Ask the Doctor: Melanoma Detect Early Is Curable
DEAR DR. DONOHUE: I have been diagnosed with melanoma on my face.
I have heard this can be fatal. How is that possible?
How does it spread?
I have so many questions, but no one is giving me any information. - S.K.
ANSWER: Of the three common skin cancers, melanoma is the most deadly.
However, caught early and treated, the chances for a complete cure are good.
The ultraviolet rays of the sun are partly responsible for melanoma.
Many appear on skin exposed to sunlight, but some do arise on skin that rarely sees the sun. Genes are another factor in their genesis. More than 60,000 cases of melanoma occur yearly in the United States, and it leads to 8,000 deaths a year.
Everyone needs to be aware of this skin cancer and be on the lookout for it.
The ABCDEs of melanoma detection should be learned by all.
“A” is for asymmetry. If you were to fold a melanoma in half in your mind, the two halves would not be the same.
“B” is for border. The edges of a melanoma are irregular, jagged. Harmless moles have a smooth border.
“C” is for color. The majority of melanomas are black, but not uniformly so. Browns, tans, whites, reds and blues often are scattered through the dark patch.
“D” is diameter. Melanomas tend to be larger than 6 millimeters, about the size of an average pencil’s eraser.
And “E” is for evolution. Melanomas change; they enlarge. Their shape might alter. Don’t wait for changes to occur if you suspect you have one. Get to a doctor immediately.
Melanomas spread through the lymph system.
Lymph is a fluid derived from the blood.
It bathes and nourishes all body cells and tissues.
Vessels called lymphatics suction it up and return it to the circulation.
En route, lymphatic vessels first bring it to lymph nodes, where the fluid is filtered for foreign matter, germs and cancer cells.
Lymph nodes are its first places of spread.
From there, it can reach other organs, like the liver and lungs.
It kills like all cancers do: The rapidly growing cells rob the rest of the body of its nutrition and weaken the body’s immune defenses.
DEAR DR. DONOHUE: I had a complete hysterectomy at age 44.
I have not had a Pap smear since the operation.
My doctor says it is not necessary.
I have a friend who had a hysterectomy but still has yearly Pap smears.
What is your opinion? - E.T.
ANSWER: This isn’t my opinion; it’s the recommendation of the American College of Obstetricians and Gynecologists.
When the cervix is removed with the uterus, as it usually is, there is no need for continued Pap smears unless the surgery was done for cancer.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible.