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Part 1: “Well, this can’t be good.”
A mole on my left leg was itching terribly one day in 2012 when I was driving to work. While I was scratching it, I felt a warm liquid go down my leg. I looked down and saw I was bleeding pretty badly and the mole was hanging off my leg. I remember thinking, “Well, this can’t be good.” I went home, called the dermatologist and ended up with an appointment 4 weeks later. At the appointment, the doctor said it looked fine and he doubted I had anything to worry about.
Three days later he called and told me my biopsy came back positive for melanoma. About a week later, the mole was surgically removed and I was told margins were all clear. I was good to go on with my life.
Part 2: Not so fast...
In September 2014, I was taking bins down from my attic to start decorating the house for Halloween when I noticed a hard bump in my groin area right where my lymph nodes would be. I was a little concerned but blew it off. After a week of this bump still being there, I told my sister who told me to call my doctor immediately. To be honest, I didn’t know which doctor to call. My general practitioner or my OB/GYN? I hadn’t thought to call my dermatologist until someone asked me if it was on the same leg where I had my melanoma in 2012, and it was. After about 3 weeks of my sister yelling at me and now someone telling me I should call the dermatologist, I finally did. I explained the situation to the receptionist who seemed uninterested and didn’t make the appointment for another 3 weeks.
At the appointment, the doctor examined the lump and I watched the color from his face drain. Again, I thought: “Well, that can’t be good.” He immediately sent me to the same surgeon who removed my melanoma in 2012. The surgeon seemed unconcerned and said: “I know I got it all in 2012.” I then broke down in tears because I just knew he was wrong...I could feel it. I went in for my surgery on October 13, 2014. The surgeon removed that one lymph node and said he would call me in a few days with the results. On October 16, he called me with the devastating news that it was indeed melanoma in my lymph node. I had Stage 3 melanoma. I felt like I was standing in the middle of a room and everything around me was going 100 mph! After I hung up, I had to call my husband and other family members. In between the calls, I was pacing back and forth and begging God not to take me from my children. I also had a lot of guilt for all the years I used a tanning bed and didn’t put sun block on at the beach. How could I be so vain and stupid? I honestly never knew you could actually die from skin cancer.

Stay tuned for more of Amy's story !

 

 

hiking in snow

Printed with permission from South Shore Hospital's Youth Health Connection Newsletter 

It is wintertime here in New England, and for many of us, it means hitting the slopes. Whether you are a skier, snowboarder or skater, you must know the importance of protecting your skin – even with below freezing temperatures. Ultraviolet rays are more dangerous at higher altitudes, reflecting off the snow and onto our skin. This makes us just as susceptible to skin damage in the cold winter months as in the summer months! Even just a few minutes of high sun exposure a day can lead to noticeable changes to the skin and will accelerate facial aging, making you look much older than you really are. Who wants that?

To protect your youthful skin from sun damage, perhaps even preventing a deadly melanoma, remember these tips before hitting the slopes:

-Wear an SPF (Sun Protection Factor) 30 sunscreen on your face with broad-spectrum protection (protecting against Ultraviolet A & Ultraviolet B rays).
-Apply this before stepping outside and heading to the mountain for the day and remember to apply every two hours. Snow and strong wind can wear away sunscreen.
-Wear good sunglasses or goggles to protect your eyes, eyelids and the sensitive skin around your eyes. Each of these is common sites for skin cancers.
- Lip skin is very thin! Be mindful and apply SPF there too. Use a lip-balm with at least a SPF 15. These lip-balms are easy to carry and easy to use.
- Pay attention to the early signs of sun damage – uneven pigmentation, lesions and changes in mole appearance. Go see a dermatologist! To learn more about the ABCDE’s of skin changes visit: http://bit.ly/1MU2StE

For more information on skin cancer visit: www.skincancer.org
To learn how to read a sunscreen label visit: http://bit.ly/1L85koN

 

The Skin Cancer Foundation says “Its never too early to teach your children about sun protection. They’ll learn from your example, so be their role model, and just like they remind you to buckle up in the car, they’ll never let you forget to cover up in the sun.”

We believe this is true and suggest that you keep the five easy action steps of SunAWARE posted in the kitchen or near the door. It will remind you of the different methods employed to foster UV protection and ensure good health.

Children as young as age four can be taught to check their skin. Scott Naughton, author of “What Are These Spots On My Skin” has provided a wonderfully illustrated book for very young children that teaches how to perform a body check and how to recognize unusual or changing moles and freckles. “Prom Prep 101”, by Mary Barrow and Maryellen Maguire-Eisen (ages 8-12) not only talks about the hazards of indoor tanning but also reinforces the importance of protecting your skin from natural light. “Wiseheart Saves the Dawn”, by Jane Shanny (Ages 8-12) tells the story of a curious and courageous boy from the Cahto Indian tribe. As he dares to confront his tribe's dark secret, he makes a remarkable discovery. This story has been adapted from traditional tales and is designed to teach a very important lesson—sun protection. Electronic books are available for free on Kindle and IBook through links on our website at http://www.melanomaprevention.org.

If you search “sun safety games for children” you will find many links to educational games and activities that are fun and informative. For example, check out the sun safety relay game available at: http://pbskids.org/zoom/activities/games/sunsafetyrelay.html
Or access fun, educational games and coloring pages with the Spot Children’s Outreach Toolkit found on the American Academy of Dermatology website, http://www.aad.org

Our children are curious and ready to learn about sun safety even at very young ages. Provide them with child-friendly lessons about taking care of their skin and teach them to avoid unprotected exposure to the sun’s rays. For more information about our SunAWARE Children’s Program, explore our website and download our curriculum.

On Saturday, November 14th, South Shore Skin Center Spa hosted a day of beauty to raise funds for Children’s Melanoma Prevention Foundation’s SSSC StaffSunAWARE Program. Supporters spent the afternoon beautifying, bidding, and buying for a great cause! The newly opened state of the art spa in Norwell provided clients with an array of discounted cosmetic procedures and beauty products. Each patron received a designer UV bracelet and raffle ticket. Fabulous raffle items included a sonic facial system, champagne, martini set, sun protection clothing, coveted cozy mittens, etc. The incredible silent auction included fifteen fabulous items from VIP passes to the House of Blues to a 2-week safari at Zulu Nyala Reserve in South Africa. In case the retail excitement wasn’t enough, there was delicious food catered by Cranberry Vine Caterers, sponsored by our friends at SkinCeuticals Corporation. It was great to see that foundation friends and corporate sponsors alike came to the Open House to show their support. Dr. Hongmei Li and Anthony Drapos represented DermDX New England and Sean Boucher of Eastern Bank bought three generations of his family to the event. Special thanks to the spa staff for donating their time and service. CMPF was pleased to have raised over $15,000 for their SunAWARE Program! The Executive Director, Maryellen Maguire-Eisen said, “the generosity and enthusiasm of South Shore Skin Center staff made this event particularly special. It is wonderful to see a group of people willing to give up a Saturday to show that they support our mission to prevent skin cancer one child at a time”.

NursingGeorgetown Tanning Infographic
Of all the risky behaviors that teens may engage in, indoor tanning is one that’s most directly related to preventable and potentially deadly skin cancers — namely, melanoma. That’s why it’s important for teens, their parents, and healthcare providers to have a clear understanding about the facts of teenage indoor tanning — and why the risks are particularly high for adolescents.

Indoor Tanning Trends Among Teens

Although indoor tanning rates are trending down among high school students, the prevalence is still dangerously high. According to the 2013 U.S. Youth Risk Behavior Survey,  just over 20 percent of female high school students used an indoor tanning device in 2013 and 10.3 percent did so frequently. Most commonly, these were non-Hispanic white females.  Among male students, just over five percent engaged in indoor tanning, and two percent tanned frequently.

To understand such trends, it’s important to know the motivation behind them. According to the Surgeon General’s Call to Action to Prevent Skin Cancer, one central reason is the age-old symptom of youth: peer pressure. Social norms equate a tan with attractiveness and health. In addition, indoor tanning may actually be somewhat addictive — and researchers are currently evaluating if this is the case.

How Teen Habits Impact the Overall Rate of Indoor Tanning in the U.S.
The indoor tanning industry is definitely benefiting from the habits of teens — since it’s estimated that 2.3 million teens visit a tanning salon at least once a year. However, the increased evidence of risk has led to more regulations for the industry — with an ongoing call for even more.
Currently, 44 states and the District of Columbia have some kind of law or regulation in place that restricts indoor tanning for minors under a certain age — and evidence suggests that such restrictions are effective in reducing usage in this population.

The Risks of Indoor Tanning for Teens
Indoor tanning exposes users to two types of UV rays, UVA (tanning/aging and UVB (burning) — both of which damage skin and can cause various types of cancer. This is particularly the case for teens, who have a higher long-term risk for getting melanoma associated with indoor tanning behaviors — as well premature skin aging. Short-term risks include the potential for burns to the skin and eye damage if appropriate protection isn’t used.

How Can Parents and Providers Discourage Indoor Tanning?
In addition to the issues discussed previously, other factors which influence indoor tanning by teens include lack of awareness of the dangers involved, and the influence of the adults in their lives. Research has shown that parental acceptance of tanning has a strong influence on adolescent tanning behaviors, especially between mothers and adolescent daughters — so it’s important for parents to set good examples.
In addition, in order to increase awareness, primary care providers need to properly educate young patients and appropriate education about the dangers of indoor tanning to their young patients and their families — as well as regular screenings for skin cancer detection. If everyone involved is armed with the facts about teenage indoor tanning, a coordinated effort can be achieved to help discourage this high-risk behavior.

 This infographic was produced by Nursing@Georgetown, the online Master of Science in Nursing degree from Georgetown University's School of Nursing & Health Studies.

People ofTeenage diversity the world come in an array of shapes, sizes, and colors. The dissimilarities among us are what creates the diversity that we can so fortunately enjoy in the “melting pot” that is America. These differences did not all happen by chance, however. In fact, scientists can trace back to the earlier stages of civilization to a time where we were not so different. In the same school of thought as evolution, there are theories that humans began with a dark complexion, and some northward populations eventually developed lighter skin as a means for survival. Believe it or not, much of this theory is attributed to the sun!
Yes, it is true... the sun is responsible for more than just harmful UV-rays (but you didn’t get that from us!). Along with the solar power that makes vegetative life and sustainable energy possible, we humans even require some of the nutrients given by the sun, like Vitamin D. Vitamin D helps us maintain healthy bones, teeth, and fight certain diseases. This vitamin is available to us through fatty foods and fortified food sources, but can also be metabolized through the skin secondary to exposure to the UV B radiation (burning rays). Those with lighter complexions, though, metabolize vitamin D at an efficiency rate six times faster than those with darker complexions. This is for the same reason that those with fairer complexions will burn much quicker than those with darker pigmentation. This concept is what leads us to the explanation as to how white complexions came about.
After the last ice age, there was a large migration of modern humans from Africa to Europe. Since northern Africa is at lower latitude, the sun is more intense, and thus UVB is more intense. As people moved north, there was less UV intensity and therefore they were not metabolizing adequate amounts of this essential vitamin. Since fortified food sources of today, (milk, juice, etc.) were not in existence just yet, humans had to evolve in order to solve this threat to survival. By developing paler skin, they were able to absorb more UV B rays and metabolize Vitamin D at a greater rate, and so the intense sun of Africa was no longer necessary. Even in areas outside of Europe and Africa, such as North America and South America, there is a definite gradient of lighter to darker skin as people migrate away from the equator. Although this is just one hypothesis with other contributing factors, many scientists agree that Vitamin D synthesis is the most probable cause for skin color diversity.
Today, with skin cancer being the most prevalent of all cancers in the US, pale skin no longer provides a survival advantage. In 2010, the Institute of Medicine tackled the issue of sun exposure and vitamin D. Their official report stated, “concerns about skin cancer risk precludes incorporating the effects of sun exposure in the DRI (dietary recommended intake) process.” They went on to recommend that Americans ensure adequate vitamin D through the ingestion of foods rich in vitamin D and supplements rather than by exposing their skin to the sun. It is clear that all Americans need to be SunAWARE. Remember to limit unprotected exposure to UV radiation. Be safe, Be SunAWARE!

 

Vitamin D reference Intake

As temperatures drop, for those of you whose tan lines are fading, now is a great time to consider alternative options for achieving the ever-desirable self tanner face“sun-kissed” glow. This kiss of the sun, however, is not as pleasant as the phrase implies. Cancer-causing and otherwise damaging UV-rays that penetrate the skin have consequences that far outweigh any flattering result that comes from sun-tanning. I, for one, would choose my pale skin over scars, wrinkles, and possibly terminal illness any day. Like any cosmetic product, sunless tanners have their drawbacks. Some of you may have even heard of alarming warnings about the use of these products. However, current research indicates that these warnings are unfounded. I would like to clarify some of these misconceptions, and offer you all a safe and effective way to use sunless tanners.

To start, let’s talk about how sunless tanners work. The active ingredient in the majority of sunless tanners is dihydroxyacetone, a color additive that I will refer to as DHA. This is not a dye or a stain, but rather it is a chemical reaction between DHA and the amino acids in the dead cells within the skin’s surface. The temporary darkening of the skin does not affect your skin pigmentation and will fade after a few days. Something to note is that DHA and erythrulose, another common ingredient, makes skin more susceptible to UV-rays for at least 24-hours after application. For this reason, users of sunless tanners should avoid exposure to sunlight directly after application, and should keep up with their daily practice of applying sunscreen. It is also important to remember that although these are generally considered safe products, the FDA advises to avoid product around the face, nose and mouth. Especially when applying spray-products, always keep eyes closed and block your nose and mouth to avoid inhalation.

Aside from safety, some people avoid sunless tanning products for fear of coming out “orange” or “spotty”. If you are selective about your product, and mindful of your application, these unsightly results can be avoided. One way to ensure proper application is to get a professional spray tan. Although the cost can be off-putting to some, ranging from $25-$50 or more for one session, it is still a bargain when compared to the real cost of indoor tanning. To achieve the same beautiful result from one spray-tan session, you would have to commit to two or more weeks of indoor tanning which go for about $10 a session. This is even without considering the preventative savings taking place by dramatically decreasing the chance of needing medical treatment.

Understandably, some people might prefer the convenience and privacy of applying sunless tanners at home. The topical creams, mousses, and gels are also a good way to avoid the possible inhalation of chemicals that is affiliated with spray tanners. A piece of advice is to do some research before selecting a product. Look at customer reviews that are consistently positive, and try to find out if the tanner is best suited for your natural pigment of skin. Always follow carefully the instructions provided on the package of whichever sunless tanner you choose. Additionally, if you do decide to take matters into your own hands, try following these steps outlined by the Mayo Clinic for optimal results:

1. Exfoliate first. Before using a sunless tanning product, wash your skin to remove excess dead skin cells. Spend a little extra time exfoliating areas with thick skin, such as your knees, elbows and ankles.
2. Apply in sections. Massage the product into your skin in a circular motion. Apply the tanner to your body in sections, such as your arms, legs and torso. Wash your hands with soap and water after each section to avoid discoloring your palms. Lightly extend the product from your ankles to your feet and from your wrists to your hands.
3. Wipe joint areas. The knees, elbows and ankles tend to absorb more of sunless tanning products. To dilute the tanning effect in these areas, gently rub them with a damp towel.
4. Take time to dry. Wait to dress at least 10 minutes. Wear loose clothing and avoid sweating for three hours.

Research may still be developing related to any risk that might be associated with sunless tanners and DHA, but the research surrounding the dangers of exposure to UV rays is clear. If a tan is something that you can’t live without, consider the safe practices outlined above with sunless tanning. The End

In Victorian England, pale skin was the coveted fashion necessity representing wealth and sophistication, whereas tanned skin was indicative of low socioeconomic status. Essentially, being tan meant you were a poor farmer. Fast forward to 1920's America, and the provocative Flapper style of icons like Coco Chanel popularized tanned skin as the new fashion accessory. Ever since the roaring twenties, people have had a huge misconception of what tanning is and its effect on the body. Although unfortunate, it is not surprising that it is the impressionable youth that has been most strongly affected by this dangerous trend.Indoor tanning kills

Trips to tanning salons have progressed from being reserved for special events like prom, to a regular, even daily practice. Tanning salons across the country are taking advantage of young women’s need for “beauty” by marketing directly to these customers, with reduced prices and even free first sessions at the first sign of prom season. Despite the frequent lack of monetary price, the real payment these teens make is the accelerated aging, risk of infection, sunburns, and increased potential for the onset of skin cancers, particularly melanoma. The unfortunate irony is that in trying to attain perfection, these girls are tarnishing the natural beauty of their complexions.

Indoor tanning before age 35 raises the risk of melanoma by 75 percent. The World Health Organization added tanning beds to its Group 1 List of carcinogens (the same category as cigarettes). According to the NCSL, 42 states regulate the use of tanning facilities by minors, and 11 of those states (plus the District of Columbia) ban indoor tanning for all persons under 18 (Massachusetts is working to be added to this list).
However, it’s not just indoor tanning that is the problem here. The whole concept of soaking up radiation (whether natural or artificial) to fit the societal mold of “pretty” is the real danger in our modern world. Please, say no to tanning! Teach your children to respect the color of their skin and acknowledge its natural beauty. Help them to protect their bodies from the sun when in its rays, and to avoid exposure when at all possible. Teach today’s youth to stop valuing appearance over health.

Go to http://www.huffingtonpost.com/2011/04/11/tanning-ban-teens_n_847325.html to see videos and to take a poll about teens, tanning, and proms. There is a lot of information about the sad effects of indoor tanning. Read it and share your newfound knowledge with some teens you know.
Be Safe. Be SunAWARE!

By the time you are reading this, you are probably back to school. Hayden and I have been back for about one month. Where I live in New England, the weather has been unusually hot! Unless it is raining really hard, we usually go outside for recess. At our school, we have two playgrounds; the little kids usually use the one closer to the school, and the bigger kids go to the one next to the soccer field. We can choose to play on the playground, or play in the field. The problem is, it’s really hot and really sunny. Don’t get me wrong, if I had to choose recess or staying in class, I would definitely choose recess, but the thing is....there really isn’t any shade anywhere except for one tiny area under the play structure, and there is usually a ton of kids there. So, when we are outside for recess or gym, we are mostly in the sun. Sometimes we feel like we are actually “cooking” when we are outside. Fortunately, we have been checking the UV Index each day and realize that although it is hot the average UV Index is much lower than in the spring or summer. This past month the UV has been mostly moderate, 5-7 on a scale from 1 to 11+.
Before school, my mom or dad has us put on sunscreen before we leave the house. Our recess is after lunch, which happens to be around 12:30 or 1 o’clock in the afternoon. I know that this is the time of day that UV rays are strongest. I knew that the sunscreen bottle said that you need to be reapply every 2 hours.  However, I learned last spring, in a SunAWARE class, that this means after two hours exposed to UV rays.  I also learned that UV rays break down sunscreen. The higher the UV the faster sunscreen disappears off your skin and you loose its protective benefit. The rule to reapply every 2 hours is really a recommendation based on research that shows sunscreen only lasts about 2 hours when exposed UV radiation. I was really glad to hear this because my problem is, it is so hard to remember to put it on again, and it is kind of a pain to do it too. I think that I mentioned in a previous blog that I do not like to feel sticky from sunscreen. What is worse, is feeling sticky and then going to eat lunch. Gross!! I am really happy to know now that the sunscreen that I applied before I left home is still going to protect me for the recess period. I now know that after recess, because of UV exposure and sweating, I would need to reapply before going out again. I also recommend wearing a UV shirt and hat to school, but I heard some schools won’t let you wear hats at recess. So what is a kid to do?? It’s not always easy to protect yourself.

canopy tentBeing back in school is good and bad. I really like the summer and the fact that we don’t have homework, but I missed my friends. Since we got back to school, It has been really hot; like 90 degrees or hotter for a whole bunch of days. Going outside for recess and gym has been pretty miserable, but we are only outside for 30 minutes. I kinda feel bad for my friends who play sports; it is still really hot and sunny, and they are out there for 2 hours after school and on the weekends. Most of the ball fields don’t really have any shade. I noticed that many of my friends have become pretty tan, but I haven’t noticed any of them sunburned.

I know that shade is one of the best ways to block the sun’s UV rays, but this really isn’t an option at my school or town. UV protective clothing is also a great idea, but kids that play on a team, like baseball or Shade Structures for sportssoccer, have to wear a uniform. I don’t think their uniforms are UV protective. It seems that wearing sunscreen is a no-brainer! But I gotta tell you, having sunscreen on your face that runs into your eyes when you get sweaty, really stings! Plus having slippery hands from greasy sunscreen makes catching or throwing a baseball or football pretty hard to do.

So what does this all mean? Clearly, playing outside sports put kids at risk for sun damage. This is not ideal!! There are simple ways to address this issue. For example, the town could provide tents, or at least large umbrellas for the players to stand under when they are on a break, or when not playing, etc. The coaches could stay under the tent during much of the game too, so they don’t get sunburnt. I know it costs money, but I bet if the town knew how important being SunAWARE was, they would agree to do something. Also, kids could have some sort of a fundraiser to raise money for these things. Another idea is for the team uniforms to be UV protective, and to include a wide brimmed-hat (this may not look so great, but would be sun-safe!)

Since some kids play sports or do outside activities starting from when they are really young, the amount of time that they are exposed is huge. Protection from the sun’s damaging rays over those years is really important. Sun safety for players should be an important consideration for towns and schools!!!

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