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Melanoma
Dr. Maguerite Barnett M.D., P.A., F.A.C.S.
Melanoma is a most dangerous form of skin cancer. Although it is less common than
such skin cancers as basal cell or squamous cell carcinoma, it causes a
disproportionate number of the skin cancer deaths in the USA each year. It is so
deadly because it has the ability to metastasize (spread to a distant site) so
easily. The good news is that it is becoming more curable each year and it is
usually more obvious than some other forms of skin cancer because of the dark
pigmentation, therefore, it can be found at an early, more curable stage. This good
news is offset by the fact that this cancer has the fastest increase in incidence of
any cancer. Most scientists believe that the increase is due to the increased
exposure to sun and possibly because of the stronger rays with destruction of the
ozone layers. It is a well-known fact that countries/states where the sun is strong
and people are out in the sun, (particularly if they do not have the protective
melanin pigment of dark skin) have a much higher incidence of melanoma. California
and Florida for example have higher rates than New York or North Dakota. Many
patients have a history of a sunburn years earlier so it is particularly important
to protect children from this type of sun damage. Remember that the damage of the
sun is caused by ultraviolet rays which are present in tanning beds so even if you
never go into the sun, if you are an afficionado of tanning beds you should be
concerned. A recent Miss Junior USA found that out, getting melanoma before she
graduated from college!
Most melanomas develop in pre-existing moles, so one should be on the look-out for
any unusual change in a pigmented mole such as a darkening, thickening, change in
shape or size or bleeding. Many doctors use the "ABCD"s to identify suspicious
lesions. "A" stands for asymmetry. If you draw a line through the mole and it
looks symmetric on each side of the line, it is less likely to be a melanoma. "B"
stands for border. If the edge of the mole is smooth, it is less likely to be a
melanoma than if it has little finger-like extensions or bubbles off the edge. "C"
stands for color. A uniform brown color is less likely to be a melanoma than
irregular dark black mixed with browns or pink-tans. "D" stands for diameter. A
mole that is smaller than a pencil eraser is of less concern than one larger. These
descriptions are only guidelines as to whether you should see a doctor about a
mole; if you are worried about a lesion, IT IS BETTER TO SEE YOUR DOCTOR THAN
ASSUME EVERYTHING IS OK. This is especially true if you are the typical melanoma
patient with pale skin/hair/light eyes who sunburns easily and even more so if you
have a family or personal history of skin cancer. Your doctor can make the decision
if a mole is suspicious enough to need a biopsy and which simply need observation.
Most people do not need to see a dermatologist or a plastic surgeon unless they are
diagnosed with melanoma as your family doctor is able to screen for this disease and
decide if a specialist consult is warranted.
Don't avoid going to the doctor because you are afraid you have melanoma. If it is
found early, and most are, it is nearly 100% curable by surgery. If you delay it
can lead to much more severe problems requiring more complicated treatments or even
lead to death. A thin melanoma, one less than 1/32th inch thick is less likely to
have spread than one thicker. Once a melanoma has metastasized, it may not be
curable by surgery so get it early! Better than treatment is prevention. Since sun
exposure is so tightly connected to the development of melanoma, sun avoidance is
the best method of prevention. Dermatologists and plastic surgeons are sometimes
accused of being vampire life-style proponents but we see daily the results of sun
damage not just in causing skin cancer but also in premature aging of the skin.
That is why we recommend staying out of the tropical sun during peak hours (10-4)
and covering up AND using sunblocks properly. Sunscreens are less desirable as they
often fail to block uva as well as uvb rays and all can lead to false sense of
security if they allow people to stay out longer in the sun's rays without
sunburning. If you really must look tanned, check into the good fake tan products
now available; they no longer have to make you looked streaked or orange and they
are much safer. Most people can manufacture all the vitamin D their bodies need
with ten minutes of sun exposure a day; if you feel you need more, consider
supplements.
Aesthetic, Reconstructive Plastic Surgery
American Board of Surgery
American Board of Plastic Surgery
Member: American Society of
Plastic Surgeons, Inc.
Dr. Barnett has a medical practice in Sarasota, FL where she is also the Director and Owner of the Mandala Med Spa.
She is a Double Board Certified Harvard/MIT Trained Plastic and Reconstructive Surgeon Certified by the American Board of Surgery and American Board of Plastic Surgery, Past Surgical Section Chief at Bon Secours Venice Hospital and current Active Staff, Emergency Disaster Physician Coordinator for Red Cross and Sarasota County, Sarasota County Medical Society's Immediate past President and current AMA Alternate Delegate, former Major USAR and three time board member of the Florida Medical Association. She is board-certified in general surgery and continues to maintain her certification in addition to having attained board certification in plastic surgery and having completed a hand surgery fellowship.
Striving always for excellence, she completed a four-year Liberal Arts degree in two years delaying entry into medical school for a year of postgraduate education. She turned down a spot at Harvard Medical School in order to enter the joint Harvard-MIT health sciences and technology program, an MD program limited to only 25 students per year in order to exploit the advantages of a top of the line medical education grounded in the world-premier basic sciences of MIT.
Dr. Barnett spent 11 years on active duty attaining the rank of Major before going into private practice in Florida. Her invaluable military training includes the world famous Brook Army Burn Center, John Hopkins Shock Trauma Unit and the St. Louis microvascular program. She was a trauma surgeon in the Army, heading a Terrorist Response team stationed in Germany in the mid 80s and remains as a clinical instructor in surgery for the Uniformed Services School in Bethesda. She is currently on staff at Venice Regional Medical Center in addition to St. Andrews Surgery Center. She is active in local, state and national medical organizations including having been the former chief of surgical section, past president of Sarasota Country Medical Society and current delegate to the FMA and alternative delegate to the AMA.
She wishes she had more time to indulge her hobbies of gardening and her other business as a professional dancer.
http://www.mandalamedspa.com/index.html
