Donna Halvorsen, Star Tribune
June 8, 2004
For these three women, all in their 30s, the shock and fear came first.
Next came a desire to tell the world about their experience with a dangerous form of skin cancer called melanoma.
Then, just one week before the women's employer, the Minneapolis YWCA, planned an education campaign about melanoma, the deadly truth about the disease became apparent.
One of the three, Deanna Hamilton of Minneapolis, died April 25 after cancer spread through her body from a mole on her back the size of a pencil eraser. At 31, she was the youngest of them.
All three women worked at the YWCA, whose campaign included free skin screenings. Black ribbons, sold in Hamilton's name, raised money for melanoma research.
"I hoped that we could do this fundraiser together," said Michele Hoard, 35, of Minneapolis, a friend of Hamilton who also has melanoma. "She was excited about it, because it was something to give her hope."
Now Hoard, a fitness instructor at the Uptown YWCA, hopes that others will learn from the women's experience with this form of cancer.
Melanoma is less common than basal cell and squamous cell cancers, accounting for 4 percent of skin cancer cases but nearly 80 percent of skin cancer deaths nationwide, according to the American Cancer Society. Although the risk of melanoma increases with age -- 70-year-olds are twice as likely as 45-year-olds to get it -- it is one of the few cancers found in younger people.
It is one of the most common cancers in people under 30, yet it often is not taken seriously. It usually is caused by overexposure to the sun, especially blistering sunburns
"It can strike young people, and they can die quickly from it," said Dr. Charles Crutchfield, an Eagan dermatologist. "It tends to strike young women on the legs and men on the trunk, but it can appear anywhere."
Hamilton had a mole on her back that she couldn't easily see. Her sister, Carol Hudson, 35, of Minneapolis, saw it between her shoulder blades in 2002 and knew immediately that it was dangerous.
Hamilton worked as the membership coordinator at the mid-town Minneapolis YWCA. In the weeks leading up to the YWCA's campaign, Hamilton's health deteriorated. She and Hoard were in a melanoma support group together; and they sent e-mails to each other about the campaign. Hoard knew her friend was terminally ill. Still, when she learned that Hamilton had gone into hospice care, the news came as a blow. She went to bed and stayed there for two days.
But Hoard roused herself for the melanoma campaign selling black ribbons made by melanoma patients and caregivers. Proceeds go to the National Cancer Institute.
Hoard says she feels "survivor's guilt." She can't say she wished she was in Hamilton's shoes, "but still my heart is breaking for her," she said.
Hamilton was the youngest of four sisters. Her family members described her as bubbling, free-spirited, golden and beloved. She was active outdoors, although she didn't get excessive sun, family members said. Like the rest of her family, she had fair skin, which carries a greater risk for melanoma.
People with lots of skin moles also have a higher risk.
That turned out to be the case for Hoard, who was a lifeguard from high school through college. She went to tanning booths "to get a base tan because I thought that was good for you, to make sure you didn't burn." Experts now say the ultraviolet rays you get in tanning booths are as dangerous as those from the sun.
Hoard was having some benign moles removed in January 2003 when she asked her doctor to look at a spot on her inner thigh. It was melanoma. Since then she has had a second incision when it appeared the cancer had returned, and she fears it still may spread.
"You're always worried about melanoma," she said.
She said people shouldn't rely on the pictures of suspicious moles that are found in doctors' examining rooms. Hers didn't look like any of those. "It doesn't have to be a big, ugly mole," she said.
The prognosis with melanoma depends on the thickness of the mole. "The earlier you catch it the better," Crutchfield said. If there's any change in a mole, "get it evaluated, don't watch it."
Having a family history of skin cancer is another risk factor. One of 10 people who has melanoma has a family member with the disease, according to the National Institutes of Health.
Suzanne Kranitz, 36, of Minneapolis, the third of the women, is a fitness instructor at the Uptown Minneapolis YWCA. She learned in 1998 that she had melanoma. After her diagnosis, she found out her maternal grandmother had melanoma.
Kranitz hopes the disease is behind her.
She had a freckle on her knee for a decade before she noticed it darkening and beginning to look like a mole. She waited a couple of years before she had her primary doctor look at it and another six months before she saw a dermatologist. Then things moved quickly: A few days after seeing her, the dermatologist called her back to the office and removed the melanoma.
Part of her body
"I just went home and remember feeling so bad and crying that part of my body was removed," she said. "I've always been pretty healthy. To have something like that happen is mentally disabling."
The cancer was shallow and hadn't spread. Five years later, Kranitz considers herself lucky. There has been no recurrence, and she looks back on her sun-seeking behavior as a teenager with regret. She remembers going into her Minneapolis backyard to tan at 10 a.m. and staying there until mid-afternoon. Instead of using sunscreen to block the sun's rays, she used baby oil or water to deepen her tan. She went to tanning booths, too.
"It was considered a beauty thing," she said. "My mom said, 'You know, you've got to be careful' and things like that. And, of course, being a teenager, I didn't always listen to everything my mom said."
It's still "a beauty thing" for some, especially people in their teens, 20s and 30s who may think skin cancer happens only to older people.
"People are inordinately focused on things to beautify their skin, because it's what everyone sees on the surface," said Deanna's sister, Brenda Hamilton, 37, of Alameda, Calif.
Hamilton's sisters say the skin should be seen for what it is: the body's largest organ, which helps regulate body temperature, stores water and fat, produces vitamin D and protects against sunlight, heat, injury and infection.
"If they have a little pain in their heart, or if their stomach hurts, they'll immediately race in to the doctor, but if something happens to their skin, they see it as a superficial problem," said Carol Hudson, whose twin sister, Amy Wehr, lives in Richfield.
The death of their sister, the youngest in the family, was hard to grasp; it seemed to violate the natural order of things. The flowers from the funeral, following their own natural order, brought the point home painfully.
"The petals are falling off," Carol said. "They're starting to die. It's just so sad because it means that time is passing, and she is becoming more distant to us."