Oregonians enjoying spring weather may not know it, but they're in the middle of a "war on melanoma."
It was started by Oregon Health And Science University back in 2014 — mainly because Oregon has one of the worst rates of skin cancer in the nation.
On Saturday, the university and the Knight Cancer Institute hope to recruit a legion of new foot soldiers at the Portland Skincare Festival. Scientists want hair dressers, makeup artists, masseurs, electrologists, nail technicians and tattoo artists — anyone whose job involves looking at skin — to tell their clients to see a doctor, when they see a suspicious blemish in the course of work.
"If we can teach people about what to look for with melanoma ... [and] anything that is a melanoma gets taken off early, we've beat the problem I think," said Sancy Leachman, chair of the dermatology department at OHSU.
Leachman was recruited to Oregon from Texas by the Knight Cancer Institute a few years ago. Since then, she’s been working to see whether teaching people about skin cancer can reduce the disease.
The first step, she said, is establishing a baseline.
“For example, we know currently how deep the melanomas are on average in Oregon. What about after we give that public health campaign? Did those depths go down?” she said.
Leachman wants to know how public education affects everything from the melanoma death rate to the cost of treatment.
She's recruiting people into a nationwide registry, which already numbers almost 8,000 in Oregon. Leachman is also looking for people who've already had skin cancer, families with a history of the disease and redheads who are at higher risk. She's even interested in people with no link to the disease because maybe they'll illustrate a trait that reduces their risk.
Her hope is that instead of only being able to study patients, scientists will be able to use the registry to access dozens of similar cases at the touch of a button.
“It speeds up the research process enormously,” Leachman said.
Once Leachman establishes that baseline for the cancer, skin care professionals can play a big role in prevention, she said.
Esther Prentice, a 31-year-old hair dresser at Gilly's Salon in Southeast Portland, has been recruited as one of Leachman's skin care professionals.
Prentice already warns clients about unusual rashes or spots — on average about once every couple of months.
But doing so makes her nervous.
“I do worry that I’m going to make somebody uncomfortable, or I’m going to scare them unnecessarily," she said. "Because as soon as you say [cancer], people are like: ‘What!’ Because there’s that fear.”
Prentice said she’s very matter-of-fact about the warnings and sometimes lets customers know the famous reggae singer Bob Marley died from skin cancer at 36 after a lesion first appeared on his toe. Apparently, he dismissed it as a soccer injury.
Last month, Prentice was cutting her dad’s hair when she noticed a sore on his bald spot. She told him about the sore, but he doesn’t want to go to the doctor.
“It’s funny how certain people view their bodies and cancer differently,” she said.
Prentice said her dad is stoic and doesn’t want to be a burden.
But that attitude has dermatologists groaning, because melanoma is the one type of cancer that doesn’t usually need expensive medical scans to find — it’s right there, on the skin.
And if melanoma is caught early, treatment can be as simple as snipping off a small piece of skin. On the other hand, said OHSU dermatologist Leachman, if a melanoma remains untreated, it can metastasize and spread throughout the body.
“If you have a metastatic melanoma, even with the best therapies that we’ve got, the best chance that you’ve probably got is about 50 percent chance. Fifty-fifty is not what people want to hear,” she said.
OHSU and the Knight Cancer Institute have other fronts in their fight against melanoma.
They want people with iPhones to download the "Mole Mapper" app.
Leachman said people can take a picture of their mole, add it to a nationwide database, and track it to see if it grows. It compares the blemish to a coin, so people can see if it changes size, shape or color.
The app can’t diagnose skin cancer. But over time, Leachman said, such crowd sourcing research might help scientists figure out which moles are cancerous.
“And then at that point, maybe we will be able to figure out how you tell whether something is really a melanoma or not,” she said.
Medical staff are also increasing their use of tele-dermatology. That’s when a patient arrives in a small rural clinic with an unusual patch of skin. If the doctor doesn’t see a lot of melanomas, tele-dermatology allows him or her to take a picture and send it off for expert diagnosis.
Leachman said Oregonians should be taking their skin care seriously.
She said skin cancer is more associated with being burned, than the actual amount of sun.
“Because people stay inside with all the rain during the winter, they have a higher tendency to burn and they have a tendency to take vacations in sunny environments where they get burned," she said. "Oregon is always like in the top five incident rates of melanoma in the country. And that’s just a shock to people. They have no idea.”