Live In Our Skinz!

From http://www.wausaudailyherald.com:

August 4, 2008

By John Faherty
Gannett News Service

PHOENIX — Ashley Garcia was just like any other patient about to have surgery to remove the tissue surrounding her melanoma tumor.

She was nervous and hungry and a little bit grumpy.

What made her different as she was wheeled into the operating room recently was her mother’s concern that the surgery and treatment might delay her daughter’s start in kindergarten next month.

Ashley is 5 and represents a disturbing trend in the number of children, teenagers and young adults getting melanoma, the most lethal form of skin cancer.

New data from the National Cancer Institute shows that the melanoma incidence rate for people age 18 and younger increased 84 percent from 1975 to 2005.

The number of children with pediatric melanoma is still small, representing just one of every 100 cases diagnosed, but the trend is cause for concern.

“Melanoma is the only cancer that is growing at this high rate,” said Dr. Jeffrey Goldstein, a pediatric plastic surgeon who performed a radical excision on Ashley’s right wrist at Banner Desert Medical Center in Mesa, Ariz. “This is a very serious issue.”

Melanoma is a cancer of the pigment-producing cells of the skin. If it is diagnosed and removed early, the cure rate is high. If it is diagnosed late, it can spread and be more life threatening.

That is a particular issue with pediatric melanoma, because young adults and children are less likely to notice if a mole has grown or changed.

Pediatric doctors also might be less likely to recognize the disease because pediatric melanoma can manifest differently than adult melanoma. Sometimes, the growths can be the same color as the child’s skin. They might also grow deeper instead of larger.

Finally, pediatricians might not think a child is predisposed to melanoma because for so long it was considered a disease affecting the middle aged and elderly, said Dr. Julie Lange, a professor of surgery, oncology and dermatology at Johns Hopkins Medicine.

Goldstein said the biopsy and recollections of Ashley’s mother, Adi, suggest Ashley’s melanoma is at least 21/2 years old.

Doctors saw Ashley’s growth and even treated it as a possible wart before the condition was correctly identified, said her mother.

It is unclear why Ashley developed melanoma, Goldstein said. It seems unlikely it resulted from overexposure to the sun because of her age, dark skin color and lack of spending time outdoors.

Exposure to ultraviolet sunlight and tanning beds appear to be likely causes for the increase in pediatric melanomas.

People who are “easily sunburned,” have poor tanning ability and pale skin generally are most likely to develop melanoma, according to the National Cancer Institute. Visits to the beach and sunburns among 16- to 18-year-olds increased between 1998 and 2004, according to one recent study. Increased tanning bed use also might be a factor.

Adi held her daughter and tried not to cry when she talked about the cancer and the possibility that it might have spread.

“I never thought this could happen to my daughter,” Adi said.