Spring-break bound? Bring sunblock
LEBANON -- Meghan O'Shaughnessy wasn't worried about that little blemish on her leg. After all, it was just a mole, and she was a healthy 16-year-old. She played soccer. She was a kid.
"When I was growing up, it was older folks that got cancer," said her father, Danny O'Shaughnessy. "And now kids are getting it."
Meghan O'Shaughnessy, it turned out, was one of those kids.
"When it happened to us, we were totally devastated," her father said. "I mean, it changed our lives. I used to worry about, is my grass cut? Is my car clean? All that came to a screeching halt. When one of your children gets sick, it's not a good feeling."
Meghan, of Manchester, had stage 4 melanoma skin cancer. By the time the tumor under the mole was diagnosed, the cancer had spread to her lymph nodes. In addition to removing the mole, doctors at Dartmouth-Hitchcock's Norris Cotton Cancer Center in Lebanon had to remove the nodes to get rid of the cancer.
"I couldn't go to school for my senior year," Meghan, now 23, said. "I think in a way it changed a lot of things."
Like many New Hampshire families, the O'Shaughnessys spent summers enjoying the sun, swimming and playing at the beach. And while they always used sunscreen, Danny O'Shaughnessy said, they still weren't protected from cancer.
According to American Cancer Society statistics, 76,250 people were diagnosed with melanoma skin cancer in 2012. The highest numbers of cases were reported in California (9,250), New York (4,700) and Texas (4,020). New Hampshire had only 470 cases of skin cancer, but given the state's geography and climate, that is a relatively high number.
New Hampshire is felt to have a higher rate than other states, and it's not clear why it's as high as it is, said Marc Ernstoff, an oncologist with the Norris Cotton Center. He said there's a number of reasons why people get skin cancer, one of which is skin tone.
"Darker-skinned individuals have a lower risk of skin cancer, so with the population of New Hampshire being mostly caucasian, the rates may be a bit higher for that reason," Ernstoff said. "The second component may be related to the kind of sun exposure one gets."
Melanoma is associated with exposure to the sun and tanning beds, and the association is most common in intermittent exposure caused by New Hampshire's long winters and indoor occupations, Ernstoff said.
"So those people working indoors or out of the sun, they take their holiday and go to the beach, and go to the lake and want to get as much sun as they can, as opposed to the chronic sun exposure where there is a much higher rate of squamous cells and basal cells," he said.
There are three basic kinds of skin cancer: basal, squamous and melanoma. Squamous cells, when they develop, can be recurring, non-healing ulcers. The same is true of basal cells, though basal cells, Ernstoff said, tend to be bumpy and form a pearly kind of border.
Basal and squamous ulcers don't go away over time and come back when removed by hand. These forms of skin cancer typically don't cause death, but they can. They also can be disfiguring because they are locally invasive, Ernstoff said, and can lead to infection if they are not taken care of.
Melanomas are moles that typically (though not always) are pigmented - of a color different from the skin itself. Generally, they are asymmetrical, have an irregular border are larger in diameter (about 5mm), and evolve over time, Ernstoff said.
"Moles that itch, shouldn't," Ernstoff said. "If a moles itches, that usually means an inflammation of the mole, which usually means that the body is recognizing it as something different."
Melanomas can spread and can be deadly.
The only way to protect against skin cancer is to use common sense when it comes to UV rays, Ernstoff said.
"You can surely reduce your risk by not using tanning salons," Ernstoff said. "In terms of sun exposure, if you are fair skinned and not a dark-skinned individual, wearing sunblock routinely is something that I recommend."
Ernstoff pointed to a 2012 Australian study that showed a 50 percent reduction in skin cancer among the people who wore sunblock on their hands, arms and upper shoulders every day, as opposed to those who only wore it when they were planning to be out in the sun.
Ernstoff said he recommends an SPF 30 sunblock applied liberally and often. He also said sun-protective clothing that shields the skin from UV rays is helpful. Staying out of the noonday sun is a good idea too, he said.
Meghan O'Shaughnessy said she has to go to the doctor every three to six months to make sure the cancer hasn't returned. Because she had her lymph nodes removed, she developed lymphedema in her leg, which means she has to wear a compression stocking every time she works out, she said. The condition causes her leg to swell and is very painful.
Recently, her dad said, Meghan has had several moles pop up on her back. Naturally, she's worried.
Meghan didn't want to talk about it, so her dad said it for her: "I think the fear that it will come back is something that's always in the back of her mind," he said.
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