Melanoma is an increasingly common form of life-threatening cancer, usually found on the skin, and known for its early and rapid tendency to spread to other organs. Melanoma is frequently found on the back – a location often whipped during SM play. The back is also a location not easy for a person to examine themselves. Studies have shown that manipulation of a melanoma (and a whip stroke, spank, or other type of blow would, obviously, be a form of “manipulation”) definitely increases the number of cancer cells that break off and begin to spread to other parts of the body. It is therefore essential that SM practitioners know how to spot possible melanomas, both on themselves and on their partners, to avoid whipping or otherwise disturbing melanomas, and to receive early, definitive medical diagnosis and treatment.
Melanoma is a form of cancer that arises from a type of cell called melanocytes. Most of these cells are, obviously, in the skin, but melanocytes are also in the mucous membranes, under the nails, in the mouth, and in the eye (including the retina). Melanomas can develop from the sites of existing skin lesions or can develop on their own in areas of previously clear skin.
Melanoma is the eighth most common form of cancer in the United States and currently accounts for about 2% of all cancer deaths, with 6,900 deaths predicted for 1994. The U.S. death rate from melanoma has been growing steadily at a rate of about 4% per year for the last thirty years and is now more than double what it was in 1960. The frequency of melanoma is expected to continue increasing.
The skin is by far the most common melanoma site. About 600,000 new cases of skin cancer are diagnosed in the U.S. each year. Roughly 95% of these are “relatively” benign basal cell or squamous cell carcinomas and about 5% (32,000 cases) are melanomas. (Non-melanoma skin cancers are predicted to cause 2,300 deaths in 1994.)
The average overall lifetime risk of developing melanoma is about one in a hundred. Melanoma is most commonly found in fair-skinned Caucasian people, especially if they have blue eyes and naturally blonde or red hair. It is more common in people who have a family history of melanoma, and more common in people who have more than fifty ordinary moles. Melanoma is most frequently found in people aged twenty to sixty. A strong correlation exists between episodes of severe sunburn during childhood and increased risk of developing melanoma later in life.
Exposure to sunlight
Exposure to large amounts of sunlight, both in childhood and as an adult, increases the probability of certain subtypes of melanomas appearing, but not of others. (There are four basic subtypes.) Melanomas are more frequent near the equator, and the population of Arizona has the highest frequency of melanoma in the United States. Cancer prevention authorities recommend the use of sun block with a SPF of 15 or greater.
Melanoma and non-Caucasians
Melanoma is distinctly rare in non-Caucasians, and all but unheard of in Asians. Non-Caucasians face about one-twelfth the average overall lifetime risk of melanoma that Caucasians face. (Still, 200+ non-Caucasians die of melanoma every year – the majority of them either Black or Hispanic.) When a melanoma is found on a non-Caucasian, it is usually found on the palms or soles, under the nails, on a mucous membrane (including inside the mouth), or within the eye. Melanoma and people with HIV Melanoma is distinctly more frequent and more aggressive in people who have HIV or are otherwise immunosuppressed. These people must be watched especially carefully.
Location on the body
Melanomas can appear anywhere on the body's surface, including the ano-genital region, the hair on the head, the inside of the mouth – including the palate, and the interior of the eye. The back and lower legs are the most common sites in women. The back, chest, abdomen, and arms are the most common sites in men. (The issue of whether or not melanomas can be encapsulated with breast cysts – and possibly released during heavy breast play – was not itself specifically explored during the research done for this article; no mention of such a phenomenon was noted in the references consulted.)
Appearance of Melanoma
Melanomas are described according to the classic ABCD criteria:
Some authorities add a fifth (E) criteria:
Experts recommend that each person conduct a monthly self-examination of their skin, including their scalp. Mirrors can help a great deal, as can a helpful partner. Learn the location, size, color, and other characteristics of whatever marks your skin already has. This will allow you to quickly detect any changes in existing marks or the appearance of new ones. “Knowing your skin,” particularly the skin on your back, is your first, best line of defense against this very serious disease.
This monthly self-exam should be supplemented with an unhurried annual examination of your skin by an experienced physician. (One physician I consulted stressed this point, and also cautioned that not all examinations done by physicians are unhurried.)
Several different sources cautioned that moles which bleed relatively easily should be regarded with the traditional “high index of suspicion.”
Treatment is usually by excisional biopsy, which involves removing the entire lesion plus a few centimeters of surrounding healthy skin. A pathologist then evaluates the tissue. If the suspected melanoma is unusually large, an incisional biopsy is done. However this is avoided if possible because of concerns that cutting into the melanoma might cause it to shed cells. In the case of melanomas that are exceptionally large, or on a location that has cosmetic importance, such as the face, the patient may be referred to a plastic surgeon.
Complications and Prognosis
Melanoma can metastasize by either the bloodstream or the lymphatic system. If found while still localized, the overall five-year-survival rate is in excess of 90%. If the disease has spread to the local lymph nodes but no farther, the five-year-survival rate is approximately 50%. If the disease has spread beyond the lymph nodes, typically to sites such as the liver, lungs, bones, or brain, the five-year-survival rate is less than 15%. Melanomas on the torso have a grimmer prognosis than do melanomas on the limbs because less “filtering” by the lymphatic system occurs in that region.
Cancer cells do not bond to each other as strongly as healthy cells usually bond to each other. Therefore, many cancer sites “leak” cells, which then travel elsewhere in the body, to a greater degree than healthy tissues leak cells. This is known as increased friability.
Studies have definitely proven that manipulating a melanoma increases the number of cancer cells that break off and “float downstream” (or is it “upstream”?). While the body's immune system consumes most such cells, preventing them from forming new cancer sites, it certainly cannot be assumed all such cells will be so consumed.
Medical professionals are cautioned not to manipulate a suspected melanoma site any more than absolutely necessary. The treatment is excisional biopsy if at all possible. Incisional biopsies, and other cuttings of the site, are avoided unless clearly necessary. Electrolysists are trained not to stick their needles (which can give off heat, or electricity, or both) into moles. There could also be Sports Medicine aspects, particularly regarding contact sports such as football or the martial arts.
SM-related precautions include not whipping or otherwise striking a possible melanoma, not piercing or cutting through it, and noticing if a mole starts to bleed after being whipped. Those about to receive a whipping, piercing, or cutting should caution their partners about “suspicious” moles on their skin. In addition, subjecting the site to intense heat (from dripping candle wax, for example) or to jolts of electricity (from a cattle prod or violet wand) could also be much more risky than previously thought.
While many sadomasochists like “on the edge” play, I doubt that many would want their submissive partners, no matter how self-sacrificing, to risk getting a fatal case of cancer. Like many other cancers, melanoma is almost completely curable if detected and treated early. Informed, monthly self-examination of the skin is the most important step.
Check your partner's skin. If you spot a funny-looking mole, don't whip it!
Article by MissBonnie © collarncuffs.com (Disclaimer fact where correct at time of publication)
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