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A Suspicious Lump

Sometimes the first sign of cancer is not what one would expect. But noticing that something was amiss paid off for Kay Havens.

In March 1993, the 33-year-old and her husband were riding up a department store escalator to purchase a wedding gift for a friend. She bent down to adjust her swollen ankle on the step in front of her and felt a lump in her right groin that didn't seem normal. A recent television news story sent her straight to the doctor to get the lump checked out.

The doctor told Havens he believed the lump was in her lymph nodes and to come back if it was not gone in two weeks. Two weeks later, a surgeon performed a biopsy and diagnosed her with Stage III melanoma.

Melanoma is the most serious form of skin cancer and can quickly spread to the rest of the body if left untreated.
Melanoma is a more serious type of cancer than the more common skin cancers, basal cell cancer or squamous cell cancer. Melanoma can spread (metastasize) quickly to other parts of the body through the lymph system or through the blood.

She and her husband cried for four days after the diagnosis, Havens says, until they realized that no one had ever told them that her prognosis was fatal. It then occurred to her that she was lucky because she found that lump.

On April 30, 1993, Havens underwent a full right groin dissection where a surgeon removed the lymph nodes in her right leg, many of which had microscopic cancer cells in them. Meeting with the doctor after surgery, she was prepared for the next step - chemotherapy, radiation or more surgery.

"I was prepared to do whatever the doctors at M. D. Anderson told me to do, but luckily we agreed to forgo further treatment. They told me to go out and live my life," she says.

Havens wishes she didn't have lymphadema in her leg, a swelling that occurs often in limbs after the removal of lymph nodes, but she realizes it is a small price to pay. "It would be nice to have two legs the same size, but my husband reminds me how lucky I am to have two legs - and to be alive."

sunbathers
Suntanners revel in the hot summer sun, oblivious to the invisible damage caused by harmful UV rays.
The Skin Cancer Risk

Skin cancer is usually caused by the skin's exposure to ultraviolet rays from the sun. The more sun you're exposed to over your lifetime, the higher your risk of developing cancer.

It's estimated that up to 80% of a person's total exposure to the sun happens before 18 years of age. Because of this, it's good to teach children healthy sun habits from the start.

One serious sunburn in childhood can increase future cancer risk by as much as 50%.

Some people feel that if they tan well, they're protected from these harmful rays. But, while it's true that fair-haired, blue-eyed people are most prone to burning, and therefore are more susceptible to the sun's rays, even "healthy" tans are really damage control – they're your body's way of trying to protect itself from the sun.

In other words, there's no such thing as a healthy tan.

Too Young for Skin Cancer?

Jacky Sims was only 15 when she found out she had skin cancer. Below she recounts her battle against skin cancer and gives some advice for young people who think it could never happen to them.

Getting used to a three-inch scar isn't easy--even for a homecoming princess. As I walked onstage, I couldn't believe how many people stared at it."

In my hometown of Phoenix, being tan is right up there with having nice clothes and a cool car. And unlike the clothes and the car, it's free. Or so I thought. Even though I wore sunblock, I still had a year-round tan from track, soccer, and swimming.

In fact, I was heading for the pool last June when my mom said, " We have to talk." She sat me down and told me that my doctor had found a malignant melanoma. At first I didn't know what she was talking about---I'd never had real health problems. What did she mean, "my doctor"? Then I remembered the mole I'd had taken off my chest a few weeks earlier. There wasn't a lump or anything big, but somewhere under my skin there was a tumor. Tears began rolling down my cheeks as I said, "So does this mean....?" My mom finished the sentence for me: "You have cancer."

Jacky was only 15 when she found out that a mole removed from her body was malignant melanoma.
The very next day I had an appointment at the Mayo Clinic, a world-famous cancer centre. The doctor there decided to remove the tumor right away---he didn't want to give the cancer time to spread to my other organs. The urgency terrified me: Was I going to die?

On the drive to the hospital I was wondering why this happened to me. No one in my family had ever had skin cancer. I'd had two moles removed the year before, and neither was cancerous. But thinking about the years of sports in the sun made me sick to my stomach.

By the time we got to the clinic, I was really freaking out. Everything was so white and sterile, and I felt like the doctors were looking at me with a kind of pity. When the anesthesiologist put me under, I was actually relieved.

I woke up a few hours later and glanced down at the huge gash in my chest. For a moment, all I could think about was how terrible the scar would look. Then reality hit and I felt happy to just be alive--- and a little anxious. The surgeons would biopsy my tumor, and I wouldn't know the results for weeks.

Finally, the results of the biopsy came back. The good news was that the melanoma hadn't spread, so I wouldn't need radiation or chemotherapy. Since then, though, I've had five more suspicious cancerous moles removed. That meant surgery and almost daily doctor appointments for a while.

At this point, I'm pretty used to it all. I now have scars on my face neck, chest, stomach, arm and back, from all the procedures. And I go for full-body checks from a doctor every two months.

The thing that still gets me angry is the common misconception that skin cancer isn't serious. Sometimes, when people hear my story , they'll say stuff like, "Oh, yeah, I had skin cancer. I had a mole removed right here!" That makes me want to scream. Almost 8,000 people will die from melanoma this year. Your chances of developing it are related to your exposure to the sun. So each time you go into a tanning booth or lie out, try to imagine your mom or dad telling you that you have cancer. I've been there. It's not worth it.

Burn Baby Burn

Symptoms of sunburn do not begin until two to four hours after sun exposure. The peak reaction of redness, pain and swelling occurs 24 hours after exposure. Minor sunburn is a first-degree burn that turns the skin pink or red. Prolonged sun exposure can cause a second-degree burn with blistering, fever and nausea. Burned skin will peel three to eight days after exposure. Don't pull off the papery dead skin before the skin beneath it has healed. When the blisters break, trim off the dead skin and apply an antibiotic ointment.

Unless there is extreme pain or extensive blistering, sunburn usually doesn't warrant a visit to your health care provider. The pain and heat of sunburn may last for a couple of days, but there are many treatments to help soothe the skin and reduce the discomfort.

If, despite being careful, you still get burned, treat your skin as you would any other kind of burn:

  • Apply cool, wet compresses for 24 to 48 hours.

  • Cool showers may decrease skin pain, but do not apply ice as this can cause further skin damage. Also acetaminophen (Tylenol) or ibuprofen may be used for pain

  • Topical lotions to keep the skin moist can reduce pain as well as dehydration (the normal barrier to water loss through the skin may be disrupted). Aloe plants are a good source of soothing salve and can decrease the pain from the burn significantly.

  • Drink a lot of water to keep from feeling dehydrated.
sunburn
Most people don't take a sunburn seriously and see it as more of a nuisance than an injury. In reality, a sunburn is a first-degree burn that is seriously damaging the outer layer of your skin. Use your sun smarts: cover up, wear sunscreen and don't take unnecessary risks with your health.
Beat The Heat: Heat Related Illness

When you're outside enjoying the hot weather this summer, beware of muscle cramps, dizziness, nausea or confusion because these are warning signs of heat stress.

The term heat stress refers to a group of heat-related illnesses, which include heat cramps, heat exhaustion and heat stroke. Your body can experience heat stress when it isn't able to keep itself at its proper operating temperature due to excessive external temperatures.

When the temperature outside is close to or exceeds normal body temperature, it's difficult for your body to allow excess heat to escape. Your body attempts to regulate its temperature by expanding your blood vessels so that they carry more blood to the upper layers of skin and away from active muscles such as the brain and other vital organs. That's why you may sometimes feel fatigue and a decline in alertness in extreme heat.

Heat Exhaustion

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Those most prone to heat exhaustion are elderly people, people with high blood pressure, and people working or exercising in a hot environment.

Recognizing Heat Exhaustion

Warning signs of heat exhaustion include the following:

  • Beat the heat; keep your body hydrated!/td>
    Heavy sweating

  • Paleness

  • Muscle cramps

  • Tiredness

  • Weakness

  • Dizziness

  • Headache

  • Nausea or vomiting

  • Fainting

The skin may be cool and moist. The victim's pulse rate will be fast and weak, and breathing will be fast and shallow. If heat exhaustion is untreated, it may progress to heat stroke. Seek medical attention immediately if any of the following occurs:

  • Symptoms are severe.
  • The victim has heart problems or high blood pressure.

Otherwise, help the victim to cool off, and seek medical attention if symptoms worsen or last longer than 1 hour.

What to Do

Cooling measures that may be effective include the following:

  • Cool, nonalcoholic beverages, as directed by your physician

  • Rest

  • Cool shower, bath, or sponge bath

  • An air-conditioned environment

  • Lightweight clothing
Protect Your Peepers

The same UV rays that harm the skin can also cause injury to the eyes, with infants and children being particularly susceptible to this kind of damage. Standards for sunglasses have improved dramatically in the last few years, and virtually all brands are effective at screening or reflecting ultraviolet light. Look for stickers that say the lenses provide a minimum of 90 per cent protection from UV-A and 95 per cent protection from UV-B light.

When buying sunglasses, see how well they cover the eyes. Large-size lenses, glasses that fit snugly, and a wraparound design all help cut down on damaging UV rays that can easily leak in around the edges of inappropriate or poorly fitting sun glasses.

Have your clear plastic or glass corrective lenses checked for UV protection. Most clear plastic corrective lenses block UV and to a lesser extent clear glass corrective lenses do as well.

cancer cancer
Melanoma is the most serious form of skin cancer. Look for a mole that has changed shape, colour, size or appears asymmetrical. Basal cell carcinoma (BCC) appears as a round, pink bump. BCC is the most common type of skin cancer and usually appears on sun-exposed areas.
cancer
Squamous cell carcinoma (SCC)  are often red, scaly, crusted, or ulcerated. SCC are more likely to become malignant than BCC.
Heat Cramps

Heat cramps usually affect people who sweat a lot during strenuous activity. This sweating depletes the body's salt and moisture. The low salt level in the muscles causes painful cramps. Heat cramps may also be a symptom of heat exhaustion.

When the temperature rises, kids shouldn't be running around outside.
Recognizing Heat Cramps

Heat cramps are muscle pains or spasms -- usually in the abdomen, arms, or legs -- that may occur in association with strenuous activity. If you have heart problems or are on a low-sodium diet, get medical attention for heat cramps.

What to Do

  • If medical attention is not necessary, take these steps:
  • Stop all activity, and sit quietly in a cool place.
  • Drink clear juice or a sports beverage.

  • Do not return to strenuous activity for a few hours after the cramps subside, because further exertion may lead to heat exhaustion or heat stroke.

  • Seek medical attention for heat cramps if they do not subside in 1 hour
exhausted
The best way to prevent heat stress is to refrain from engaging in physical activity when it is hot and humid. If you must be outside, remember to drink lots of fluids!

 

The Danger of Sun Exposure

Everybody looks forward to the moment when they can shed their winter layers and bask in the glow of the warm summer sun. But is this really a good idea?

Skin Cancer is the most common type of cancer in Canada, with over 60, 000 Canadians developing it every year. With such a high incidence rate, it would seem likely that people would take every possible precaution to prevent skin cancer. But this is not the case. Too many people take unnecessary risks with their health for the sake of getting a summer tan, or out of sheer laziness. As a result, the number of skin cancer cases in Canada has increased by 30% between 1994 and 2004.

The sun's rays are dangerous and can harm you and your child after only 15 minutes of exposure. Prevent sunburns and limit your time spent in the sun, to ensure that you do not become a skin cancer statistic

sunburn
Everyone knows that a sunburn hurts. But did you know that suffering just a few bad sunburns in your life significantly increases your risk of developing skin cancer?
UV And You

Did you know...

Two kinds of ultraviolet (UV) rays from the sun can damage your skin and eyes. They are called UVA and UVB rays.

In general, UV-A is the least harmful, but can contribute to the aging of skin, DNA damage and possibly skin cancer. It penetrates deeply and does not cause sun burn. Because it does not cause reddenning of the skin (erythema) it cannot be measured in the SPF testing. There is no good clinical measurement of the blocking of UVA radiation, but it is important that your sunscreen block both UVA and UVB.

Broad spectrum sunscreens will protect you from both UVA and UVB rays.

Your local radio and TV stations give a UV index each day. Check the UV index before you go out in the sun.

  • If the UV index is low (from 0-2), the risk of getting too much sun is low

  • If the UV index is moderate (3-4-5), you should start to protect yourself from the sun. The amount of UV you expose your skin to depends on the time spent under the sun. The longer you stay, the higher the risk to burn.

  • If the UV index is high (6-7) or very high (8-9-10), you should never go outside avoiding the sun between 11 a.m. and 4 p.m. (If you travel to the tropics, the index could be higher than 11 which is considered extreme.)
burnt feet
Remember, there's no such thing as a healthy tan.
Practice Sun Safety

Be CAREFUL when you go outside on a sunny day! Too much sun can be harmful. You and your baby or child can sunburn in only 15 minutes.

To keep you and your child safe, you should:

COVER UP. Wear long sleeves and a hat with a wide brim. When you buy sunglasses, make sure they have a label that says compliant with ANSI. They will provide almost 100% protection against eye damage. Use long sleeves and long pants to protect your baby from the sun.

STAY IN THE SHADE. When your shadow is shorter than you, the sun is very strong. Look for places with lots of shade, such as a park with big trees. Always take an umbrella to the beach. Always keep your baby in the shade.

USE SUNSCREEN. The bottle should read SPF 15 or higher. SPF means Sun Protection Factor. Put sunscreen on your skin 20 minutes before you go out and reapply some 20 minutes after being out in the sun to ensure more even application of the product and better protection. DO NOT apply sunscreen on babies less than 6 months old.

SAFETY TIPS: 

  • ALWAYS use sunscreen when you are outside in the sun. Carry it with you and put it on every 2 hours (more often if you are swimming or sweating).

  • Try to keep out of the sun between 11 a.m. and 4 p.m. when the sun's UV rays are strongest.

  • NEVER use baby oil to protect children from the sun. It will NOT protect them.

  • If you take prescription drugs, check to see if they can make you
child
Your child's skin can burn in less than 15 minutes. Remember that 80% of a person's sun exposure occurs before the age of 18 and that one bad sunburn suffered in childhood increases a person's risk of developing skin cancer by 50%. Teach your child safe sun habits from an early age.
The Skinny on Sunscreen

How important is "sunscreen"?

Dermatologists strongly recommend that if you have to be out in the sun for any length of time (for shopping, running errands, etc) you should use a sunscreen lotion with an SPF (Sun Protection Factor) of 15 or more UVA protection. If you are going to spend the whole day out in the sun like at the beach or working outside, you and your children should use a sunscreen with an SPF factor of 30 or more and UVA protection. Look for products approved by the Canadian Dermatology Association.

For best results, sunscreen should be applied 15 to 30 minutes before exposure to the sun so it is absorbed by the skin and less likely to rub or wash off. Apply the lotion according to instructions and every couple of hours. Swimmers and those who sweat heavily should use a "waterproof" brand.

For children wearing bathing suits, make sure that sunscreen is applied up to and under the edges of the suit to protect sensitive areas like the upper thighs and chest. Pay particular attention to the tops of feet and the backs of the knees. Be careful when applying sunscreen near the eyes: these products can be irritating so avoid the upper and lower eyelids.

Babies are especially sensitive to UV radiation and heat. For these reasons, it is best to NOT expose babies less than one year of age to any intense, direct sunlight – for example, during the middle of the day.

Sunscreens, like many other products, have a limited shelf life and become less effective over time. Consumers should check the expiry date of their old sunscreen containers and replace them if they are out of date.

Skin Cancer

Skin cancer is usually caused by the skin's exposure to ultraviolet rays from the sun. The more sun you're exposed to over your lifetime, the higher your risk of developing cancer.

Excessive sun exposure is the primary cause of malignant melanoma, the least common but deadliest form of skin cancer. Having a fair or freckled complexion, lots of moles and a family history of melanoma increase the risk even further.

Since 1988, there has been a 41 per cent increase in the death rate for melanoma in men — that's the highest rate of increase of all cancers. The death rate in women has climbed 23 per cent over the same period.  This year more than 800 Canadians will die of skin cancer.

The good news is that this cancer is curable in most cases. "About 90 per cent of melanoma can be cured if caught early.

The most common skin cancers (basal and squamous cell) can look like a small, skin-coloured or red knob. Melanoma – a serious kind of skin cancer – usually begins as a mole that seems to change colour or size.

You can use the following ABCD method to help
examination
Any moles that look irregular should be examined by a doctor. It's better to be overly cautious than cancerous.
decide if you should have a mole checked by a doctor:
  • Asymmetry. The mole is not round.

  • Border. The border is irregular with jagged edges, not smooth.

  • Colour. The colour can be uneven across the mole, it can change, or it may seem very different from the other moles on your body.

  • Diameter. Cancerous moles are usually larger than 6 mm (the size of a pea or a pencil eraser).
A Prospect Who Never Got His Chance

Baltimore Orioles pitcher Steve Bechler died less than 24 hours after complaining of dizziness during a spring training workout.

Team officials said the 23-year-old prospect was pronounced dead at Northridge Medical Center, where he had been in intensive care overnight. His wife, Kiley, who was pregnant at the time with the couple's first child, was at his bedside.

Steve Bechler was just starting his major league career when he died of heatstroke.
The 6-foot-2, 239-pound Bechler was paleand feeling lightheaded while completing his final conditioning run at Fort Lauderdale Stadium. The initial diagnosis was heat exhaustion and dehydration, but his condition worsened after he arrived at the hospital by ambulance.

William Goldiner, the Orioles' team physician, said doctors who treated Bechler believe he died of "multi-organ failure due to heatstroke." He said Bechler's body temperature reached 108 degrees.

"He would rebound at times. They thought they were getting ahead of it, and then another organ system would fail," Goldiner said at a news conference at the stadium.

Bechler was said to have reported to camp overweight. When asked about the pitcher's conditioning, manager Mike Hargrove was quoted as saying it was "not good."

Goldiner said he wasn't aware of any evidence that Bechler had been taking a dietary supplement such as ephedrine, an amphetamine-like stimulant that has been linked to heatstroke and heart attacks. Ephedrine has been banned by the NCAA and NFL but not by Major League Baseball.

"Steve was a tough guy; he was a competitor," Hargrove said. "I didn't know him that well, but I knew him well enough to know he loved the game and loved to compete."

The players were briefed about Bechler's condition during a clubhouse meeting before Monday's workout. They were summoned inside a short while later and told of his death.

"They told us about the situation, and everybody was in shock," Orioles pitcher Rodrigo Lopez said.

Bechler fell down while running drills on Sunday and Hargrove said he could tell Bechler wasn't feeling well toward the end of the run.

"He was about 60 percent of the way through it when we noticed that he was a little white--faced," Hargrove said, "He was leaning against a fence ,,, which isn't unusual when guys get tired, We put him on a cart and brought him in and called the paramedics."
A Skin Cancer Scare

Dr. Judith Reichman was one of the lucky ones. Her pre-cancerous mole was caught early and treated before it developed into full-blown skin cancer. Below she recounts her brush with what could have been a much more serious illness, had she left her suspicious mole alone.

Skin cancer can happen to all of us — even doctors. It happened to me. I now have a new scar on my leg. Before that, I had a strange spot. I finally got it checked out and it was found to be pre-cancerous.

As a child, I ran around in shorts during my summers at the New Jersey shore, getting the requisite “healthy” tan. I occasionally burned. Who ever heard of putting sun block on legs?

Now I am finally paying the price. I noticed a flat brown mark on the inside edge of my right calf, which I watched with mild interest for the past year.

Recently, it developed little black specks and irregular borders. I thought it should be looked at by someone other than myself. But still I waited — my dermatologist got married and was on his honeymoon.

Finally, I went for an appointment in his office. “Probably nothing,” he said. But just to be safe, he numbed it and excised the area of dark pigment.

Melanoma is expected to strike 51,400 Americans this year and kill 7,800. While melanoma accounts for only about 4 percent of all skin cancer cases, it causes almost 80 percent of skin cancer deaths

The pathologist reported it was not “nothing.” It was a pre-melanoma.

The good news is that it was caught early and will in no way affect my health.

The bad news is that — no doubt because I am a doctor — it became infected. That superficial pigmented area became a deep, unsightly cavity that required a visit to the plastic surgeon, who will revise it, creating a more cosmetically-pleasing scar. And that’s all the therapy I will need.

I cannot promise that everyone will have such a fortunate result. 

Heat Stroke

Heat stroke occurs when the body is unable to regulate its temperature. The body's temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Body temperature may rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.

Recognizing Heat Stroke

Warning signs of heat stroke vary but may include the following:

  • An extremely high body temperature (above 103°F, orally)

  • Red, hot, and dry skin (no sweating)

  • Rapid, strong pulse

  • Throbbing headache

  • Dizziness

  • Nausea

  • Confusion

  • Unconsciousness

What to Do

If you see any of these signs, you may be dealing with a life-threatening emergency. Have someone call for immediate medical assistance while you begin cooling the victim.  Do the following:

  • Get the victim to a shady area.
    sunbathing
    Get out of the sun and find some shade!
  • Cool the victim rapidly using whatever methods you can. For example, immerse the victim in a tub of cool water; place the person in a cool shower; spray the victim with cool water from a garden hose; sponge  the person with cool water; or if the humidity is low, wrap the victim in a cool, wet sheet and fan him or her vigorously.

  • Monitor body temperature, and continue cooling efforts until the body temperature drops to 101-102°F.

  • If emergency medical personnel are delayed, call the hospital emergency room for further instructions.

  • Do not give the victim alcohol to drink.

  • Get medical assistance as soon as possible.

Sometimes a victim's muscles will begin to twitch uncontrollably as a result of heat stroke. If this happens, keep the victim from injuring himself, but do not place any object in the mouth and do not give fluids. If there is vomiting, make sure the airway remains open by turning the victim on his or her side.