Skin Checks: My How You’ve Changed

By April Pulliam

Skin checks have always been important to me. As a preteen, I obsessed over examining my skin–looking in all the right places including my back, stomach, hairline, and even my feet. I left no stone unturned– no area unchecked. If I am completely truthful, my self-examinations exceeded the expectations of normal regularly planned monthly skin checks; most of the time, I scanned my skin daily.

I was faithful. I was routine.

I was stupid.

During those skin checks, I was sure of myself and knew exactly what I was looking  for. There was one huge glaring problem: I was examining my skin regularly to make sure it was darker, and I was watching to make sure my tan lines were obvious. It was important to me that the only pale areas were under my clothing where no one would notice them anyway. I was quite literally checking to make sure I was damaging my skin. Was I burnt? Red enough? Enough contrast in the tan lines? This incredibly asinine habit went on from the time I was around twelve years old until I was 33 with two small children and countless visits to tanning salons under my belt.

Year after year, summer after summer, I made sure I spent as much time in the sun as possible and made up for any time lost to rainy days with visits to a tanning salon. As I became a busy working mother, I used tanning beds more frequently and jam-packed my beloved exposure to those harmful ultraviolet rays into 20-minute sessions sandwiched between the two fiberglass panels of a tanning bed. I faithfully followed those sessions with mirror checks to make sure I was tanning. Of course, I wasn’t. That, in and of itself, might be the most ridiculous aspect of my story. I am fair and freckled, have reddish blonde hair, and don’t tan easily, but Heaven knows I tried. Never, in all those years of tanning, was my skin a bronze color; it was always varying tones of red, and I kept a fresh-from-the-sun burnt look from February to October for about 15 years.

In 2007, my story changed–and so did the nature of my skin checks. I was diagnosed with melanoma at the age of 33. An irregularly shaped mole on my arm pointed out by my best friend led me to have a biopsy by my family doctor. With two children under the age of six, skin cancer invaded my life, but I had graciously opened the door. Overexposure to the sun and indoor tanning paved the way for sun-damaged skin and increased my chances for developing both squamous and basal cell carcinoma in addition to creating an increased risk of melanoma.

Following the excision of the melanoma on my upper left arm, I was introduced to regular skin checks–the kind that could save a life. I examine all the same places I used to check so thoroughly, but I am watching for new spots, changes in existing moles, and dry patches of skin that aren’t healing easily. These regular checks and visits to a dermatologist led to the discovery of three more problematic spots that proved to be basal cell carcinoma.

    Thanks to my obsession with tanning beds, my determination to seek sun exposure, and my compulsive checks to make sure I had visible and distinct tan lines, I am now a regular user of a topical chemotherapy, Efudex. Monthly skin checks and visits to my dermatologist every six months keep me on my toes, and I am now aware of the precancerous spots that continue to appear on the surface of my skin despite the fact that I haven’t tanned since 2007.

    Being fair and freckled with green eyes, I may have had all the right factors for skin cancer, but I created the perfect storm by abusing my skin with tanning beds and skimming right past suspicious spots and changing moles as I made the quest for tan skin my only goal. Regular skin checks and visits to a dermatologist are vital, and not enough of us realize that fact. The years I spent tanning are years I will never get back, and the damage I created cannot be reversed. I am still checking my skin, but I have changed the way I look at myself in the mirror, and the list of things I look for has changed dramatically. I have new priorities–skin checks that can save my life, not end it.  

The Melanoma Education Foundation Presents An Evening with the Singing Trooper

On April 27th, the Melanoma Education Foundation Presents a Benefit Concert in Memory of Keri McCarthy

The Melanoma Education Foundation will present An Evening with the Singing Trooper, a Benefit Concert in Memory of Keri McCarthy, taking place at Anthony’s of Malden on April 27,2019 featuring Dan Clark, the Singing Trooper.

Admission includes a full buffet dinner and 1 hour show. There will also be a live auction, 50:50 raffle and a wine pull. Individual tickets are $75; reserved tables of 10 are $700.

This event will be in memory of Keri McCarthy of Somerville who lost her life to Melanoma at 35 years old.  Like many people, Keri enjoyed being tan; she spent time sunbathing and used tanning beds sometimes.

In the Spring of 2004, Keri noticed a small bump on her leg that looked like a pimple.  She mentioned it to her mother, but, neither of them thought much about it. Not long after, Keri’s mom was reading an article in a woman’s magazine on skin cancer.  When she saw a picture that resembled the spot on Keri’s leg, she was concerned. She asked Keri to get the spot looked at right away. The dermatologist attempted to “freeze it” off and commented that a biopsy would be done if it returned.

The spot did return and now it had multiple colors.  This time the Dermatologist performed a biopsy. Keri was diagnosed with Stage 2C Melanoma five days later. After further surgery, the doctor felt confident that they had gotten it all.  

Keri was NED (No Evidence of Disease) for 3 years.   She married and wanted to have a family. After several fertility treatments, she got pregnant.  That joyful time ended abruptly 14 weeks into her pregnancy when her tumors began to reappear. The Melanoma was back with a vengeance and was out of control in her body.  

Keri underwent radiation throughout her entire pregnancy to try to keep the tumors from spreading.  Her son, Quinn, was born healthy in September of 2007 but Keri had tumors starting at her ankle and proceeding up her leg.

After years of fighting, in March 2010 (one week before her birthday), a Pet scan revealed that the cancer had spread to her lungs. She passed away on May 21.  Keri left behind her precious 2 year and 9 month old baby boy, and her supportive family and friends.

The Melanoma Education Foundation has partnered with the McCarthy Family to raise awareness about the importance of early self-detection and prevention of Melanoma.   Founder and President, Steve Fine began the Foundation after the loss of his son, Daniel, at age 26 from Melanoma. Over the past 20 years, the Melanoma Education Foundation has worked tirelessly to educate middle and high school health teachers and their students by providing comprehensive training and resources focused on early self-detection and prevention of Melanoma.  Keri’s Story is one that happens far too often. By providing resources to over 1,700 schools nationwide and helping to educate over 250,000 students annually, the Melanoma Education Foundation arms them with life-saving knowledge.

For more information about the Evening with the Singing Trooper on April 27th or to learn more about the Melanoma Education Foundation,  please visit www.skincheck.org.  


Claire’s Story

No worries, they said. “Kids don’t get melanoma.” They were wrong.

The Melanoma Education Foundation thanks Marianne Banister and the Claire Marie Foundation for sharing Claire’s Story. Recently, the Melanoma Education Foundation and the Claire Marie Foundation began a partnership to dispel the rumor that “Kids don’t get Melanoma.”

By Claire’s Mother, Marianne Banister

In 2011, we considered ourselves a typical a family of four, running here and there, caught up in the dramas of life. Our two beautiful, healthy and happy girls were busily immersed in life. As parents, we were preventative in healthcare. Our girls were screened by a dermatologist annually since the age of two, lived in sunscreen and never tanned. That summer, Claire was a regular 14-year-old, looking forward to her freshman year of high school, her blue eyes sparkling in excitement at all the possibilities. Then we blinked and it all changed.

A mole — one that had been on her ankle since the day she was born — suddenly looked “different.” Its removal was delayed by the plastic surgeon’s office. No worries, they said. “Kids don’t get melanoma.” They were wrong. Nearly four months later the call came: Our darling 14-year-old girl had stage 3a malignant melanoma.

How did this happen? In short, Claire simply became a teenager. Hormonal changes, which routinely occur in puberty, prompted development of melanoma in our daughter; a risk we never knew was possible. More specifically, it turned out elevated levels of TSH linked to her adolescence induced hypothyroid condition was the direct link. Dr. Julie Ellerhorst of University of Texas MD Anderson Cancer Center, who discovered the link between TSH and melanoma,  found Claire’s mole of origin had a very high receptor to the TSH hormone. Dr. Ellerhorst estimated that link thus allowed the elevated levels of TSH to feed melanoma development in our daughter.

Here is the link to Dr. Ellerhorst’s research: https://bit.ly/2SaJLUL

We were blindsided by her diagnosis, yet Claire and the rest of our family accepted no option but success. We were on that celebrated path more than once, only to be diverted by recurrence or metastases of the disease.

For three years, Claire fought hard with a quiet resolve, her sense of humor and joy of life fully intact. She kept her diagnosis private so she could just be a normal teenager as much as possible. Through debilitating treatments, she still managed to maintain her academics, sports, competitive aerobics and design studies. She enjoyed a bounty of friends who often found their way to our home.

The day before she passed away in October of her senior year, Claire learned she was accepted into two colleges to study design, her longtime dream. She was thrilled and still making plans for her future.

Part of Claire’s plan included becoming an advocate to raise awareness of melanoma in young people. As her family, we now champion that cause while celebrating her passion for life and the joy, color and beauty she embraced every day.

Through our CMF Collegiate Ambassador Program, 106 young people are sharing her story and offering awareness prevention through our peer-to-peer melanoma education program on 46 campuses nationwide.

Through our partnership with Johns Hopkins Dermatology we offer professional education to resident dermatologists and pediatricians to help them better understand the nuances of melanoma in adolescents and young adults.

We screen hundreds of young people annually through the CMF Free Skin Screening Program in Maryland, finding atypical moles and melanoma at the earliest stages possible.

We are still a family of four. Claire will always be with us, always our strength and inspiration. We carry out her mission every day by sharing her story and celebrating the amazing young woman we were privileged to call our daughter and sister.

“That will never happen to me.”

By Amanda Carpenter, MEF Ambassador

Like so many teenagers, I sat in the sun for hours slathered in tanning oil. I promised my mother I would wear sunscreen, but my blistering red skin always revealed my lie. To this day, I cringe thinking of what I did back then. I knew better. I knew the risks. As a child, I watched as my grandmother lost a grueling four-year battle with Melanoma.  Like so many teenagers, I thought “That will never happen to me.” But I was wrong. When I was eighteen I noticed a mole on my back that would often become irritated from rubbing on my clothing. I have always been aware to look out for any changes or symptomatic moles due to my family history, which prompted me to have this examined by a dermatologist. I made an appointment and the dermatologist told me not to worry; the mole looked harmless. It looked benign.

There was no reason for a biopsy. But that information didn’t sit well with me. Something was telling me to push my doctor and have the mole removed.  I knew my body and something about this mole just wasn’t right. I knew to look out for anything changing on my skin. I knew I was at higher risk for developing Melanoma because of my family history. I knew I needed this mole biopsied. I pushed, and finally, my dermatologist agreed to take a biopsy.

A few weeks later, I received a call that the biopsy showed Melanoma in situ, which is
Melanoma in its earliest form. I was completely shocked. The surgeon performed a wide local excision to remove it, and my yearly skin checks became even more frequent. The fact that I listened to my body and my instincts and advocated for myself spared me much more invasive treatment, and maybe even saved my life. If I had not gone to see my dermatologist and pushed for the biopsy my Melanoma could have had a very different outcome.

Melanoma can happen to anyone. And even if you never burn, even if you don’t have fair skin and freckles, and even if you are young, it can happen to you. Get a baseline skin check, know your ABCDE’s, and get to know your body and your dermatologist. You are your best advocate.

MEF Evening of Perspectives

The Melanoma Education Foundation would like to thank everyone who braved the inclement weather on Friday, November 9 for our Evening of Perspectives event.  We would especially like to recognize MS Walker, The Brody Family, William and June Braunlich, Mitch and Merrill Applebaum and Steve and Gail Fine for their sponsorship of the event.

In addition to the wonderful food, music and auction, MEF also used this event as a platform to recognize members of the medical and educational community who have demonstrated a commitment to our mission of providing education focused on Melanoma early detection and prevention.  

2018 MELANOMA EDUCATION FOUNDATION HONOREES

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Dr. Joseph Kvedar

Dr. Joseph Kvedar, our keynote speaker and honoree, is a dermatologist and pioneer in the field of telemedicine. He is the Founder and Vice President of Partners Center for Connected Health, has been a Dermatologist at Massachusetts General Hospital since 1984 and Associate Professor of Dermatology at Harvard Medical School since 2002. He served as President of the American Telemedicine Association, Chairman of the American Academy of Dermatology Task Force on Telemedicine, co-founder and Chairman of the Scientific Advisory Board at Healthrageous, Inc. and serves on the advisory boards of many companies.

He is internationally recognized for his leadership and vision in the field of connected health and has authored over 90 publications on the subject. He established the first physician-to-physician online consultation service in an academic setting, linking patients from around the world with specialists at Harvard-affiliated teaching hospitals.

He is using information technology – cell phones, computers, networked devices and remote health monitoring tools – to create a new model of health care delivery, moving care from the hospital or doctor’s office into the day-to-day lives of patients.   His book, “The New Mobile Age: How Technology Will Extend the Healthspan and Optimize the Lifespan” best summarizes the benefits of his work for all of us.  The topic of Dr. Kvedars speech was “Teledermatology.”

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Janda Ricci-Munn, Manchester-Essex Regional Middle School

Janda Ricci-Munn is the MEF 2018 Honoree for Excellence in Health Education. He is the health teacher at Manchester-Essex Middle School in Manchester by the Sea, Massachusetts. He began his teaching career there in 2005.
In addition to teaching, Janda owned and operated a triathlon and cycling coaching business while concurrently racing as a triathlete on the national level. After winning two consecutive Ironman 70.3 amateur world championship titles, he left teaching for three years to pursue his dream of professional racing.
He returned to teaching in the fall of 2011, spurred in large part by the loss of his father, long-time Gloucester High School track & field coach, Jim Munn, to melanoma. Janda has been using the MEF melanoma lesson since then and, because of the lesson, a student had an early melanoma removed, 4 others had precancerous moles removed, and Janda’s brother, Corey, had an early melanoma removed.
After students watch the lesson video, he uses the MEF “See Spot bookmarks” as a homework assignment to teach their family members about melanoma. And he took the additional step of providing faculty members with bookmarks. Spanish teacher Kristen Cressey shared with Janda’s class that the See Spot bookmark tipped her off to a suspicious mole on her husband’s back that turned out to be an early melanoma.
Janda resides in Gloucester with his wife and two children.  We congratulate Janda on this prestigious honor!
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Jennifer Linscott Tietgen Family Foundation

The Jennifer Linscott Tietgen Family Foundation was established in memory of Jennifer, who lost her life to melanoma in 2002 at the age of 27. The Foundation has been our single most magnanimous supporter for more than 15 years. 

The Impact of MEF Melanoma Lessons

In March, 2017 MEF enlisted volunteer Marissa Picerno, a talented Emerson College Heath Communications graduate student, to develop and administer a health/wellness teacher web survey.  The goal of this survey was to gain insight into how high school students, middle school students, and teachers were impacted by the MEF Melanoma Lessons presented in their schools. Responses were received from 334 teachers.   Here is what we found:

  • 49 teachers were told by students that early melanomas were found because of the lesson.
  • 90.4% of teachers either strongly agreed or agreed that the online melanoma lessons changed their students’ perception of melanoma
  • 73% of teachers reported that students made appointments to get moles checked after receiving the lesson
  • 68% of teachers responded that, due to the MEF lessons, they or a family member and been examined by a dermatologist.
  • After the lessons, 95% of teachers reported students said they would use more sunscreen, and 81% reported students said they would stop using tanning beds.

In addition, teachers provided their opinion about the MEF Melanoma Lessons in their own words.  Check out the word cloud below to see the most hit upon theme.

Visit www.melanomaeducation.net to access our classroom lessons for your students!

The Fairest Kids of All…Need to Do More to Protect Their Skin from Melanoma

Think that it is enough to apply sunscreen for your family beach days, kids soccer games or just doing yard work on the weekend? Think again. While it was previously thought that sunscreen was the key to keeping your skin and children safe from the sun’s powerful rays, it is now clear that a more comprehensive approach to sun safety must be taken and taught to your kids.
In May of 2018, The U.S. Preventive Services Task Force (USPSTF) actually changed their recommendations on when to teach your kids sun safety. The previous suggestion was to begin teaching children about sun safety at age 10. Now, due to the fact that children who get sunburns early in life are more likely to develop melanoma, coupled with the understanding that kids who learn sun
safety early are more apt to stick with it into adulthood, it is recommended that beginning at six months of age parents should be teaching their children about how to protect their skin from the sun.
In order to give your children the tools they need to keep their skin safe, just teaching them to apply sunscreen is no longer enough.  Recently, the National Cancer Institute analyzed over 28,500 responses from the 2015 National Health Interview Survey and, surprisingly, Kasey Morris, who led the study, commented that, “Regular sunscreen use, in the absence of other protective behaviors, was associated with the highest likelihood of sunburn.”
In their paper on the study, they went on to say, “Although participants who did not use sunscreen, seek shade, or wear protective clothing had a higher probability of sunburn (54.8%), the group with highest likelihood of sunburn consisted of those who used only sunscreen (62.4%). The group with the lowest probability of sunburn did not report using sunscreen but reported engaging in the other 3 protective behaviors (24.3%).”
This does not mean that you and your family should shift
from applying sunscreen to just wearing long sleeves and trying to
keep out of the sun. It is crucial to cover all of your bases.
The USPSTF makes the following recommendations for sun
protection of children:
• Wearing protective clothing, including hats
• Receiving proper advice on how to apply broad-spectrum
sunscreen, with a SPF of 15 or more
• Avoiding indoor UV tanning, and tanning beds
• Avoiding sun exposure in the middle of the day, between 10am and
4pm, when the rays are strongest
• Keep your family sun safe this summer!
 
Check out www.skincheck.org for comprehensive information on early self-detection and prevention of melanoma.
 
References
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recommendations-extended-young-children-under-10-12752
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idUSKBN1K02RB
US Preventive Services Task Force. Behavioral Counseling to
Prevent Skin CancerUS Preventive Services Task Force
Recommendation Statement.JAMA. 2018;319(11):1134–1142.
doi:10.1001/jama.2018.1623