Shortly after his oldest child Dan died of melanoma in 1998 at the age of 26, Steve Fine (of Peabody) founded the non-profit Melanoma Education Foundation and, since August of 2001, has devoted his full-time efforts to protecting young people from the disease.
The primary mission of the foundation is to educate high school and middle school wellness teachers about melanoma and to provide them with free online resources to educate their students in a single class session.
Lessons created by the foundation are currently utilized in over 1,700 schools in 49 states, and have received many honors, including having received a New England Patriots Myra Kraft Community MVP Award.
What are the misconceptions about melanoma?
The big one is that melanoma is just skin cancer, so it can’t be serious. The second is that it happens to old people, and the last is that it’s a rare disease. None of those is accurate.
Is it taken lightly because people view skin as being external?
The truth is that while it’s on the top layer of the skin, it can usually be easily and safely removed. But as time goes on, the melanoma tumor gets bigger; it starts penetrating into the dermis, and as it gets larger it starts shedding off malignant cells all around it, and as it gets deeper, there are more and more blood vessels and lymph vessels that can carry those cells anywhere in the body.
It’s still a tumor even when it’s on the surface, just starting out?
It is. When it’s in the outer layer of your skin, the epidermis, it’s called “in situ melanoma” or “stage zero melanoma,” and at that point it’s not considered to be metastatic, but as it grows downward and into the dermis, at that time it becomes invasive and the curability depends on how deep into the dermas the melanoma is at the time that it’s removed.
Is that a fast process?
It depends on the type. There are two types, radial and nodular. With radial melanoma, you generally have between 6 to 18 months before it reaches the point of no return, but with nodular it’s invasive from day one and you may have as little as three months from the time you see it on your skin.
So seeing it with the naked eye is how you spot melanoma?
It is. You don’t want to wait for other symptoms because then it can be too late.
What are other indications of melanoma?
Bleeding, itching, ulceration – if it ever spreads to an internal organ you’d have pain or some sign that something bad is going on. But the thing is that it’s easy to cure if you get it while it’s thin, and it’s one of the easiest cancers to self-detect. People who do monthly self skin exams and act reasonably promptly if they find anything suspicious almost never die from melanoma.
Can you tell us your story?
My son Dan was working on a job out in California and he paid us a surprise visit; I think it was Memorial Day weekend of 1996. As he was coming out of the shower I noticed a large mole on his back and it was raised. I didn’t know anything about melanoma, but I just didn’t like the looks of it, so I told him, “Dan, you’ve got to get that checked out right away.” Three days later he was back in California, went to a dermatologist that day, and about 10 days later the bad news came back that he had a melanoma that would need further treatment. Two years later he passed away from it.
What was that two year process?
He moved back here from California and he was treated initially at Mass. General Hospital. Back then the only treatment they had was Interferon, which is an immune system stimulant. That’s a year long process, and during that time you typically experience flu-like symptoms the whole time, so that’s a harrowing time. After the treatment was over, he seemed okay for a few months, but then he started complaining of pain in his abdomen. It turned out that the melanoma had spread to his liver and was inoperable.
In retrospect, could this have been prevented?
It developed from a mole that he had most of his life. Originally that mole was slightly raised, but it started getting raised more and by the time I saw it, it was raised well above the skin. But because it was in the mid-lower back it got fairly far along before it was noticed. He’d had some bleeding from that mole, which he attributed to a new computer chair, so he thought nothing of it. In retrospect, that was a warning sign.
If you knew then what you know now, would you have reacted differently to his mole when he was a boy?
I think so. I think parents should check their children’s skin and if they see anything that looks out of the ordinary, or if it there are any of the warning signs of melanoma, that they should have it checked out. If we had acted earlier it probably would have been diagnosed as an a typical mole, a precursor to melanoma. And that would have prompted us, probably, to recommend that he see a specialist. The lesson is to check your kids’ skin and make sure that there’s nothing that could be cause for concern.
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