By Mary Wade Burnside
FAIRMONT — Paul Greenwood had a mole on his back that his fiancé said he should have checked out, but not until a chiropractor had been treating him for about a month for back pain did he finally set up an appointment with Dr. Beth Santmyire-Rosenberger, a Fairmont dermatologist.
“She had it removed and I was supposed to go back in two weeks for the results,” said Greenwood, who runs a tool franchise. “Then she called me a week later and said she needed to go over the results.”
Greenwood, 24, had advanced melanoma, late fourth-stage bordering on the fifth of five stages.
Rosenberger sent Greenwood to Dr. John Azar, an oncologist, who cut out an inch-and-a-half wide and 7-inch long strip of skin around the mole. He also injected a dye into the area that showed him the mole was draining into Greenwood’s lymph nodes. Eight of them had to be removed.
“They believe they got the cancer out of me, but I still had to go through interferon treatment, which I’m still on.”
Interferon is a drug that can help stop the growth and spread of cancer. Greenwood got the first doses of the drug intravenously at the hospital, and now he has to give himself a shot three times a week. However, he has temporarily suspended the treatment because it caused leg numbness.
“I’ll have to stop for a week and let that calm down, and then after it gets into my system again, it will start hurting again,” Greenwood said.
While Greenwood’s experience is not typical — about 85 percent of skin cancers are called basal cell carcinoma and pose a threat of disfigurement but not death — it illustrates that a person does not have to be very old to get a serious form of the disease.
“I remember one time, as far as my back, I got sunburned when I was younger,” said Greenwood, who also has fair skin. “I remember having blisters on my back, and they said that’s what it could have been caused by.”
Melanomas account for about 5 percent of skin cancers, while squamous cell carcinomas — generally not life-threatening — account for the remaining 10 percent.
Because May is Skin Cancer Awareness Month, Rosenberger will hold two free screenings for people who would like to be checked for suspicious moles or marks. The screenings will be held from 7 a.m. to noon Saturday at the Middletown Mall and during that same time on May 17 at Fairmont General.
Skin Cancer Awareness Month comes at a good time of year, as people begin to wear fewer clothes just as the sun is getting hotter and staying out longer. That also means that when Rosenberger holds screenings, she can see more skin.
“The less clothes, the better,” she said. “That’s more places that I can check. That’s why it’s nice to do it in the spring and summer. There is not a lot of privacy” at the screening locations.
Like Greenwood, men tend to get cancerous spots on their backs, while the most common area for women are the legs, Rosenberger said. That’s what happened to Stacey Spadafore.
She had a red spot on her upper thigh for a couple of years that her doctor did not consider suspicious. But when Dave Matthews, a teacher at East Park Elementary that she knew through her job, died of melanoma, she made an appointment with Rosenberger.
The red spot was not typical-looking for melanoma, but it still concerned Spadafore, who was persistent about having it biopsied.
“I waited two weeks for the results and I made my sister come with me,” she said. “As soon as she came in, I said, ‘It is good news?’ She said, ‘It’s not good news, but it’s not bad news.’”
Like Greenwood, Spadafore had melanoma. But hers was in the first stage, in which the mole “occupies only the epidermis,” according to the scale used to judge the cancer, Clark’s level of invasion, according to www.skincancer.org.
During stage three, the melanoma can reach regional lymph nodes; and in the fourth one, other internal organs, most often the lungs.
In Spadafore’s case, excision was enough. She also will get checked periodically and take more precautions in the sun.
Spadafore considers herself to be somewhat fair-skinned, and she too remembers a particularly bad sunburn and wonders if it caused the cancer.
“My sister and best friend no longer go to tanning beds since I was diagnosed,” Spadafore said. “I think that’s wonderful. It upsets me that people know going to tanning beds can cause skin cancer but don’t believe it or think it’s going to happen to them. The facts are out there. It doesn’t matter if you are lying out in the sun or going to tanning beds. You are putting yourself at risk for skin cancer.”
Rosenberger has trouble believing it, too, but she has patients who refuse to quit. After she lectures them on the dangers, “A handful of people come back and say, ‘I’m not going to a tanning bed.’ But usually, peer pressure and what they think they should look like outweigh common sense about cancer risks.”
She cites a study that says using tanning beds prior to the age of 35 increases risks for melanoma by 75 percent. “That’s a lot.”
And some people even think they need extra sun to get vitamin D, but that is not the case, Rosenberger said.
“You get enough vitamin D from sun just by going out and about,” she said.
An A-B-C-D system has been developed to alert people to what could be a melanoma. A is for asymmetry, B for irregular borders, C is for multiple colors and D is for diameter bigger than a pencil eraser.
“I’d like to add to that E for evolving,” Rosenberger said. “Anything that is growing, changing, itching and won’t heal — all of those things are of concern.”
In addition to staying away from tanning beds and tanning in the sun, Rosenberger recommends wearing clothes and hats with a sun protection factor, as well as sunscreen with a high SPF that also contains zinc.
“Zinc is more like a metallic shield so it’s not going to break down,” she said. “Chemical sunscreen breaks down. If you put it on a 8 a.m., by noon you have nothing left on your face unless it’s one with lots of zinc.”
E-mail Mary Wade Burnside at mwburnside@timeswv.com.
