Caution saves lives
P.E.I. most at-risk Canadian province for melanoma
CHARLOTTETOWN — After attending the funeral of a friend who died from melanoma, Kate Flick decided to err on side of caution and ask her doctor to check out a mole on her leg.
"I try to lead a healthy lifestyle, and I was totally feeling fine," said the P.E.I. high school teacher.
Flick didn't consider herself to be a part of what could be termed a high-risk category for the disease. While the exact cause of skin cancer has yet to be pinned down, certain risk factors have been identified, including spending too much time in the sun without taking adequate precautions.
Flick has always loved being outdoors, especially in the summer, but she says she's always been sure to guard against getting too much sun.
However, there are some risk factors Flick wasn't aware of at the time. A recent study at John Hopkins University in Baltimore, Md. indicates there has been a major increase in melanoma cases in people under 40, especially women. Having a family member with a previous history of the disease also increases the risk — and Flick later found out that her grandmother had previously had a mole removed that was diagnosed as melanoma.
That decision to see a doctor may have been one of the best she's ever made.
ISLANDERS AT RISK
Flick lives on P.E.I., and according to a 2016 study conducted by the Canadian Cancer Society, the Island has the highest rate of that type of cancer in the country.
She was diagnosed in January of that year.
"That was one of the first things my doctor told me, and I was surprised," she said.
So far, researchers have been unable to explain the high rate of melanoma occurring in the province. Living close to the equator and high elevations are considered to be geographic risk factors, but P.E.I. doesn't fit the bill on either score.
According to the Canadian Cancer Society, an estimated 8,000 Canadians are diagnosed with melanoma each year, and the disease claims approximately 1,300 lives annually.
Last year in P.E.I., there were 60 cases and 10 deaths. Nova Scotia had 360 cases and 50 deaths, while Newfoundland and Labrador had 120 cases and 15 deaths.
WHAT IS MELANOMA?
Melanoma develops in the cells that produce melanin, which is the pigment that gives skin its colour.
While melanomas can develop anywhere on the body, they are most often found in areas that have had exposure to the sun, such as the back, legs, arms and face.
In Flick's case, the mole was found on the side of her leg, just under her knee. Since being diagnosed, she has needed three different surgeries on her lower left leg and her right hip. Unlike many cancers, melanoma does not respond to chemotherapy or radiation, leaving surgery as the only option.
"I was fortunate that the melanoma did not spread to my lymph nodes," she said. "When that occurs, the prognosis for recovery decreases considerably."
While Flick felt fine physically throughout her diagnosis and treatment, she admits the disease had a major impact on her mental health, as the disease was never far from her mind. Even though it's only been five years since she was diagnosed, there have been some promising treatment breakthroughs such as targetted immunotherapy before surgery.
According to the Mayo Clinic in the United States, one of the first signs of the disease is a change in an existing mole or the development of an unusual-looking growth. Normal moles are generally a uniform colour and separated from the surrounding skin by a distinct border. They also tend to be oval or round — usually no bigger than six millimetres.
Many people get moles in childhood, and new moles can actually form until well into our 40s. Some people naturally have a lot of moles — Flick is in that category — but the Mayo Clinic notes having more than 50 ordinary moles on your body indicates an increased risk of melanoma. The worldrenowned clinic recommends being extra-vigilant looking for any moles that have an irregular shape, a notched or scalloped border, an uneven distribution of colour or are more than six millimetres in diameter.
TAKE PRECAUTIONS
Flick said melanoma doesn't really impact her day-to-day life a great deal.
She takes steps to limit her exposure to the sun, always making sure she wears protective clothing and making sure she is not outside in the middle of the day when the sun is the strongest.
Sunscreen is also essential — the Mayo Clinic also recommends wearing sunscreen of at least 30 SPF (sun protection factor) — as well as protective clothing, including dark, tightly woven fabrics that cover your arms and legs, and a broad-brimmed hat.
The prognosis for recovery is good if the melanoma is detected early and Flick has a simple piece of advice: get any suspicious moles checked out immediately.
She also advises having discussions with family members to find out if there is a case history in the family.
"Having a family history is not the only factor, certainly, but it is a factor and it is important to know," she said.
The Mayo Clinic also recommends keeping an eye out for new skin growths or changes in existing moles, freckles, bumps and birthmarks.
People with weakened immune systems can also have an increased risk of melanoma and other skin cancers.
"There are lot of people that don't spend a lot of time in the sun, so they may not think they are at risk, but that is not the only factor," Flick said.
"If you have any doubt at all, please get it checked out — the worst thing that can happen is the doctor says you are healthy and that is pretty easy to live with."