DEAR DR. DONOHUE: My mother died at age 43 of a melanoma. I was only 10 then, and the memory of it has never left me. I live in fear of melanoma. I have two moles on my back, and I watch them like a hawk. Can you supply some facts about melanoma that might ease my mind? – P.L.

ANSWER:
That’s a young age to lose a mother. No wonder the fear of melanoma stays with you. Inspecting your skin and watching for any changes in your moles are all you need to do to stay clear of missing an early melanoma. Caught early, most melanomas are treatable and curable. Melanoma is, however, the most dangerous kind of skin cancer. Everyone should follow your lead and periodically do a full search of the skin to look for any suspicious dark spots. Such a search requires a full-length mirror.

You ought to be careful about sun exposure. Intermittent sunburns predispose a person to melanoma more than does tanning, but all extended sun exposure is dangerous. Sun protection is a profitable path for you to take in melanoma prevention.

This isn’t intended for you but for readers not as conversant with melanoma. A melanoma is a black or brown spot, bigger than a pencil eraser. It has varying shades of black and brown, and reds and blues are frequently interspersed on the darker background. The color is not the same throughout. Melanomas, unlike most moles, don’t have a symmetric shape. In your mind, you cannot fold the melanoma in half so both halves are exact copies. The edges of a melanoma are jagged. One of the greatest warnings of a melanoma is a change in the size or shape of the patch.

Depth of penetration is an important determinant of a melanoma’s lethalness. It takes time for it to sink more deeply into the skin. A melanoma that is near the skin surface has an 80 percent or greater expectation of cure. One that is deeper in the skin and has traveled to distant body sites like the lung has a very poor chance of cure. With your program, you’re bound to discover a melanoma in its earliest stages.

DEAR DR. DONOHUE: I have a few moles, and I have had them for several years. How am I to know if they are really moles or if they could be melanoma cancers? – J.K.

ANSWER:
Moles increase in number from infancy to around age 29. From middle age on, they tend to disappear. Dark spots that have stayed the same size for several years are not likely to be melanomas. Melanomas increase in size. Moles stay the same size.

Unlike melanomas, moles have a uniform color – all black, brown or tan. They have nice, smooth borders, and they are smaller than most melanomas, being less than one-quarter inch (6 mm) in diameter, the size of a pencil’s eraser.

Any pigmented spot or patch, regardless of size or color, that grows or changes shape should be viewed as a danger and should be examined by a doctor. In fact, any skin lesion about which you are uncertain needs a doctor’s evaluation.

DEAR DR. DONOHUE: My 40-year-old daughter has gone diet crazy. She used to wear a size 16 dress. Now she wears a size 6 and still thinks she is too fat. She never eats a full meal. She picks at food. She has three small children. Can a person of this age have anorexia? – W.L.

ANSWER:
Anorexia usually begins at younger ages, but no age is immune to it. She has one of the primary signs of an eating disorder. She believes she’s overweight when there is striking evidence to the contrary.

She is headed for serious trouble if she doesn’t start to eat sensibly. She’s on the path to osteoporosis – brittle bones. She’s going to find that her estrogen production begins to wane, and that sets her up for many problems. She’s not going to get enough vitamins and minerals on her restrictive food intake.

What does her husband say about all this? Enlist his help. Badgering your daughter is not going to get you or her anywhere. Show her what I have written, and tell her I said she needs to see the family doctor.

DEAR DR. DONOHUE: My son and his girlfriend are expecting a baby. Both he and a roommate, who also lives with them, smoke. I am concerned for the baby’s health because the apartment reeks of cigarette smoke. Please explain what effects secondhand smoke has, especially on a newborn. – K.E.

ANSWER:
Your son must be spending lots of time on another planet if he hasn’t heard what secondhand smoke does to those breathing it. Young children living in a smoke-filled atmosphere have more respiratory infections than other children. They’re more likely to come down with asthma. The smoke retards the development of lung function. It makes these children vulnerable to middle-ear infections (the middle ear lies behind the eardrum). This is only a sample of what secondhand smoke does to those breathing it, particularly infants and children.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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