The other day, I went to the park with some friends. After spending some time in the lake, the boys went to light the barbecue pit and the girls sat on the grass and gossiped. I was angled towards one girl's back, and as I chatted away, I couldn't help but notice a large marking on her back that looked like a combination of all of these warning signs for skin cancer. It's something that no one would notice if she wasn't wearing a bathing suit, and while I'm certainly no doctor or even somewhat of an expert on skin cancer, I felt compelled to tell her to get it checked out, even though it would probably end up being nothing. But then again, we were having fun and I don't know her that well -- I didn't want to become 'that girl' -- the one who ruins parties by telling people they hardly know that they might have cancer. Because that girl is always such a downer.

So I kept my mouth shut and am wondering now, a few days later, if I should have just said something. I suppose it's not too late. What do you think? Would you be offended or upset if someone told you that you have a suspicious mole on your back? Would you rather that person kept his or her mouth shut?

Last Tuesday night, I watched Greta Van Susteren of Fox News' On The Record as she interviewed Brittany Lietz, Miss Maryland 2006. Greta asked Brittany what her Miss Maryland job entails. Brittany told Greta her full-time job is to represent her platform -- skin cancer.

Brittany didn't choose just any topic for her platform. She chose one that is entirely personal.

Skin cancer has left more than 20 scars on Brittany's body. One, on her back, marks the site where a stage two melanoma was removed when she was just 19 years old. It presented as a mole, a little smaller than a nickel, she says. In all likelihood, the cancer was caused by two years of tanning bed use. Brittany says she probably tanned every day for two years. Her pursuit of bronzed skin began when she was 17 and wanted a tan for her prom. It ended after doctors told her she had cancer.

We're still basking in the hot sun, bronzing our bodies in tanning beds, and playing outdoors without slathering on the sunscreen. What will it take, I wonder, for our society to catch on, to take real steps toward preventing skin cancer?

It seems education isn't enough. Most of us know by now all it takes is one bad sunburn to increase our risk of skin cancer, yet we continue to collect burn after burn after burn. Perhaps like all habit-forming behaviors -- think smoking -- it takes something tragic in our lives to inspire change. When someone we know gets lung cancer after a lifetime of smoking or someone we know develops melanoma after years of sunbathing, maybe we get the hint. Maybe

Now, I know you don't personally know this young woman -- she calls herself Miss Melanoma -- but I suggest you read her story. And I recommend you take what happened to her -- she lost part of her foot to melanoma and is currently battling a spread of the disease -- and allow it to really sink in, allow it to motivate you to take cover from the sun, before something like this happens to you. Because it can.

She's cute and spunky and full of life. She's Miss Melanoma, and her mission is simple: to raise awareness about skin cancer. Her slogan -- Attitude is everything. You're living with melanoma, not dying from it -- sums up this survivor girl, also known as Lori Lee, whose main goal is to get a Surgeon General's warning in every tanning bed salon window.

Think about this:

Miss Melanoma has a website. It's a spot for readers to learn, explore, RANT, even curse at cancer. "We won't censor your thoughts," she writes. "And we promise someone here will get exactly what you're saying."

The site features news, articles, artwork, shopping, and Miss Melanoma's personal blog, which is simply captivating. And quite shocking too.

Miss Melanoma, who learned in 2005 that a mole on her right foot was the absolute worst form of skin cancer, has endured the amputation of part of this same foot and aggressive treatment for a disease that began spreading up her leg and into her lymph nodes. And now, right now, Lori Lee is awaiting news from her surgeon about whether or not a likely cancerous lymph node deep in her pelvis can be surgically removed.

"Is it weird what a relief it is to be fighting cancer again?" she blogs. "It's something only a cancer survivor can understand, I think. You just don't know until you've been there. It's the new abnormal, people. Sitting around waiting for it to return when every doc you see tells you it's most likely coming back will drive you up the walls. Knowing that it's here and it's really just one lymph node and that we can treat it, that's a relief. I know. I can't explain it."

I urge you to think some more about Miss Melanoma, visit her website, her blog, and even send her your warm wishes as she continues living -- not dying -- from cancer.

This comment just arrived in response to yesterday's post Headed for melanoma, and it's just too raw and powerful to leave buried in the comment section of the site.

So here it is, word for word -- a chilling and empowering message from a 37-year-old mom of two living with a disease that is downright deadly.

I have melanoma. I was diagnosed last August and have had 6 surgeries in 6 months.

I have lost 4 members in my melanoma support group. I go to Jaime's funeral tomorrow afternoon. She was 29 years old. Heather was 37 when she died on March 2, 2007. The midwife noticed a suspicious mole on her leg during the birth of her 4th child. She died 23 months later. Jan was a mother of 5 ages 9 to 19, she passed away on February 8, 2007. Ceri was only 20 years old when melanoma claimed her life on January 14, 2007.

I always thought skin cancer had to be HUGE, ugly, and hard to ignore. I didn't know it could be small, have no symptoms, and KILL you.

Melanoma incidence is increasing faster than any other cancer. According to statistics found on the American Cancer Society's website (www.cancer.org), the prognosis for someone diagnosed with melanoma is worse, stage for stage, than someone with breast cancer.

Getting more than 3 blistering sunburns during childhood doubles your risk. Sunbed use increases ones risk. Having fair skin and light eyes also puts you at a higher than average risk, but having dark skin does not make you immune. Bob Marley died from Melanoma in 1981.

Everyone at higher risk should get screened by a dermatologist every year. And all of us should be checking our own skin each month.

Melanoma is a virulent and aggressive cancer. It begins in the melanocytes, or the pigment in the skin. It presents itself as a change in an existing mole or skin pigment, or in the formation of a new one. It is easily treated in its most early stages. Once it spreads, though, it is often fatal.

Unfortunately, there is no cure for melanoma. Melanoma is one of the cancers that won't respond to conventional chemotherapy. There have been no significant advances in the medical treatment or survival rate in the last 30 years.

More awareness is needed. Most think "it's only skin cancer" and consider it nothing serious. But I can tell you with absolute certainty, they are DEAD wrong.

Not all melanomas are alike, and the characteristics of a fast-growing melanoma skin cancer begin in skin tumors that are thicker, symmetrical, elevated, have regular borders or have symptoms, according to the conclusions of a survey study completed by Peter MacCallum Cancer Center researchers. They also note that the faster-growing melanoma is more likely to affect men 70 years or older and individuals with fewer moles and freckles.

"In summary, this study provides descriptive data on the spectrum of melanoma rates of growth and insights into subgroups of patients with melanoma that are associated with rapid growth," stated the researchers. "We propose that this information on melanoma rate of growth be incorporated into education programs for patients and health professionals."

The advantage of identifying the more aggressive melanoma will allow for more aggressive treatment. Details of the study will be published in the December issue of Archives of Dermatology. Of the different skin cancers, melanoma is the most serious and most often appears as a change in size, shape, or color of a mole. To learn more about melanoma, visit the National Cancer Institute's melanoma section and The Cancer Blog's melanoma and skin cancer category of posts.

Usually, when we announce a celebrity is raising awareness for cancer, it is the result of a news release that the celebrity has joined a cancer foundation in an effort to lend a higher visibility to the campaign.

In the case of actress Julia Roberts, it appears simply having your photo taken is enough to raise awareness about cancer. At a Hollywood tribute to George Clooney, photographers noticed a mole on her right breast which led to a cancer expert urging Roberts to get it checked out. A dermatologist is suggesting that it looks like a scar resulting from the removal of a mole, according to the movie and entertainment reporting of the incident.

Do you think celebrities ever get fish-bowl claustrophobia from such intense scrutiny and unsolicited advice into their private life? Roberts strikes me as an intelligent woman, and I would wager she is aware of her mysterious mole and has sought medical attention for it.

However unintended as a service to public health information, this latest celebrity gossip about Roberts' right breast does create conversation into what might qualify as a suspicious-looking mole likely to warrant medical attention.

The warning signs of a mole that can cause cancer concern are:



Asymmetry -- One side of the mole does not match the other side of the mole and appears uneven.

Border -- The edge of the mole has a ragged or irregular border.

Color -- The color of the mole is uneven and varies in shade.

Diameter -- A mole bigger than a pencil eraser.

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal cell carcinoma and squamous cell carcinoma are the most common and malignant melanoma can be the most deadly if not caught in its earliest stage. This year in the US, more than one million people will be diagnosed with non-melanoma skin cancer, and 62,190 will be diagnosed with melanoma, according to the American Cancer Society. For more information on skin cancer related posts, visit Melanoma and Skin Cancer.

I am an expert in the game of what-if. I guess it's because my recent what if this hard lump in my breast is cancer worry turned into Oh My God, it is cancer that I am so polished at this exercise in all things irrational. Sure, some worries will be fulfilled by reality but for the most part, things turn out okay. But still, I worry. When a bone hurt in my arm last year, I was sure it was bone cancer. It wasn't. When I felt a soft bump on the roof of my mouth, I whisked myself to the dentist for my mouth cancer diagnosis. It was just a little bit of inflammation, probably from a cold. A headache landed me in a tube for a scan of my head. It revealed nothing interesting, and ibuprofen fixed me right up. And lately, I am checking every mole, freckle, spot, speck, and discoloration that adorns my fair skin.

I asked about each of these what-if marks yesterday at my annual skin cancer screening. Surprise -- nothing is wrong with me. But all unfounded fears aside, there is some method to my madness about skin cancer because I have had several bad burns in my life, have spent too many hours in the sun in search of a tan, and have already had a few pre-cancerous spots removed from my skin. So I do plan to monitor my skin -- just maybe not every day -- for the ABCDs of melanoma. And you should too -- because melanoma is the deadliest of skin cancers, and it is known for spreading, which makes treatment essential. So consider these what-ifs when screening yourself for skin cancer.

What if a spot on my skin is Asymmetrical? This means that one half of the mark on your skin does not match the other half. See your dermatologist.

What if the Border of the spot is irregular? This means that the edges are ragged, notched, or blurred. See your dermatologist.

What if the Color of the spot is not uniform? This means that shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. See your dermatologist.

What if the Diameter is more than 6 millimeters? This is about the size of a pencil eraser. Any growth of any mole should also be of concern. See your dermatologist.

It is estimated that 44,000 Americans will develop melanoma annually. Of these people, 7,300 will die. But the death rate is declining -- because patients are seeking help earlier. Perhaps the ABCDs of melanoma are helping. I hope they help you -- and me too.