop cancer nor die from cancer,” says Amelia Hausauer, who worked on the report. She says it’s frightening that melanoma among young women has increased 73 percent since the late 1980s.
“Socioeconomic status turned out to be a much more important predictor of melanoma than we expected and it interacts with ambient UV radiation exposure to change risk among more affluent groups,” Hausauer says. Girls and women living in census tracts that scored in the highest 20 percent in socioeconomic status were six times more likely to be diagnosed with melanoma in comparison to those living in census tracts ranked in the lowest 120 percent.
Hausauer says her team speculates that wealthier women are more likely to be visiting tanning beds, vacationing at the beach or at ski resorts and engaging in outdoor activities such as tennis and golf.
Americans, they insist, need to be diligent about sun protection from an early age. One or more blistering sunburns in childhood or adolescence more than doubles a person’s chances of developing melanoma later in life.
“If you have little kids you need to make sure they are wearing protective clothing or sunscreen, ideally 30 SPF or greater and they reapply it every couple of hours,” Hausauer says.
Jenny Fischer has learned that important lesson the hard way.
“Needless to say I have made some major lifestyle changes since my diagnosis,” she says now. “Sunscreen has become my best friend and tanning beds are a distant memory. I still enjoy being at the pool or the beach but am much more cautious about how much sun I get.
“And as the mother of two blond-haired, blue-eyed boys, I am extremely careful with them when we’re out in the sun.”
Contact this reporter at (937) 225-2440 or mmoss@DaytonDailyNews.com.
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