Knowing your ABCs could mean a difference between life and death when it comes to melanoma, a rare form of skin cancer that results in a significantly high mortality rate.

Making people aware of the effects of prolonged ultraviolet radiation from the sun is a good step toward preventing many forms of skin cancer.

"The mnemonic for melanoma is ‘ABCDE' for skin lesions," said Dr. Abdur R. Shakir, medical director of the Sarah Bush Lincoln Regional Cancer Center.

A standard practice for patients with a history of melanoma, or for anyone concerned about a skin lesion, is to pay attention to "ABCDE."

A-Asymmetry (one half of the lesion does not match the other half);

B-Borders (the edges are notched or ragged);

C-Color (the lesion has varied shades of tan, black and brown);

D-Diameter (is greater than 6 millimeters in size);

E-Evolving (significant change in size, shape or shade of color).

Melanoma accounts for less than 5 percent of skin cancer cases, but it causes more than 75 percent of skin cancer deaths. Two other common types of skin cancers are basal cell and squamous cell carcinomas, Dr. Shakir said.

"In life, everything should be in moderation, such as sun exposure," Shakir said. "I don't want people to be afraid to go outside. But I do want people to understand that it's not in vogue to get a sunburn any more, especially when you're a young adult."

Some people today are weighing the differences between years of a golden tan and a potential shortened life, due to deadly forms of skin cancer.

Knowing what to look for could help doctors form an early diagnosis of melanoma.

"Early detection, early detection, early detection is the key. Melanoma found in stage 0/1 have between 90-99 percent cure rates," Shakir said.

Melanoma is the most common skin cancer for adults between the ages of 25 and 29, he said.

Treatment options

Melanoma treatments are determined based on the stage in which the cancer is discovered and may include surgical excision, lymph node removal and chemotherapy.

But a recent breakthrough in treatment of late-stage melanoma is helping people live longer with the disease.

Yervoy, a drug recently approved by the Food and Drug Administration, is administered intravenously and uses the body's own immune system to fight against this form of cancer, Shakir said.

"The good news is that early detection leads to cure in many cases. The other good news is that in late stage melanoma, while before we did not have a good treatment options - now we do.

"The bad news is that melanoma in the late stages is still not curable. But if we can make it treatable that would be just as great," he said.

Cases discovered in stages 2 and 3 have decreased in recent years because of prevention and awareness measures.

Prevention

Prevention is always best. Studies show that common-sense applications such as wearing protective clothing and using sunscreens properly, pay off.

The Journal of American Medical Association recently published results of randomly assigned 1,600 adults to regular sunscreen use or - as a control group - discretionary sunscreen use, during a five-year treatment period.

While both groups had similar risk factors, one group was asked to apply a broad-spectrum sunscreen with sun protection factor 16 every morning, and to reapply it as necessary. The discretionary group use of sunscreen ranged from sporadic to none at all.

"As recorded in a 10-year follow-up period, among those who regularly applied sunscreen, there was a 50 percent reduction in the incidence of primary melanoma and a 73 percent decline in invasive melanoma. The higher the SPF the better," Shakir said.

Wearing hats and sunglasses are common-sense recommendations that he gives to patients. Also, limit time in the sun, especially between peak sunlight hours of 10 a.m. and 3 p.m.; wear protective clothing, including a shirt with sleeves that cover the arms, and a long skirt or long pants; and use sunscreen.

There are risk factors and some genetic links with melanoma. Fair-skinned people are more susceptible, as those with less pigment melanin means there is less protection from ultra violet radiation.

Other risk factors are a history of sunburn, especially during childhood; excessive UV light exposure; those who live closer to the equator or at higher elevation; a person with a family history of melanoma; and one who has more than 50 moles.

SBL Regional Cancer Center

The SBL cancer clinic sees 25 to 30 patients daily, which is up from 8 to 10 daily a year ago.

"I believe this increase (in number of patients) isn't because of more cancer, but instead because I believe our community and the surrounding communities have developed trust in our center.

"There is a misrepresentation that patients will get better radiation treatment somewhere else. It's the same radiation being given here as it is in Champaign, Decatur, Effingham and Chicago," he said.

While 90 to 95 percent of patients can be treated at SBLHC, certain types of radiation, such as gamma knife, is not given at this location.

The clinic is also staffed with Dr. Seong Cho, radiation oncologist; Dr. Kuppuswampy Jagarlamudi, medical oncologist; five registered nurses; two dosimetrists; two radiation therapists; clerical staff; and care partners.

He added that the cancer center is the only one in the area that offers an oncologist/hematologist available 24 hours a day.

Shakir added that his position as assistant professor at the University of Illinois at Chicago has enabled him "to keep my finger on the pulse of ever-changing, improved technology and data for the treatment of various cancers."

The mission at the SBL cancer center is to establish a personalized, high quality, family centered cancer institution without having to leave the neighborhood.

But, it is more than just treating the cancer patient.

"What makes us unique is that our patients also become a part of our greater family-knit structure," Shakir said. "The goal of our staff is to treat each patient on a personal basis, where their individual needs will be met and fulfilled."

Contact Dawn Schabbing at dschabbing@jg-tc.com or 238-6864.