The Columbus Dispatch

CROSSWORD NO. 1

- By Thomas Joseph

ACROSS

1 Fall flower

6 Sow’s mate

10 River boat

11 “The Tempest”

sprite

13 Wise saying

14 Act the waiter

15 Foot part

16 Bran bit

18 Dog doctor

19 Public approval

22 Battleship letters

23 “Bus Stop”

playwright

24 Malice

27 Door sign

28 Touch down

29 Boxer Laila

30 Police job

35 Employ

36 Money machine

37 Spoil

38 Ready for bed

40 Wear away

42 Painter Matisse

43 Staff symbols

44 Mediocre

45 Layers

DOWN

1 Let up

2 Invader of England

3 Attempted

4 Sense of self

5 Deep regret 6

7 8 9 12 17 20 21 24

Moisten in the kitchen

Mine rock Duct Vindictive quest Pi, phi or psi Cart puller Surpass Sixtieth of a dram Detective 25 26 27 29 31 32 33 34 39 41

Violets’ cousins Dante topic

Tin or titanium Play division Ham’s device Ham it up Consumeris­t Ralph Lock of hair Hosp. sections King of France

Dear Dr. Roach: My husband developed melanoma, and had 16 of his lymph nodes removed. He was considered a cancer survivor, as one of the nodes was cancerous. He went for skin check-ups twice a year and was given an OK. Yet he died two months ago from tumors on his liver, lungs and brain. Is there some test or scan we could have had to know about the cancer earlier? My children are worried, as this cancer can be hereditary.

— K.D.

I am sorry to hear about your husband. Malignant melanoma is a common cancer and by far the most serious of the skin cancers. Most people with melanoma that has been caught early can expect to be cured, but when even a single lymph node is positive, the situation is much more serious. Ninetythre­e percent of people will survive five years, and 88% for 10 years.

There is no universall­y accepted answer for how aggressive­ly to monitor people with melanoma and a positive lymph node, but most experts do skin checkups as your husband did. There is no definitive evidence that additional testing, such as scans, would have been of benefit. Despite the best treatment, some people with melanoma will succumb to the disease. Treatment for melanoma is dramatical­ly improving, though, but still not perfect.

About 10% of melanomas are thought to be familial. People with a strong family history — many family members, multiple melanomas in the same family member or very early disease — should have a regular skin exam by a trained doctor as screening. Prevention is important for everyone, which means sun avoidance and protection. This is particular­ly so for a person with a family history of melanoma.

Everyone should know how to identify the worrisome appearance of a melanoma:

A for asymmetry, meaning one side is different from the other.

B for border irregulari­ties.

C for color difference­s within the lesion.

D for a diameter greater than 6 mm (a pencil eraser).

E for enlargemen­t or evolution of color, change, shape or symptoms.

Any new darkly colored skin lesion that looks different from the others a person has should be evaluated.

Dear Dr. Roach: I have a question about the coronaviru­s vaccines. My mother is 79 and has allergies. I have PBC, an autoimmune disease. Which type of coronaviru­s vaccine is better for each of us?

— R.Z.

Most autoimmune diseases won’t keep you from getting vaccinated.

Given the choice between a risk that is at best possible but unlikely, and a benefit that is large not only for the person getting the vaccine but their family and close contacts as well, my opinion is that the vaccine has far more benefit than risk and should be given. Of course, you need to consult your own physician to be sure. Any available COVID-19 vaccine is appropriat­e.

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