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McCain's Skin Cancer Gets Americans to Ask About Their Own Skin

WebMD Health News

Aug. 17, 2000 -- By midafternoon Thursday, Paul Bujanauskas, MD, had seen 45 patients in his Philadelphia dermatology practice. Three patients, he says, have heard about Sen. John McCain's recent bout with malignant melanoma and asked him to check their moles as well.

"Already, I have seen an increased vigilance about skin cancer," says Bujanauskas, a clinical assistant professor of dermatology at Jefferson Medical College of Thomas Jefferson University. Increased public awareness can be good, he says, as long as patients don't worry so much that they are too afraid to go see the doctor at all.

Doctors performed tests on McCain on Thursday to find out more about his most-recent case of skin cancer.

Bujanauskas says the treatment McCain will receive depends on what his doctors find from the test. With melanoma, the most serious of skin cancers, doctors want to know how deeply the cancer has invaded the skin.

If the melanoma stayed on the surface of the skin and did not invade the lower layer of skin called the dermis, then it's removed with just a bit of healthy skin around the margins, he says.

Treating the skin cancer while it still is on the surface is almost always curable, says Debra Jaliman, MD, a New York City dermatologist and clinical instructor at Mt. Sinai School of Medicine.

But if the cancer invades the dermis, then doctors are more worried about it spreading and need to take out the skin cancer, plus a larger margin of what looks like healthy skin -- probably about one to three centimeters, Bujanauskas says.

The worry is that melanoma can spread to the lymph nodes in the area as well as to the chest and brain.

On Wednesday, McCain's office said doctors had found two spots of melanoma, on his left arm and temple. He also had a melanoma removed from his shoulder in 1993.

Finding two new areas of cancer simultaneously could suggest the pair are part of a more serious form of the disease. McCain's office said the two recent spots are not related, however.

Because of his history with the disease, friends say McCain has been checking with his doctors about every three months. That way, if melanoma is discovered, chances are better that it is still on the surface of the skin and hasn't spread.

"That's probably the best way to do it," Bujanauskas says.

But Jaliman notes most of her melanoma discoveries happen when the patient is in for something else and she says she wants to check for moles. Women know to go for a Pap smear or a mammogram, she says, but most of her patients don't come in to see a dermatologist for a mole check regularly.

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