Menace of melanoma

Henry Lichtenstein of Forestville survived the wrath of Adolf Hitler. Now he is working on defeating skin cancer. During World War II, Mr. Lichtenstein, 82, who is Jewish by heritage, was imprisoned in several concentration camps, including Auschwitz, Mauthausen and Birkenau. Originally from Lodz, Poland, he also suffered in the Lodz ghetto at the hand of the Germans.

While under the oppression of the Nazi regime, he was forced to work outdoors in scorching weather, and he suffered several severe sunburns. About 55 years later, Mr. Lichtenstein developed melanoma, a form of skin cancer. The growth on his back was removed surgically in March 1998. He also has developed non-melanoma skin cancers and pre-cancerous tissues that have been excised.

“In the concentration camp, you would stay in the sun all day long,” he says. “When it got hot, you would take the shirt off. … Yesterday, I was cutting my grass, and I wore long sleeves, and I have a nice little hat.”

The number of people developing melanoma is increasing faster than the number for any other form of cancer, according to the National Cancer Institute.

In 2003, the American Cancer Society estimates there were 54,200 new cases of melanoma in the United States and about 7,600 deaths. Melanoma accounts for about 4 percent of skin cancer cases but causes about 79 percent of skin cancer deaths.

Excessive exposure to sunlight doesn’t account for all melanoma, however, says Dr. Gary Peck, director of the Melanoma Center at Washington Hospital Center’s Cancer Institute in Northwest. Although medical professionals haven’t identified the other causes, Dr. Peck says, doctors are sure they exist. The cancer can occur anyplace there are pigment cells, such as on the genitals, in the anal canal, inside the nose or sinuses and inside the eyeballs.

“One patient treated for sinusitis wasn’t responding to treatment,” Dr. Peck says. “Finally, they did an X-ray and found a tumor, and it was melanoma.”

Until researchers discover other reasons why people have melanoma, the best way to lower the risk of its occurrence is avoiding too much sun exposure and ultraviolet light, says Dr. Catharine Lisa Kauffman, chief of dermatology at Georgetown University Hospital. If people must be in the sun, she says, they should apply sunscreen with at least 30 SPF before going outdoors and reapply it every two hours, more when perspiring. Further, she says, there is no such thing as a “safe” tanning bed.

“Try not to be outside unless you absolutely have to between 10 a.m. and 4 p.m.,” she says. “You need to wear a hat, preferably with a 4-inch brim. Wear sunglasses with proper UV protection. … You need to wear sun-protected clothing. Toss Rit Sun Guard in the wash with clothing to increase its SPF.”

Factors that increase the risks of melanoma are having more than five serious sunburns as a child, red hair, pale skin, blue or green eyes, freckles, lots of atypical moles, an outdoor occupation, and relatives with melanoma.

“To a certain extent, we’re a slave to pop culture,” Dr. Kauffman says. “If we could get Britney Spears to go pale, we’d be doing great. Nicole Kidman is a good dermatological advertisement.”

If melanoma is found, patients should return to their doctor for checks every three to six months until the doctor says otherwise, Dr. Peck says. He thoroughly examines Mr. Lichtenstein for new lesions, including on his lips, his scalp, his ears, under his toenails and on the bottom of his feet. The doctor uses a dermascope to examine moles and dark spots on his body.

In addition to melanoma, Dr. Peck also searches for other malignant patches, such as basal cell skin cancer and squamous cell skin cancer.

“I had one patient where the hairdresser found the tumor,” Dr. Peck says. “Sometimes, the part in the hair line can have melanoma; sometimes, under the hair.”

On other patients, such as Riaz Latifullah, 47, of Northwest, Dr. Peck uses mole mapping, a procedure in which he takes pictures of the skin and magnifies them to analyze skin cancer risk. The images are stored in a computer and are used for comparison during future visits.

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