Melanoma cases increasing in Maine Skin cancers have tripled since mid-’90s

DOVER-FOXCROFT – Jim Brown likely would have overlooked the small discolored spot on the back of his right leg in 1990 had it not been for his wife, Barbara.

Brown, a Foxcroft Academy English teacher, recalled this week that his wife called the faint-colored spot “funny-looking,” and she urged him to have a doctor check it.

Although Brown thought the spot – the size of a pencil eraser – was nothing since it was not painful and did not itch, he made an appointment with a local surgeon to satisfy his wife. Laughing at the spot, the surgeon suggested that it was a benign skin lesion, sort of like a freckle, Brown recollected. Just to be sure, the surgeon removed it and sent it away to be tested.

“She [Barbara] did me a huge favor,” Brown said, because the diagnosis of that small spot was melanoma.

The finding “shocked and frightened” the surgeon, who told Brown that it was about the earliest melanoma he had seen in his long career. The surgeon then made a wider incision where the spot had been removed to make sure the surrounding skin was not malignant. The test came back negative for melanoma.

Brown, who has fair skin, became one of Maine’s growing number of victims of the deadliest form of skin cancer. Because the cancer was detected early, no further treatment was needed.

According to the American Cancer Society, the number of new cases of melanoma has tripled since the mid-1990s, making it the fastest-growing cancer diagnosis in Maine.

The rates of melanoma incidence are higher in the coastal communities, according to Anita Ruff, coordinator of the Maine Comprehensive Cancer Control Program, a statewide program that looks at cancer prevention, detection, treatment and survivorship.

The rates are significantly higher in Hancock, Kennebec and Lincoln counties compared to the rest of the state, she said recently. The national trend also shows an increase, she noted.

To raise awareness of the importance of sun safety and its role in skin cancer, the program has awarded $17,000 to a total of 34 schools in Maine. The schools will use the funds for special events, to incorporate skin cancer prevention into school health education, to create educational materials, for staff training, and for the purchase and building of shade structures.

According to the National Cancer Society’s Web site, the signs and symptoms of skin cancer include:

. Any change on the skin, especially in size or color of a mole or other darkly pigmented growth or spot, or a new growth.

. Scaliness, oozing, bleeding, or change in the appearance of a bump or nodule.

. The spread of pigmentation beyond its border, such as dark coloring that spreads past the edge of a mole or mark.

. A change in sensation, itchiness, tenderness or pain.

There are three main kinds of skin cancer: malignant melanoma, basal cell carcinoma and squamous cell carcinoma. Malignant melanoma is the least common of the three kinds of skin cancer, but it is the most life-threatening. It generally shows up as a mole or skin growth in varying shades of brown or black or in multicolored patches of red, white and blue. It may have an asymmetrical outline with notched or scalloped edges and usually is larger than one-fourth of an inch.

The treatment of melanoma is based on the age and health of the patient as well as the stage of the disease. The first treatment is removal of the tumor. If the cancer has spread, the treatment could include chemotherapy, radiation therapy or immunotherapy.

Castine Verrill, an epidemiologist at the Maine Cancer Registry, a statewide, population-based cancer surveillance system operated by the Maine Bureau of Health, thinks that part of the increase in melanoma in Maine can be attributed to the fact that more physicians are reporting their cases than before.

Hospitals have routinely reported the cancers they treat, but physicians have not always disclosed their finds, she said.

In 1995, there were 92 males and 67 females identified with melanoma in Maine, according to Verrill. Using 2001 figures, which are the most recent complete figures, she said that 151 males and 127 females were diagnosed with melanoma.

Melanoma, which affects a smaller population than most skin cancers, is one of the cancers that tends to affect people at a younger age, Verrill said. People whose melanoma is detected early have about a 96 percent chance of living for about five more years, she said. In comparison, those whose melanoma is detected late, allowing the cancer to spread, have about a 14 percent chance of living five more years.

Those statistics are a sobering reminder for Brown.

“I guess I would have noticed [the spot] at some point. It would have begun itching, but by then it could have spread and been too late,” Brown said.

“Certainly I’m more conscious now of the possibility of getting something like that,” Brown said. He believes his cancer resulted from a “really bad sunburn” that he received after a day at the coast the summer before the spot appeared. “It was just silly on my part to put myself in that position,” he said.

“I was a big-time sun lover, and I still am,” Brown said, “but the difference now is that I use sunscreen.”