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CHICAGO
– At age 10, freckle faced Corey Halpin had bigger things to
think about like basketball and Boy Scouts than the little black mole
he noticed on his arm while camping.
At first, he thought it might be a
tick. “I pushed it but it didn’t move, but it bled,” he
recalled.
It
wasn’t until a few months later, during a spring 2002 visit to his
pediatrician, that Corey casually asked his dad if he should mention
the odd mole. That led to a referral to a specialist and alarming test
results that caught even his doctors by surprise.
Melanoma,
the most serious and potentially deadly form of skin cancer, was until
recently, almost unheard of in children, and it was a diagnosis that
his family wasn’t prepared for.
“My husband and I
were scared to death and so was Corey”, said his mother, Marge
Halpin.
Pediatric
melanoma is uncommon in children, affecting only 7 per
million, or about 500, according to 2002 statistics from the National
Cancer Institute. But that number has risen from 3
million in 1982.
Dr.
Charles Balch of the American Society of Clinical Oncology, who has
specialized in melanoma for 30 years, saw his first pediatric case
five years ago. Since then, John Hopkins Hospital, where he works, has
treated about 20 youngsters, the youngest just 8 years old.
Dr. Anthony Mancini, dermatology
chief at Children’s memorial Hospital in Chicago, diagnosed Corey
Halpin’s melanoma and said he and his colleagues have treated eight
cases in the past nine years, about double the number seen in
the previous two decades.
Recent studies also report
increases in England, Sweden and Australia.
“There’s an appropriate level of alarm here”, Mancini
said. “Clearly it’s happening and it’s deadly, and it’s
missed.”
Some pediatricians who see unusual
moles in children “would ordinarily dismiss this as nothing because
melanoma is not supposed to happen in this age group,” Balch said.
“We all should be aware that this can occur and biopsy
suspicious or changing moles in children.”
Balch said reasons for the
increase are uncertain. Some doctors think it might be from the
depletion of the ozone layer, which protects the Earth from some of
the sun’s damaging ultraviolet radiation. Others attribute it
to excessive sun exposure and blistering sunburns in early childhood,
though some experts had thought it took much longer for skin
damage from repeated sun exposure to develop into cancer.
Melanoma prevalence has
risen in adults too – more than doubling in the past 30 years,
said the cancer institute. The American Cancer Society estimates that
this year about 60,000 U.S. adults will be diagnosed with
melanoma and that 7,600 will die from it.
Melanoma develops in skin cells
called melanocytes, which produce the pigment that colors the skin’s
surface and protects deeper layers from sun damage. It is much more
invasive and likely to spread to other parts of the body than other
skin cancers.
Research from Italian doctors
found that melanoma lesions in children may look different from
those in adults and may be misdiagnosed.
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Melanoma
also can affect Children