At age 81, Gerald Ray has a mission: to let as many people as possible know about the dangers of skin cancer.
Having survived three bouts of melanoma - the deadliest of skin cancers that kills one American almost every hour - he feels lucky to be living. To him, it's a clear message that he needs to spend his days handing out brochures from the National Cancer Institute that outline the signs of skin cancer and ways to protect your skin.
"Death is real," said Ray, who retired as an educator in the Reardan School District (before it combined with Edwall) at age 55 when he got his first melanoma on his chest. He said the tumor was so deep the surgeon dug through his chest muscles to the sheath of his heart.
"He told me I better retire and go fishing because I only had about two years," Ray said.
Some 25 years later, Ray puts on his custom-made white T-shirt with large, black block letters that reads "PROTECT THE SKIN YOU'RE IN" on the front and has the black melanoma awareness ribbon on the back and heads out to preach about skin cancer screenings, sun screen and hats. Of course he wears a large brimmed hat during his trips to wherever he has errands - the grocery, pharmacy and sometimes even large churches with lots of people to talk with. He would like to speak with civic and senior groups and anywhere people will listen.
Ray is thin and his body twisted - he has a knee that isn't operable and causes mobility issues and pain. But that doesn't stop him, even if he has to use a cane or two or even his walker. He exercises daily, including lifting the small treat bags for his dog several times a day, and drinks smoothies he makes from peppers, broccoli, fruit and other healthy ingredients. He has to maintain himself because he has a job to do. He's persistent. (He's also a prolific writer of letters to the editor of various publications and likes to call in to local talk radio shows to opine about everything from teacher unions to his desire for the state to pass an English-only law).
Ray said most people are friendly and willing to listen and take a brochure, including one that has photos of different shapes, colors and sizes of melanomas and questionable moles.
He shrugs off those who don't want a pamphlet and quick skin cancer primer. He hopes that the encounter will at least spark some recognition and action. He especially makes a point to talk to parents of small children. He beams with pride as he tells of a mother who stopped him with thanks a few years back. Ray's spiel in the aisle of a pharmacy encouraged her to take her two young daughters to the dermatologist where pre-cancerous spots were found on both children. These successes keep Ray motivated.
"It's amazing how many have had skin cancer in the family," Ray said. "But they've forgot about it."
Back in 1990, when Ray first found the spot on his chest that looked strange and discolored, his doctor discounted it. Ray had a feeling and argued with him to biopsy. Soon he was in surgery.
Ray was adamant, because when he was superintendent of the Edwall School District, he had watched his secretary die of melanoma at age 45 because nobody believed skin cancer could occur in the pelvic region when there is usually no sun exposure.
"Sun is not the only cause of skin cancer," said Chadd Sukut, a board certified dermatologist and surgeon at Advanced Dermatology Skin and Surgery Center in Spokane. Family history, personal history of skin cancer, skin that burns easily and various medical conditions and medications can be other skin cancer factors.
"If you are ever concerned about a skin lesion being skin cancer we always recommend seeing a dermatologist for a skin check," he said.
Here are a few things Sukut suggest people look for and have checked by a dermatologist:
Anything on the skin that changes size, shape or color.
Anything that bleeds.
A pimple or cyst that doesn't seem to go away within up to six weeks.
After all, anybody can get skin cancer no matter their skin tone - although it is more common with fair complexions and especially people with freckles. Legendary Jamaican musician Bob Marley died of melanoma at age 36 after a dark spot appeared under his toenail. Marley attributed it to a recent soccer injury but it turned out to be an aggressive cancer, according to the Skin Cancer Foundation.
Sukut recently spent three days helping do free skin cancer screenings with the Inland Northwest Health Services, which offers the screenings every May to mark national Melanoma/Skin Cancer Detection and Prevention Month. Other providers included Valley Dermatology and Skin Cancer Center and Dermatology Specialists of Spokane. Together they checked more than 200 people during three-day screening, said Katy Larsen, a health educator with INHS Community Wellness.
Advanced Dermatology, which has a Coeur d'Alene, Idaho, office, does occasional free screenings in North Idaho, in partnership with Kootenai Health.
The screenings often identify skin cancers such as basal cell skin cancer (most common on the face), squamous cell skin cancer and melanoma.
Advanced Dermatology along with Inland Northwest Community Foundation created a nonprofit organization to educate children on how to protect their skin because the earlier the prevention, the better.
Sunburns received in childhood can cause skin cancer to form several decades later, Sukut said.
"The earlier you educate young kids about skin protection, the better," he added.
Besides wearing hats, long sleeve shirts, pants and sunglasses, the most important thing people can do to protect themselves is wear a broad spectrum (that protects from both UVB and UVA rays) sunscreen with a SPF 30.
There are debates over the effectiveness of sunscreen, the chemicals in the products and whether aerosols are dangerous.
Recent research by scientists at Ohio State University discovered that using sunscreen with SPF 30 may prevent melanoma by 80 percent, according to an article by Tribune News Service. It's long been known that sunscreens are an effective guard against sunburns but their ability to protect against melanoma has previously been unknown.
The rates of melanoma have doubled in the past 30 years, the article said.
Sukut said his opinion is to use sunscreen and most importantly reapply it every hour or two. Putting it on in the morning isn't adequate.
"The benefits far outweigh any negatives of using sunscreen," Sukut said, adding that, in general, most chemicals in sunscreen don't absorb through the skin. He likes the aerosol sunscreens, especially for children, but warns people to use it in well ventilated areas.
He also reminds people that sunscreen and skin protection isn't just for the warm, summer days that follow the Memorial Day holiday. Anytime skin is exposed to the sun - even in winter or on cloudy days - it needs protection with clothes or sunscreen or both.
Ray tells people the same thing and doesn't stop his proselytizing in the winter months.
"If I was getting just shut out and not making any progress I wouldn't keep doing it," Ray said. "I'm somebody who believes we have a purpose in life. In my case, I think I was born to help people."
For more information about skin cancer, go to the National Cancer Institute website at www.cancer.gov/types/skin.
The National Cancer Institute has a LiveHelp online chat service at livehelp.cancer.gov, for questions about skin cancer - and any cancers - clinical trials or even help with quitting smoking. You can also call (800) 422-6237.
"Stop the Burn:" To learn more about this local nonprofit organization founded by Advanced Dermatology and Inland Northwest Community Foundation to teach children the importance of protecting their skin from the sun, call (509) 456-7414.
Seek the shade, especially between 10 a.m. and 4 p.m.
Do not burn.
Avoid tanning and UV tanning beds.
Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
Use a broad spectrum (UVA/UVB) sunscreen SPF 30 or higher.
Apply 1 ounce or about two tablespoons of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or immediately after swimming or excessive sweating.
Keep newborns out of the sun.
Examine your skin head-to-toe every month.
See your physician every year for a professional skin exam.
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