Monday June 7, 2010 | Melanoma: A Survivor’s Story

June 3, 2010 at 11:32 am | Posted in Coming Up | 17 Comments

The sun is a part of our Spring and Summer outdoor plans, but too much sun can be deadly. Since people get almost 80% of their sun exposure before age 20, many people may already have sun damage on their skin that could turn into cancer. We’ll talk about the dangers of melanoma – both in prevention, how to monitor your skin for signs of cancer and how one local man was diagnosed, treated and is now in remission with Stage 3 Melanoma.
Guests
Dr. Richard L. White
– M.D., Chief of Surgical Oncology at Carolinas Medical Centerand Co-Director, CMC Immunotherapy Program, Blumenthal Cancer Center
Chic Huber – Local financial consultant who is a Stage 3 Melanoma survivor now in remission

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  1. Assuming that over the years people now see much less sun because of the invention of air conditioning and the modern indoor lifestyle. Adding to that there are probably many and more advanced sun screen products today than there were in the past as well. One could make the assumption that the incidence of skin cancer should be declining? But, according to CDC we’ve seen a significant increase of 3% per year since 1986. So if we have better defenses against the sun and are inside more often yet cancer incidences are rising significantly, are we focusing on the wrong area?

    I understand that the intensity of the suns rays may be changing, but…The true change happening is in our body’s natural ability to defend itself against any cancer (which it naturally does every day). This trend can be directly tied to the change in our environment and nutrition. We are now exposed to an exponentially greater amount of chemicals through industry and in our own food than we were 50 years ago. This topic is to broad to expand on here and there is no single smoking gun, but until we address our food supply, nutrition and a chemical free “terrain”, it will only get worse. Sunscreen has almost nothing to do with this issue.

  2. I am an African American. My grandmother died of melenoma at age 95. the cancer started as a mole on the bottom of her foot. I have a squamous cell removed from my temple 2 years ago. could you tell me if just getting a 1x year exam from my determotolgist is the only way to monitor for skin cancer? also, talk about this disease among black people. There is not much written about this.
    thank you.

  3. A lot of people don’t know that the Charlotte area is on the same latitude as North Africa and parts of the Middle East – the 35th parallel north latitude – and thus the sun’s rays are VERY strong here, similar to what you’d get in North African countries like Algeria, Morocco, etc, and Middle Eastern countries like Iraq, Syria, Iran, etc because the 35th parallel passes through those same nations.

    So if you are a person with ethnic/racial roots in Central or Northern Europe, with European physical features like blue or green or gray eyes, light hair, fair skin, etc, you REALLY have to protect yourself from the sun’s very strong rays here in The South. People who have roots in Europe evolved to handle the less harsh solar rays of places in northerly latitudes, not the solar radiation found here in The South – so it is imperative that you protect yourself from too much exposure: and the more fair you are (such as redheads), the more you have to protect yourself.

    • I’m not so sure about the link between sun intensity and skin cancer. Check out this map.

      http://www.cdc.gov/cancer/skin/statistics/state.htm

      Note that Washington probably sees the least sun, but has one of the highest incidence of skin cancer.

      • You make a good point, but look at the other map on the webpage you link to – death rates from skin cancer are high in The South.

        But my point still stands, and is very obvious – the closer you get to the Equator the stronger the sun’s rays get. The South is closer to the Equator than the northern half of the USA, and Canada, and Europe, so the UV radiation is much stronger and more injurious as a result for people who have fair skin. As people from Europe evolved in northern latitudes, they do not have the evolutionary defenses to handle very intense solar radiation – just imagine how rapidly a person with red hair, blue eyes, and very fair skin would get skin cancer, major skin damage, cataracts, and so on in a country right on the Equator.

        A large proportion of Americans have British ancestry – so for example take London (which is in southern England) is at the 51st parallel north latitude, and often cloudy and rainy – while like I said before Charlotte is at the 35th parallel north latitude and often sunny and hot. So you can imagine the huge difference in UV radiation between a place like London which is very far north vs. a place like Charlotte which is pretty far south.

      • Not sure what you are seeing in the second map. Looks very random to me. How do you explain SC, GA, MS, LA, TX…etc? Still dark blue in the NE and NW then sprinkled throughout the middle. For NC, AL and TN I’ll add that these states also have the worst diets leading to the weakest defenses of any type of cancer once it appears. Even then, you are only looking at 0.003% death rate in a dark blue state. I still think that although the sun can be a catalyst, the western diet and lifestyle is the biggest risk, and not the sun. That is the only trend that matches the stats. As seen in this map for all cancers…

  4. I’m concerned that going to a dermatologist for a skin exam will result in “going overboard” by taking off lesions that do not need to be removed. After all, a doctor gets paid more the more lesions he/she removes.

  5. Charlotte Mecklenburg Schools requires special written permission for kids to put on sunscreen or wear a hat at school. What do we need to do to change that policy? It is contrary to the program and educational practices that your guest describes.
    Thanks,
    Hermes
    Charlotte, NC

  6. Hi Mike, Would have liked to hear more about the relationship of a plant based diet and prevention of cancer. There are researchers that believe that people who eat low fat, low animal protein and high phytonutrients from fruits and vegetables have less melanoma even if they are exposed to the sun. Farmers used to be in the sun all day but they ate a lot of vine ripened fruits and vegetables and the rate of melanoma was much lower. The low Vitamin D levels from staying inside and wearing sunscreen have also been associated with more cancer. Is it possible that this disease is a nutritional and lifestyle problem instead of a sun exposure problem? Many of the scientists I have talked to are staring to believe it is so.

    • “Farmers used to be in the sun all day”

      Nah, not usually – that is a historical misconception.

      They were in the sun from sunrise until around 11AM or so – then again from the early evening until sunset: when the UV radiation was weakest and least injurious.

      Throughout history most farmers and ranchers have avoided the strong mid-day sun as much as possible because it was so zapping: usually they would do as much work as they could in the early morning before the sun got high up in the sky, then they would do a lot of indoor work during the hottest parts of the day, or nap, rest in the shade, etc: then they’d go out again in the early evening when the sun got lower in the sky and it began to rapidly cool off.

      • “Nah, not usually – that is a historical misconception.”

        Not the farmers I know and have known… and that’s many. Sun up ’til sun down. That’s the way I roll too, most of the time, (sometimes it’s sun down to sun up). It hasn’t killed me yet. We’ll see.

      • Are you a farmer or rancher, Gregg?

        Just saw this excerpt in a book I’m browsing:

        “Nevertheless protection is not perfect, for as a rule all tropical people hide from the midday sun whenever they are able to. It is remarkable how all classes in the Philippines disappear into their houses in the middle of the day. In Java the natives do not dare to work in the fields from 9 or to 10 A. M. to 3 or 4 P. M.” – http://books.google.com/books?id=iWUAAAAAMAAJ&printsec=frontcover&dq=the+effect+of+tropical+light+on+white+men&source=bl&ots=jS34zj2uR-&sig=MJkAbdcrgpFytKp_ZUJSmNAzl4c&hl=en&ei=GD4PTKaEPMP38Abbl9DdBQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBIQ6AEwAA#v=onepage&q=the%20effect%20of%20tropical%20light%20on%20white%20men&f=false

        Though it’s certainly different in more temperate latitudes, I know for a fact that Whites in the American South were not out working in their fields or pastures during the 90+ degree heat of Summer – and neither were the Blacks either. Everyone rested during the hottest part of the day unless the work HAD to be done right then – otherwise they just did all the hard work in the mornings or when it cooled off in late afternoon. Notice I’m not talking about modern times in terms of air-conditioned tractors, etc.

      • Eman, are you Realist? Just curious.

        Although I primarily make my living as a musician my wife and I run a horse barn with 65+ horses, I don’t know if that qualifies me as a rancher or not. We will begin putting up hay next week weather permitting. The hay must be cut then cure in the sun for a day or two before being baled. If it gets rained on then it’s ruined for horses. It is necessarily done in the heat. We pick it up out of the field, load it onto trailers then unload it in the hay barn. We pack a lunch and eat it in the sunny hayfield then back to work. We put up 3000 bales a year and it takes weeks to do.

        When I moved to the Boone area in 1980 I lived in farming country. Those guys are tough. Have you ever been given a hoe and been pointed to a 25 acre cabbage field? I have many times. Gotta get it done and the window is small. It won’t get done by taking siestas. The farmers I knew never stopped.

        I also have worked as a carpenter. The sun can be brutal especially putting on shingles or even worse if you have to deal with hot tar. 30 minutes for lunch, hopefully some shade can be found but not always.

        I grew up in Miami so maybe that has something to do with my tolerance.

        Having said all that, I don’t disagree that people try to avoid the sun if they can. Farmers start very early and quit early. Most of my carpentry jobs were from 7:00 AM to 3:30 or 4:00 PM. I’ve done roofing at night under lights in the summer too but that is mainly because if it’s too hot the shingles can’t be walked on or footprints will be left. It is nicer though.

        My comments were in support of Aaron’s logic. I just don’t think people are more exposed to the sun now than they used to be but melanoma is up. It seems there must be something else at work. Aaron suggests nutrition, I’m not sure. Maybe we are just better at recognizing what would have been missed before.

      • Yeah Gregg, I am Realist.

        Before I respond to your post, I wanted to ask if you are hiring in any capacity at your horse ranch? It sounds awesome…over 65 horses! That’s amazing, you must be a major landowner. Just to let you know, I asked a similar question at the following comment: https://charlotteblogs.wordpress.com/2010/06/01/wednesday-june-2-2010-economic-forecast/#comment-4159

        I know it’s a long shot, but still worth asking. I’m bored out of my mind at my current office job, and I’ve always been interested in farming/ranching and have wanted to get involved in it for a long time. I also want to escape the tedium of suburbia and get out more in to Nature – modern mass-industrial civilization is crushing my spirit. I’m willing to work, and work very hard doing pretty much anything to escape the Bureaucracy as best I can. So if you are hiring in any capacity on your ranch or know of other similar work on a ranch nearby (even if just for a few months) please let me know here and I’ll pass my email address along.

        Now to respond to your comment:

        June 7th comment – yes you may work sun up to sun down sometimes, but surely not always. That’s the good thing about farming and ranching, there is usually gaps in the work and down-time on certain days (like when it rains and so on) – that is when you have ample time to engage in preferred hobbies for a whole day or more. This is a luxury unavailable to the majority of the populace who must work 9-5 M-F (or 2nd/3rd shift) just to stay financially afloat. An independent farmer or rancher has a whole lot more leeway, you must admit.

        June 9th comment:

        What type of musician are you? Do you travel a lot to perform? If so, how do you constantly upkeep your ranch?

        All of that info about preparing hay is very interesting. Good hard work, but it’ll keep you in shape. That’s another good aspect of that type of work – it keeps you in shape while also feeding the livestock that support or feed you (in terms of cattle). So farmers/ranchers get the best of all worlds: hard constructive work; often working for themselves; exercise and staying in shape while working (as opposed to so many who degenerate physically in their jobs); ample leisure time on off-days to pursue hobbies. Can’t beat it, wish to join it.

        “When I moved to the Boone area in 1980 I lived in farming country.”

        I love Boone and surrounding areas. Wish I could live there, but jobs are of course scarce in the area. The whole area of the 421 corridor from Boone to Winston-Salem is very nice, probably my favorite area of NC.

        “Those guys are tough. Have you ever been given a hoe and been pointed to a 25 acre cabbage field? I have many times. Gotta get it done and the window is small.”

        Definitely tough. And many could be too if they’d done it their whole lives. In terms of the sun issue, the NC mountains are a bit different from the lowlands of NC because it is much cooler and usually cloudier up there, so the heat and sunlight isn’t as intense.

        I WISH I could’ve had the opportunity to work on a cabbage field, or any farm or ranch actually. The thing is, the vast majority of people have just never had the chance or opportunity. I did hand dig a 1000 square foot garden earlier this year, in hard packed red clay. And tilled it many times too, brought in 5 tons of dirt and spread it by hand, dug the rows, etc.

        But you also have to think that once the planting is done there is only some fairly easy maintenance to do until harvest. So yes there are periods of intense work followed by more down time – which is good, as it should be. It is the constant go-go-go of the modern American economy that is driving so many people nuts in more ways than one.

        “It won’t get done by taking siestas.”

        Agreed, but the question is: does it HAVE to get done at that moment or can it wait or be down at a more leisurely pace? As we can now see by the civilization we have built, too much work and activity by so many millions, nay, BILLIONS, is leading to major degradation of the environment. We are victims of our own success, basically. I agree that it feels great to work hard and accomplish things, but it’s also good just to relax and indulge your interests – and slower living is a lot better for the environment as I said than having so many billions zooming around in carz all day just to make few bucks. We have more than enough, in fact we produce a huge surplus of all necessary goods and services, so why not slow down a bit to let people psychologically and physically recoup?

        “I also have worked as a carpenter. The sun can be brutal especially putting on shingles or even worse if you have to deal with hot tar. 30 minutes for lunch, hopefully some shade can be found but not always. ”

        You looking for apprentices too? I want to learn a trade of some sort.

        If you are working on a roof, why not just do it in the morning or evening before or after the heat over a couple of days instead of trying to cram it all in one day in the intense mid-day heat?

        “I grew up in Miami so maybe that has something to do with my tolerance.”

        Yeah, that definitely hardened you off to sun exposure here. Miami is downright TROPICAL, I have no idea how you could stand it. But of course I am light skinned and fair haired (red bearded, too), so I don’t personally do too well in intense heat – it simply goes against the physiology I was born with. Cool, cloudy weather is much more to my liking, I can work all day in that.

        “My comments were in support of Aaron’s logic. I just don’t think people are more exposed to the sun now than they used to be but melanoma is up. It seems there must be something else at work. Aaron suggests nutrition, I’m not sure. Maybe we are just better at recognizing what would have been missed before.”

        Yeah, that last part is probably correct – we just diagnose it better nowadays. People in the past did spend much more time outdoors for sure, but there weren’t records kept about skin cancer and so on back then. Nutrition too could play a role.

        Please excuse this overly long comment, but I’ve had time to ramble this morning. And seriously, if you are looking to hire a laborer on your ranch or take on a carpenter apprentice, please let me know – I must escape my current office job and do some real work of real value and worth in a field I am genuinely interested in. Plus, the modern USA needs more people learning about and working in these ‘green-collar’ jobs because so much of this critical knowledge has been lost as farming and ranching has become so mechanized and ‘massified’ in the last century or so.

      • Gee wiz Realist, that was a thorough reply. I appreciate it because it shows a complete difference in perspective. We agree that the sun is brutal and most people try to avoid it when they can but some can’t or don’t. I believe there are less of those that can’t or don’t now than in times past.
        “Agreed, but the question is: does it HAVE to get done at that moment or can it wait or be down at a more leisurely pace?” Yes, because if the weeds get too high the work is much harder and weeds grow very fast in the summer. There is also a tobacco field to hoe, top and spray. The same holds true for building houses, time is money. Same with the hay, when there isn’t hay to put up there is fencing, bush hogging, trail clearing, pulling weeds from the arena, various construction and much more.

        Our main disagreement is about the opportunities you (and Mr. Howard) refer to. So at the risk of coming off self-indulgent, let me tell you about the opportunities I’ve had. I learned carpentry after leaving home at 17. My first construction job was tearing down chicken houses to be rebuilt on another site for $2.50/hour. I spent months pulling nails (most on the roof) only to put them all back in later. I dropped out of college after a year and a half. I was heading for a double major: music/engineering. I thought I knew everything and was gigging already so I quit. My guitar playing band mate and I packed up and moved to Boone with no place to live or work waiting. We got a weekly Sunday night gig for $75 plus tips. We lived in a tent and bathed in a river. After a year he went back to Florida and I stayed. It was during those days that I was a farmhand. I’d hitch hike into town with tools and show up on job sites looking for work as well. That led to some carpentry jobs. I was playing in a garage band at night. I was skinny and dirty. Eventually the band started making a little money and the carpentry work was better because I knew more and could be cut man instead of laborer. After a while I could be foreman. The break came in ’82 when “The Spontanes” needed a keyboard player. I got the job and so did some of the other guys in my band as the Spontanes were reforming. To hone our sound we got a house gig at the “Oak Tree Inn” in Charlotte. We’d play 6 night’s a week and rehearse after the gig from about 2 to 6 AM. My salary was $40/week. We got by in part by girlfriends and eating the free h’orderves at happy hour in the hotel bar. We did the same thing in Asheville for a month and a half. The band got good. Soon we were a big deal and were playing 200+ nights a year. I got raises, always $10/week, and went from $40 to $440 over the course of ten years. After that I started getting payed by the gig. I was still working construction during the day (after the house gigs) when we were close enough to Boone. It was a lot of driving and very little sleep. To be quite honest I relied on drugs. I don’t recommend it. That eventually led to being the backing band for Archie Bell and the Drells, Ray Peterson, Little Eva and finally Percy Sledge. It also allowed us to be the opening act in front of big crowds. I and 5 other band mates went in and owner financed 2 lots in the “Top of Boone” subdivision in ’86. We paid $3000 a piece and our payment (split 6 ways) was $60/month for 10 years. That was also the year I met my horse loving sweetie in a bar in Lenoir that we played at. Her family had sold their house in Michigan and moved to Hickory and bought 37 acres with the proceeds. They rented a barn and started a business. Dana is very good and began teaching riding lessons. The business grew. They borrowed $50,000 (with the 37 acres as collateral) to build their own barn. The land had a dilapidated shack that I brought back to life working for her. We live there now. The barn was being built by a contractor but he did nothing but the shell and didn’t finish that, I did. When we got another boarder we would by another 100 fence post. In ’90 I bought (owner financed) 20 adjoining acres with rock-n-roll money. $191.60/month for 10 years. By ’97 she had paid off the $50,000 and we had 30 boarders and 60 students. We bought 25 more acres behind us. Now that’s paid for and last year, having no debt, we borrowed more and built an indoor arena. That has led to her coaching the ASU Equestrian team and teaching a class for Lenoir Rhine College. One of the little 10 year old students grew up went to college, got married, became a teacher, hated it, quit and now (at 30) has been teaching lessons here for 5 or so years. We have over 100 students. We just bought 3 of 14 heirs interest in 16 more acres that connects our farm to the Middle Little River which is beautiful and plum full of fish.

        So here I sit at 50. I’m more into classical music, recording and composing than performing these days. I can choose my gigs. We have land that’s paid for. The lots in Boone are listed for $60,000 each and there are now only 4 of us that own them. I have all the money I need to live modestly. I don’t have to work as hard as I used to. Add to that, we supply jobs. We keep the feed mill, blacksmith, veterinarian and hardware store in business. We have summer camps and programs for handicapped kids. We still work hard but life is good.
        The moral of the story is anyone can do what we did if they are willing to spend sweat and some very lean years. My story is typical and not special. Forgive me if I get put off by being accused of having special opportunities. The price was high.

      • As if I wasn’t long winded enough I almost forgot to answer your job question. The short answer is no. We are a little short on feed help right now but we mostly trade out with students and parents of students for that. It’s tricky if you don’t know the horses and which kids are riding on any particular day. When we do pay it’s $25 per feeding and takes 2 1/2 to 3 hours to do. Twice a day 365 days a year. I suppose if you wanted to help put up hay that will start in a couple of weeks but we’re north of Hickory and I don’t get but a couple of days notice before we start so it’s hard to plan. I’ve got some fencing to do and it’s very hard without help but I’m used to it. Can you drive a tractor? I don’t know exactly when I’ll get around to it. Also, I’m liable to get sidetracked at any time if a horse gets sick or someone can’t make it in to feed or something breaks. Lots of things break. There’s stall cleaning on Tuesdays but between Dana, me and the girl that feeds on Tuesday we’ve got that covered. We’ll need counselors for camp but usually use kids around the barn for that. There’s help needed with the handicapped children (one leading and one on each side supporting) but that’s all volunteer work, we don’t make any money there.

  7. Dear Mike,
    Thank you for your show and all I have learn through your show for so many years. I think I have learn more listening to your show than going to college. I appreciate the well thought and relevant questions you make to your guest.

    Mike and team I wanted to make a suggestion that I don’t know if you have think about it yet.

    Some times I miss some information because I am taking notes. It would be great to look at a transcription to go back to, but I am sure that may cost money and time, but how about if your guest could write a summary about their topic or a list of good practices and redflags to wacth out for about their topics that you can tell listener that they can get at your site.

    Or a email list where listeners can register to receive a daily email telling about your tomorrow’s show and a link to today’s show summary sheet and good practices and redflags.

    Thath piece of paper could have also Sponsors adds.

    I hope this is helpful.

    Thank you all for the wonderful service you provide to our community.

    Emilio
    704/351-9473


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