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MEFNEWS
A PUBLICATION OF THE MELANOMA EDUCATION FOUNDATION
SPRING 2017
Childhood Melanoma
Warning Signs Often Different than for Adults
A
pproximately 80 percent of melanomas in adults are radial,
with typical “ABCDE” warning signs, but in children ages
10 and younger, only 40 percent are. The other 60 percent are
nodular, often red or flesh-colored (“amelanotic”), without any
ABCD warning signs. In teens, about 40 percent of melanomas
are nodular. Nodular melanomas often arise from clear skin, may
look innocent, and are invasive immediately, without proceeding
through an in situ stage. In adults, 50 percent of melanoma
fatalities arise from nodular melanomas, even though only 20
percent of new melanomas are nodular.
There is no published data on nodular vs. radial melanoma mortality in teens and young children, but the disproportionate morbidity
of nodular melanomas in adults has worrisome implications for
teens and preteens. Unfortunately, health videos or texts with skin
cancer lessons for teens don’t include information about nodular melanoma. The exception is our high school video My Melanoma Vlog.
Also in this Issue…
 2 In Situ Melanomas
 32017 Melanoma
Incidence Projections
 3 Introducing the
MEF Blog
 4 Sundicators UV
Wristbands
 4 Request to Boston
Globe Subscribers
 5 The Melanoma Lessons
 5 2017 TCS NYC
Marathon Openings
6 Calendar of Events
Summary of Warning Signs of Childhood Melanoma
“ABCD” Radial Melanoma Signs
(~40 percent of melanomas)
“EFG” Nodular Melanoma Signs*
(~60 percent of melanomas)
A = Asymmetry­—two halves not the same
E = Elevated
B = Border—irregular or notched
F = Firm­— hard to the touch, not flabby
C = Color­—two or more different colors or shades
G = Growing—more than 2–3 weeks
D = Diameter­—1 ⁄4-inch or greater
*All three “EFG” signs must be present to warn of a
possible nodular melanoma. Some benign growths
also exhibit these signs in young children and teens.
The photos at left show invasive melanomas
on a 10-year-old (far left), a preteen (middle),
and the finger of a three-month-old (right).
continued on page 2
Childhood Melanoma
continued from front cover
Melanoma is much less common in children than in adults, but the following are risk factors for
children. (Some of these are also risk factors for adults.)
•Fair skin that burns easily and tans poorly
•Immunodeficiency or immunosuppression
•Freckles
•History of retinoblastoma
•Many moles
•Giant birthmarks ( > 15-inch diameter) g
•Family history of atypical moles
In Situ Melanomas
I
n situ, or stage 0 melanomas, are thin melanomas confined to the
epidermis, or the thin outer layer of skin.
They are 100 percent curable, usually by simple excision in an
outpatient setting. As with radial melanomas, they typically have some
of the “ABCDE” warning signs, and are easily recognizable by selfexamination. The three photos below show typical in situ melanomas.
At left are photos of a lentigo, lentigo maligna,
and lentigo maligna melanoma, respectively. g
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Another type of in situ melanoma may develop in
an age spot (or liver spot), known medically as a
lentigo. Lentigos are caused by sun exposure and
are common in seniors and middle-age individuals,
often appearing on the face, nose, scalp, and
backs of hands. Most lentigos do not progress to
in situ melnomas and do not require treatment, but when one progresses, the resulting growth is
known as a “lentigo maligna.” Approximately 6–10 percent of lentigo malignas progress further
to invasive melanomas, referred to medically as lentigo maligna melanomas. Unlike other
melanomas, the evolution of lentigo malignas
to invasive melanomas is usually a slow process
that occurs over several years.
2017 Melanoma Incidence Projections
US Incidence Continues to Increase
T
he 2017 melanoma incidence projection from the American Cancer Society (ACS) continues
the decades-long upward trend of invasive melanoma incidence. We placed the ACS figures
on a map of the US, showing the expected incidence by state. The projected overall incidence of
in situ melanoma has also been increasing, although the ACS does not provide individual state
projections. g
WA
2,590
MT
400
OR
1,580
ID
550
NV
560
CA
9,180
VT
220
ND
210
WY
190
MN
1,330
SD
240
UT
950
AZ
2,050
CO
1,590
MI
2,780
MO
1,690
OK
790
NM
490
WI
1,590
IL
IN
2,810 1,730
KS
830
PA
4,140
OH
3,140
KY
1,410
WV
700
MA
1,890
CT 970
NJ 2,790
DE 340
MD 1,700
DC 120
SC
1,740
AR
610
AL
1,320
VA
2,500
RI
270
NC
3,060
TN
1,840
MS
560
TX
4,240
ME
450
NY
4,900
IA
1,020
NE
490
NH
470
GA
2,930
LA
960
FL
7,610
AK
130
Total (Invasive): 87,110
HI
460
Total (Invasive & In Situ): 161,790
Introducing the MEF Blog
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M
EF has launched blog at blog.melanomaeducation.net. Weekly posts
focus on different types of melanoma (Radial and Nodular Melanoma,
Childhood Melanoma, In Situ Melanoma), and early self-detection (SelfExamining for Early Signs of Melanoma, Normal Moles vs. Atypical Moles). g
Sundicators UV Wristbands
Reminds Users When to Reapply Sunscreen or Get Out of the Sun
S
undicators are patented, UV-sensitive wristbands that serve as sun protection reminders
for both adults and children. They can be used during all outdoor sports and recreational
activities, including swimming in salt water, fresh water, and pools with chlorinated water, and
are rugged enough to be used in extreme sports. The wristbands work with all sunscreens that
have SPF values of 15 or higher.
How to Use Them
Activate the Sundicators wristband by exposing it to direct sunlight; the wristband will turn
dark purple. Apply sunscreen with an SPF 15 or higher to both the Sundicators band and your
skin. As time passes and the sunscreen loses its effectiveness, the dark purple will start to fade,
indicating it’s time to reapply sunscreen to all exposed parts of the body (or to seek shade).
Why We Like Them
In addition to their effectiveness, we prefer Sundicators over other UV wristbands because they
are produced by Pretty Pale, Inc., a nonprofit organization that uses all proceeds to provide skin
health education.
To learn more or order Sundicators, visit sundicators.com. g
Request to Boston Globe Subscribers
T
here is an easy, no-cost way for Boston Globe home delivery and online
subscribers to help the Melanoma Education Foundation get free advertising space in the Globe. Just visit BostonGlobe.com/GRANT and fill in the
following information under “Submit Grant Voucher:”
• Subscriber Number (Your Boston Globe subscriber number)
• Name of Certified 501(c)(3) Organization (Melanoma Education Foundation)
• Non-profit City and State (Peabody, MA)
Hit “Submit” and you’re done!
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Depending on the type of your subscription, MEF will receive either $50 or $100 toward
Globe advertising for every subscriber who submits the form now through April 30th.
Thank you in advance! g
The Melanoma Lessons
Behind the Scenes of MEF’s Signature Program
A
t last count, over 1,700 US middle and
high schools were using MEF’s Melanoma
Lessons to educate their students about early
self-detection and prevention of melanoma.
One of the most important elements in the
high school video (and in our 30-minute
teacher-training video) was the inclusion of
nodular melanoma, the most aggressive type
of melanoma. It affects teens and children
disproportionately, usually looks innocent,
and doesn’t display the usual “ABCD”
warning signs of radial melanomas.
The student videos comprising the cores
of the lessons were co-developed with the
help of talented graduate students from the
Emerson College Department of Health
Communications. Prior to the creation of
Should’ve, Could’ve, Would’ve for middle
school students and My Melanoma Vlog for
high school students, focus groups at both
school levels were shown every skin cancer
video we could get our hands on, and asked
what they liked and didn’t like about each video.
No other health texts or videos include
information about nodular melanoma. Glencoe
Health textbooks (both print and online) are
widely used in US secondary schools, and
although their coverage of most health topics
is excellent, their treatment of melanoma is
brief and inadequate.
When producing our videos, we incorporated
student “likes,” and avoided features that
students didn’t like. We also made the videos
and lessons short and teacher-friendly, so they
could be presented in single class periods
with minimum advance preparation. And we
did our homework to ensure that content was
accurate and relevant.
Lives of students, teachers, and student family
members have been saved because of our
lessons. If you know of any middle or high
schools that are not using MEF’s Melanoma
Lessons, do the health teacher and students
a favor by asking the teacher to check out
our three-minute introductory video at
melanomaeducation.net. g
2017 TCS NEW YORK CITY Marathon OPENINGS
A
s an official charity partner of the New York
Road Runners Association, MEF was approved
to enroll runners in the November 5, 2017 TCS
New York City Marathon.
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If you or someone you know is interested in running
the world’s most prestigious marathon, please find
out more here. g
Calendar of Events
July Calendar Raffle Sales
Buy tickets at skincheck.org/store.php starting May 1st.
July 30, 2017
MEF Annual BBQ Board Meeting, Peabody, MA
If you would like to meet us and learn more about MEF, you are welcome to
attend our open board meeting with no obligation. Email [email protected].
September 23, 2017
Gala Fundraising Event, Winthrop, MA
Details to be posted at skincheck.org.
November 5, 2017
2017 TCS New York City Marathon
Email [email protected] or call 978-535-3080 to apply for a charity
runner spot.
P.O. Box 2023
Peabody, MA 01960
tel. 978-535-3080 | fax 978-535-5602
[email protected]
w w w. s k i n c h e c k . o rg
w w w. m e l a n o m a e d u c a t i o n . n e t
The Melanoma Education Foundation is a nonprofit preventive health organization that saves lives by promoting
greater awareness of melanoma and the importance of early self-detection. The Foundation, which was incorporated as a nonprofit 501(c) (3) organization in Massachusetts in August 2000, evolved from a father’s website
tribute to his son, Dan Fine of Peabody, who died of melanoma in 1998 at the age of 26.
PUBLISHER/EDITOR
Stephen A. Fine
GraPHIC DESIGNER
Aron Fine
MEFNEWS is published in the spring and fall of each year. If you or someone you know
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Copyright © 2017 Melanoma Education Foundation. All rights reserved.
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May 1–June 30, 2017