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Malignant Melanoma in 2007

James C. Fairfield, MD

 

Dr. James C. Fairfield has been in practice in Lansdale, Pennsylvania, since 1982, and as such has the oldest, busiest and most experienced Dermatology practice in the area. He and his staff see 350 to 400 patients per week, and since about 2000, they’ve been diagnosing 2 to 3 NEW cases of malignant melanoma per week.

“We network closely with the Plastic Surgery, Cutaneous Oncology and Pigmented Lesion Departments at the University of Pennsylvania for our melanoma patients. With Penn’s worldwide reputation in this field, and being so nearby, I’m able to offer the highest standard of care for my patients,” says Dr. Fairfield.

He goes on to say, “Malignant melanoma has become an epidemic. In the past we would see seasonal spikes in the new cases: Spring, when people are preparing for summer vacation and discover their lesions, and then again in the fall when they’ve finished putting off having something checked because of vacation commitments. That’s all changed. Discovery is now constant.”

Dr. Fairfield has two theories as to why this is happening. “Contrary to the conventional wisdom that we’re seeing Baby Boomers reaping the consequences of their years in the sun, the new cases are occurring without respect for age, or gender,” says Fairfield.

He believes successful patient awareness campaigns about changing moles are having an effect, with the result that the melanomas being discovered are in an early stage, and thus more likely curable with appropriate surgical intervention.

The second theory carries a more sinister import. “We’re seeing young people and even children with melanoma, and that may mean that the ionizing radiation from the sun is more damaging than in years past. In other words, the ozone layer depletion is allowing more damaging rays to reach people’s skin.” He believes that daily sunscreen application is necessary. “Ultraviolet A light has the potential of deactivating our natural abnormal cell repair mechanisms – giving cancers the opportunity to develop. UVA is present year round, in all weather, and people need to understand that, in order to protect themselves adequately,” explains Dr. Fairfield, who relates most head and neck cancers are on the left side due to driving, with exposure to UVA passing through the car’s window glass.

Tanning beds have now been implicated in the statistical increase of incidence of melanoma. This is an area where further public education is necessary. The American Academy of Dermatology has been in the forefront dealing with this problem.

The situation is not hopeless, Dr. Fairfield believes. “With increased public awareness, and having any skin mark that’s changing checked by a dermatologist, we can remove these lesions at their earlier stages, with lifesaving consequences.” He firmly believes that even regular skin screening exams by a doctor can miss melanoma, since in their earliest stages they can look like a normal mole. “We look for the obvious melanoma – but our success comes from removing anything that has changed by patient history. To be sure, many changing lesions are benign, but an alarming number are early melanomas. We just can’t take that chance and miss them.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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