Melanoma is a very serious form of skin cancer. It is more prevalent in older adults, but people of any age are susceptible. It is very important to check your skin, and consult a dermatologist at the first sign of any change in a mole or freckle, or if you develop a new skin lesion. If detected in the early stages, melanoma has a very high survival rate. If left untreated the survival rate drops dramatically. *It is estimated that 62,480 men and women (34,950 men and 27,530 women) will be diagnosed with and 8,420 men and women will die of melanoma of the skin in 20081 . *Based on rates from 2003-2005, 1.81% of men and women born today will be diagnosed with melanoma of the skin at some time during their lifetime. This disease needs to be taken very seriously, because the number of people developing it is on the rise.
I recently interviewed Dian Newell, a two time melanoma survivor. Her insight and perspective on this deadly disease could prove very valuable to the newly diagnosed.
ANGEL: How old were you the first time you were diagnosed with melanoma?
DIAN: It was in May of 1983, and I was 30 years old.
ANGEL: Did you have a family history of melanoma or skin cancer?
DIAN: None, although I do have a family history of other cancers.
ANGEL: How was your reaction different between the first and second diagnosis?
DIAN: When I was first diagnosed, it was caught early, and my dermatologist assured me that I was "cured." However, at my three month follow up with my surgeon, I had two more shallow primary melanomas removed. This was considered rare back then, so I was put on close follow up. It did affect my life back then. Having a cancer diagnosis was very scary, but I felt lucky, like it had been caught early, and that I had a second chance at life. It colored many things about my life in the following years, from lifestyle choices to career choices.
When I had my recurrence, 20 years later, it was much more serious, and I was much more frightened, and had to make choices about treatment that I did not face in 1983, when the only treatment available was surgery.
ANGEL: When you were diagnosed the second time, it was with stage 3B melanoma. Can you tell us what that means?
DIAN: My cancer advanced to stage 3B in 2003, after 20 years. It is rare to see a recurrence after so long, but it happens more often then one would imagine. Stage 4 melanoma means that the melanoma has moved to distant sites or major organs. Stage 3 indicates that the cancer has moved from its original site to other local sites, or into the lymphatic system.
ANGEL: Whenever someone is given a cancer diagnosis, they are also told their survival odds. What were yours?
DIAN: Five year survival rates for my stage are 30% to 50% before treatment. In comparison, stage 1 five yr survival rate is about 97%, and stage 4 five yr survival rate is about 3%.
ANGEL: What treatment protocol and follow up schedule were you put on?
DIAN: After my recurrence was confirmed by biopsy in 2003, I had a ‘sentinel node biopsy’, and a ‘wide local excision’ During the SNB, dye is tracked from the site of the tumor to the nearest lymph node basin, indentifying the ‘sentinel node’ which is then tested for cancer. Mine were negative, which is good news, but I was still considered stage 3B due to satellite tumors discovered during my wide excision.
I was ineligible for any of the available clinical trials, and went on the only approved therapy for my stage, alpha interferon 2B. It is infused 5 days a week by IV for the first month, and then the dosage is reduced by half, and self injected, 3 days a week for one year. I discontinued use of interferon after 10 months due to side effects in my respiratory system.
During my first month of treatment, I was at the cancer clinic 5 days a week, and I saw my oncologist once a week. Then, during my remaining time on interferon, I saw my oncologist once a month, and had scans every three months. After interferon, my doctor visits were reduced to every 3 months, and my scans to every 6 months. Now I have gone to scans once a year, and visits every 6 months.
ANGEL: How long has it been since your second diagnosis?
DIAN: It’s been 4 and a half years since my diagnosis, and I am doing well, with no evidence of disease.
ANGEL: Do you credit the interferon for your cancer-free state?
DIAN: Well, it’s hard to say. Sometimes I am sure it helped me, other times I wonder if it wasn’t the surgeon who saved my life.
ANGEL: Did you join any support groups or organizations?
DIAN: Yes, I joined an online community, the Melanoma Patient’s Information Page (MPIP.org) which is an active bulletin board for the support of melanoma patients and caregivers. It is connected to the MRF, the Melanoma Research Foundation.
ANGEL: What advice do you have for someone newly diagnosed with melanoma?
DIAN: Melanoma is VERY treatable in its earliest stages, and very untreatable in its higher stages, so it depends on the stage. When I meet someone who is stage 1, I advise them to keep a vigilant eye on their skin, to see their dermatologist regularly, and to use sunscreen on themselves, and more importantly, on their children. If I meet someone who is newly diagnosed at a more advanced stage, my best advice is always to seek out the second opinion of a major melanoma center if at all possible.
ANGEL: Is there anything else you’d like to add?
DIAN: Because of my involvement with the MPIP, I have known many people with melanoma who have died. I’ve also known small children with melanoma, as young as 3 yrs old. Melanoma is so often misunderstood. I’ve had people tell me I am ‘lucky’ to have such a ‘good’ cancer, but, melanoma is one of the most deadly cancers out there in its higher stages. I guess what I’d like the general population to know is that it is deadly, and that it is on the rise. It’s the fastest growing cancer in America. I’d also like them to know that the best thing they can do to avoid it is to avoid tanning booths and sunburns.
Dian Newell is an amazing woman who is a wonderful example of fortitude and strength. She is fighting a daunting battle and winning. If you receive a melanoma diagnosis that is in the early stages you need to stay strong, keep a positive attitude, be diligent with your self exams and doctor appointments, and your chances are good. Find a support group like Dian did and seek advice and help from others facing the same situation. Even if your melanoma is in the later stages you should still fight the good fight, and don’t ever give up!
For information on melanoma please visit these websites:
*Information is based on NCI’s SEER Cancer Statistics Review2.