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More than 5 million Americans are diagnosed with skin cancer each year, making it the #1 cancer in the United States. Although $8 billion dollars is spent annually on treating skin cancer, we still loose one person every 45 minutes to the disease. Nurses play an important role in educating patients and their communities about skin cancer prevention.

In 2014, the U.S. Surgeon General, Admiral Boris Lushniak, issued a Call to Action (CTA) to Prevent Skin Cancer. He declared that skin cancer was a major public health problem for Americans. The CTA included five strategic goals to educate, advocate, research and protect Americans from skin cancer.

The Surgeon General’s Call to Action Goals:
1) increasing opportunities for sun protection in outdoor settings;
2) providing individuals with information to make informed, healthy choices about UV exposure;
3) promoting policies that advance the national goal of preventing skin cancer;
4) reducing harm from indoor tanning;
5) strengthening research, surveillance, monitoring, and evaluation related to skin cancer prevention.

The Surgeon General’s CTA has been an important step forward in galvanizing all stakeholders to take action to prevent skin cancer. One nursing organization, the Dermatology Nurses Association (DNA), has responded to the CTA by issuing an official Position Statement that includes strategies to address the national CTA goals. DNA issued a press release on May 2, 2016, outlining its position on the CTA and recognizing its efforts in support of May as the official Melanoma Awareness month in the U.S.

The DNA’s official position is to use the SunAWARE acronym and materials to promote the Surgeon General’s Call to Action by educating our patients, individuals, colleagues, teachers, administrators, lawmakers, town planners, and others to Be Safe, Be SunAWARE!

The SunAWARE acronym is comprised of five easy steps, in order of prevention priority:

Avoiding unprotected UV exposure, seek shade, and never indoor tan.
Wear sun protective clothing, including broad brimmed hats, long sleeves, pants and sunglasses.
Apply adequate amounts of a BROAD SPECTRUM sunscreen and reapply at least every two hours.
Routinely check your whole body for new and changing growths, and report suspicious changes to a health care provider.
Educate your family and community about sun protection and skin cancer prevention.

Reference:
Call to Action: http://www.surgeongeneral.gov/library/calls/prevent-skin-cancer/index.html.

DNA Position Statement on the Call to Action:
http://www.dnanurse.org/docs/5216pressrelease.pdf

1. UV intensity peaks mid-day and on the Summer Solstice (June 21st in the Northern Hemisphere). Therefore it is easier, on average, to sunburn in May CMPF 8511 r6F 1than August.
➢ This is important because the UV Index is a measure of sun damage risk. To lean more download a free UV app (EPA, UVUS) on your smartphone.
2. Sunscreen is an over–the-counter medication with a dose and frequency of application. To use this medication properly: apply a handful of BROAD SPECTRUM product to cover the entire body, 15 minutes prior to sun exposure, and reapply every 2 hours or more often if perspiring or exposed to water.
➢ This is important to know because if you apply 1/3 of the sunscreen dose then you get 1/3 of the protection. Most sunburns in sunscreen users are due to inadequate dosing and failure to reapply.
3. In 2010, the Institute of Medicine reissued their dietary reference for vitamin D, recommending that we obtain the required dose from food and oral supplements not sun exposure.
➢ This is important because only the most damaging, midday, burning (UVB) rays, are capable of metabolizing vitamin D in the skin.
4. Sun protection clothing is superior to sunscreen in providing UV protection.
➢ This is important because the UPF (Ultraviolet Protection Factor) in specialized clothing, unlike sunscreen, never loses its UV protection.
5. A tan is a compensatory protective mechanism and a sign of sun damage.
➢ This is important to know because a tan develops following overexposure to UV radiation when our melanocytes (pigment producing cells) release additional melanin to protect us from further damage.
6. We are not born with freckles but rather a genetic predisposition to develop them.
➢ This is important because freckles develop at sites of overexposure and are a sign of sun damage and skin cancer risk.
7. Moles come in different types and impart different risks for skin cancer.
➢ This is important because a congenital mole (present at birth), or typical (small, round, symmetrical, even color) and atypical (larger than an eraser head, irregular in shape or color) have varying degrees of malignant potential.
8. 1/3 of melanomas in men develop on their back.
➢ This is important because men need to “Watch their Back” or have someone else look for new or changing growths.
9. Melanoma has increased in children by 2% per year for the past thirty years and 72% of melanoma cases in children occur in teenage girls between 15 to 19 years old.
➢ This is important because American girls are exposing themselves to UV rays (natural and artificial sources) starting at a very young age to achieve a tan.
10. Most people do not realize that the Surgeon General issued a Call to Action to Prevent Skin Cancer in 2014.
➢ This is important because the Surgeon General has called on all Americans to learn about UV radiation and protect themselves from overexposure.

Hingham educator Susan Keyes knows all too well the pain and misery that melanoma can mean for a family. From 1995-1997, she underwent a grueling treatment regimen for metastatic melanoma. Against the odds, she survived—although she can never be in the sun again—and became committed to helping others understand prevention of the disease so that they can protect themselves and their loved ones.

As the head of the foreign language department for the Hingham Public Schools and a French teacher at the High School, Keyes has taken an active role in bringing an awareness of the dangers of tanning to students. She presented a gripping account of her struggle with melanoma to the entire high school at an assembly that was held in the spring of 2013. Known to her students as “Madam,” Keyes presented in a very matter-of-fact and even tone the agonizing effects of her treatment.

“It was so quiet in that auditorium that you could hear a pin drop,” she says. “The students were focused on what I was saying, and they really seemed to get the idea that this could happen to anyone.”

That presentation made an impact on Lea Concannon, who is now a senior co-captain of the HHS girls golf team. “Her whole statement really stuck with me, especially the timing of it during prom season when there is so much pressure to look your best and for some people that means tanning,” she says.

The golf team will be volunteering on March 19 at Putt for Prevention—a fundraiser for the Children’s Melanoma Prevention Foundation (CMPF) from 11 am to 4 pm on Saturday, March 19, at South Shore Skin Center in Norwell. All ages are invited to play an indoor 18-hole mini-golf course for $5 per player or $20 per family. The event is being sponsored by a number of South Shore businesses including Hingham Institution for Savings and Robin’s Nest.

“We are particularly excited about this event because it was created with kids in mind,” says Maryellen Maguire-Eisen, executive director and founder of CMPF. “Our organization is focused on kids, and we want as many kids as possible to come and have fun.”

Keyes became familiar with CMPF a few years ago, when Maguire-Eisen’s daughter Laura ended up being one of her French students at the high school. Keyes describes a “serendipitous moment” when she learned about the foundation through one of Laura’s assignments, which was written in French.

“After reading her essay, I spoke with Laura about the work her mother was doing and then introductions were made,” says Keyes, who became a CMPF board member in 2011. “I am uncomfortable talking about that part of my life, but if I can help one person, then it’s worth it,” she says.

More than 5 million people are diagnosed with skin cancer each year, and one person dies every 45 minutes from the disease in the United States. What makes melanoma particularly frustrating for medical professionals is that it is largely preventable and also very treatable when caught early. But in the later stages of the illness, cure rates are very low and the treatments are exceedingly difficult for patients and their families, Maguire-Eisen says.

In February, the state of Massachusetts passed a law banning anyone under the age of 18 from using or operating a tanning bed. Cancer activists, including the American Cancer Society and the CMPF, had been pushing for passage of this law for more than a decade because numerous studies had demonstrated a clear link between tanning and melanoma.

“Melanoma is now developing in very young women because the newer tanning machines are even stronger and more carcinogenic than they used to be,” says Maguire-Eisen, who testified at the hearings for this bill. “I am very pleased that children in Massachusetts will now be protected from this carcinogen at least until they are 18 years old.”

The Hingham-based CMPF is a non-profit, educational foundation established in 2003 that teaches children and their caregivers how to protect themselves from the harmful rays of the sun while enjoying outdoor activities. Each year, more than 50,000 students from kindergarten through 12th grade actively participate in presentations and projects provided by trained Foundation staff members at local schools, sailing clubs, day care centers and health clubs. All programming is provided free of charge to participants and is made possible by sponsorships and fundraising by the organization. More information is available at www.melanomaprevention.org.

Hello!Norbert

It's me, Norbert. I thought it would be fun to share some news about what I've been up to lately. The Norberthood has been a busy place!

I recently moved all the way across the country to sunny Los Angeles. I'm having fun, and being safe, in the sun. Last month I earned my renewal as a registered therapy dog and continue to volunteer to spread smiles & inspire kindness. I was recently featured in a Paper Magazine article and next month I am honored to be the cover dog for Animal Wellness Magazine.

A project I am excited about is the development of my Norbert Plush Toy which will be available this summer -- a life-size, soft, huggable plush that I hope will make people smile. More info is here: bit.ly/norplush

Thanks for checking in with me.

High-Five!
Norbie

Children’s Melanoma Prevention Foundation (CMPF) applauds Governor Baker for signing a bill into law that bans indoor tanning for minors. This legislation is critically important because of the connection between tanning devices, melanoma and death in young women. Melanoma is now the most common cancer in young adults and the fourth most common cancer in children. A recent JAMA study showed that 97% of women diagnosed with melanoma before age 30 reported indoor tanning prior to being diagnosed.

As the only national foundation focused on preventing skin cancer in children, CMPF has strongly advocated in favor of an indoor tanning ban for minors and played an integral role in support of the bill’s passage. We are so pleased that this ban will ensure that high school students can no longer indoor tan—especially during prom season, when even the most health savvy teen forgets it is not safe. We would like to recognize Senator James Timilty (D-Walpole) for introducing the bill and working so hard to protect children. With skin cancer rates skyrocketing and one person dying every 45 minutes from the disease, we must protect children from unnecessary risks.

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Trying to cope
The next month was a whirlwind. I was having terrible anxiety attacks and couldn’t eat or sleep. I visited one oncologist who was supposed to be the best in Philadelphia, but all he did was scare the crap out of me and recommend that I go back to the South Jersey doctors who got me in this mess because they were not successful in removing my cancer in the first place! However, I tried one oncologist he recommended in South Jersey who was such a kind man; however, he only had less than a handful of patients with melanoma and did not seem very knowledgeable about current treatment methods. Finally, someone told me that the place I had to go for melanoma was the University of Pennsylvania Hospital in Philadelphia. That was the best decision I ever made! I was introduced to the best doctor who got my insurance to approve immunotherapy. Out of all three doctors I saw, she was the only one to ever mention immunotherapy. First though, I had to get all my lymph nodes removed from my leg as a precaution and thankfully melanoma was not found in any of the other lymph nodes. I then proceeded to have four immunotherapy treatments every three weeks and began physical therapy for my leg from the lymph node dissection surgery.

After all that was done, I got a PET scan in March of 2015 and it was all clear! Wonderful news! I wish I could say all was rosy, but to be honest now that I wasn’t busy fighting this monster anymore, I was terrified of it coming back. It took me months with the help of antidepressants (and lots of prayer!) to get through it and start living my life again. Cancer doesn’t just mess you up physically, it messes you up mentally too!!

Sharing the sun-safety message
While going through this process, I really had to believe this happened to me for a reason. I grew up at the Jersey Shore. My high school was literally on the beach. I knew my kids would eventually be going to school there and going to the beach after school and on weekends. I knew I had to reach the kids so they could enjoy the beach without it coming back to hurt them later. Luckily, my 16-year-old niece had written a paper about the Children’s Melanoma Prevention Foundation to spread awareness to her class. I started researching locally to see if we had an organization in my area doing the same thing and found nothing. I couldn’t believe it. How do we live at the Jersey Shore and not have an organized way of spreading this life-saving information to kids!
The next thing I did was reach out to the superintendent of the schools to see if they discuss the dangers of the sun in health class. He said they touch base on it, but my now 13-year-old son says he has never heard this message in school. That is when I contacted Maryellen at the Children’s Melanoma Prevention Foundation to see if she would be willing to come all the way to New Jersey to help teach these children the importance of sun safety. She was more than willing to do so, but several months later I am still trying to get the PTO and the superintendent to give me a date when Maryellen can visit us with her message. It is so frustrating! However, I will not give up because I don’t want any child to grow up and have to deal with this terrible diagnosis when it is one of the most preventable cancers around.

I will keep you all posted on this journey to educate the kids in my community on melanoma prevention and to stop this ignorant thought that skin cancer isn’t a big deal!!!!

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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”.

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