If you teach health and wellness in middle and/or high school, we can provide you with melanoma education that is specifically geared to teens. We encourage you to preview the videos and download any of our resource PDFs, including our lesson plan. When you register you will then have access to our on-line videos that you can use in your classroom anytime you like. To register or for more information and resources, please visit www.melanomaeducation.net With one lesson, you will have equipped your students with enough instruction to prevent this potentially devasting disease while it is curable.

1. MELANOMA EDUCATION
FOR HIGH SCHOOL & MIDDLE SCHOOL
HEALTH EDUCATORS
Revised January, 2019
© 2002 – 2019 Melanoma Education Foundation
All rights reserved

2. OBJECTIVES
Ø UPDATE YOUR KNOWLEDGE OF MELANOMA
Ø ENABLE YOU TO:
u PRESENT SHORT MELANOMA LESSON TO STUDENTS
u ANSWER STUDENT QUESTIONS
THIS VIDEO IS FOR:
* HIGH SCHOOL & MIDDLE SCHOOL HEALTH & PHYSICAL EDUCATION TEACHERS
* NURSING & ALLIED HEALTH INSTRUCTORS
* INSTRUCTORS IN HEALTH-RELATED PROFESSIONS

3. OVERVIEW
Ø YOUNG LIVES LOST TO MELANOMA
Ø COMPARISON OF COMMON SKIN CANCERS
Ø MELANOMA
INCIDENCE STATISTICS RISK FACTORS WARNING SIGNS
Ø ULTRAVIOLET RADIATION
SUN AND TANNING BEDS SUN PROTECTION SUNLESS TANNING
Ø WHY STUDENTS DON’T KNOW ABOUT MELANOMA
Ø MELANOMA LESSON SUMMARY

4. Bethany Cobb
Age 11

5. Jillian Beach
Age 15

6. Leanne Schmall
Age 16

7. Matthew Walsh
Age 20

8. Jen Di Reeno
Age 21

9. Jeff Parker
Age 25

10. Daniel Fine
Age 26

11. Glenna Kohl
Age 26

12. Danielle Keefe
Age 26

13. Jennifer Sweatman
Age 26

14. Jennifer Tietgen
Age 27

15. Karl Kiklis
Age 30

16. Dena Brown
Age 30

17. Susan Tobia LeBlanc
Age 30

18. Amanda Brown
Age 31

19. Mark Maloney
Age 31

20. Keri McCarthy
Age 35

21. SKIN CANCER COMPARISON
TYPE ONSET AGE SERIOUSNESS
BODY
LOCATION
MORE IN
SUNBELT?
BASAL CELL
CARCINOMA
USUALLY 40s
OR OLDER
SELDOM FATAL
HEAVILY SUN-
EXPOSED
AREAS
YES
SQUAMOUS
CELL
CARCINOMA
USUALLY 40s
OR OLDER
SOMETIMES
FATAL
HEAVILY SUN-
EXPOSED
AREAS
YES
MELANOMA 12 OR OLDER
FATAL IF NOT
FOUND EARLY
EXPOSED OR
UNEXPOSED
NO

22. BASAL CELL CARCINOMA
Ø RAISED WAXY NODULE
Ø OFTEN CRATERED
Ø SLOW GROWING, SELDOM FATAL
Ø DELAYED TREATMENT MAY NECESSITATE
LOCALLY DISFIGURING SURGERY

23. SQUAMOUS CELL CARCINOMA
Ø SLIGHTLY RAISED RED PATCH THAT
IS ROUGH, DRY, SCALY AND BLEEDS
OR SCABS
Ø DEVELOPS FROM ACTINIC KERATOSIS
Ø MAY SPREAD INTERNALLY & BECOME
FATAL IF UNTREATED
Ø GROWS RAPIDLY WHEN ON LIPS

24. U.S. MELANOMA STATISTICS
Ø NEW MELANOMA DEATH EVERY HOUR
Ø 25% OF NEW PATIENTS UNDER AGE 40
Ø MOST PREVALENT CANCER IN 25 – 29 AGE GROUP
Ø 2nd TO BREAST CANCER IN WOMEN UNDER 39
Ø INCREASING AT EPIDEMIC RATE
HIV MELANOMA
56,000
192,310
2019 PROJECTIONS

25. MORE BAD NEWS ABOUT MELANOMA
Ø VULNERABILITY INCREASES THROUGHOUT LIFE
Ø STRIKES REGARDLESS OF HEALTH, PHYSICAL CONDITION,
OR COMPLEXION
Ø NO FAMILY HISTORY IN 90% OF NEW CASES
Ø USUALLY NO SYMPTOMS EXCEPT VISUAL UNTIL TOO LATE
Ø INCURABLE WHEN IT SPREADS TO INTERNAL ORGANS

26. ARE THERE ANY REDEEMING FEATURES?
Ø EASIEST CANCER TO SELF-DETECT EARLY
Ø NEARLY GUARANTEED CURABLE WHEN FOUND EARLY
Ø REMOVAL IS PAINLESS, QUICK, DONE IN DOCTOR’S OFFICE
USING LOCAL ANESTHETIC
Ø NO CHEMOTHERAPY OR RADIATION NEEDED
WHEN REMOVED AT EARLY STAGE

27. MELANOMA RISK FACTORS
Ø INHERITED
u 50 OR MORE MOLES
u LARGE OR IRREGULAR SHAPE MOLES
u RED OR BLOND HAIR, FRECKLES, LIGHT COLOR EYES, FAIR SKIN
u FAMILY OR PERSONAL HISTORY OF ANY SKIN CANCER
Ø CONTROLLABLE
u BLISTERING SUNBURN(S) UNDER AGE 20
u EXPOSING NORMALLY COVERED SKIN TO STRONG SUN
u REGULAR TANNING BED USE
Ø AVERAGE LIFETIME RISKS
o WHITES: 1 in 44 o ASIANS: 1 in 800
o HISPANICS & LATINOS: 1 in 250 o BLACKS: 1 in 1100
o NATIVE AMERICANS: 1 in 300

28. BLACK MELANOMA VICTIMS
Bob Marley
Died 1981, Age 36
Dr. Yvedt Matory
Died 2005, Age 48

29. NORMAL AND ATYPICAL MOLES
ATYPICAL MOLES HAVE ONE OR MORE: irregular
shape, fuzzy borders, nonuniform shades,
fried egg surface, > 1/4 wide
NORMAL MOLES: sharp borders,
uniform color, < 1/4 wide

30. MORE ABOUT MOLES
Ø RISK OF MELANOMA IN NORMAL MOLE < 1/3000
Ø RISK OF MELANOMA IN ATYPICAL MOLE ~ 1/100
Ø MELANOMA MORE LIKELY TO DEVELOP IN FLAT OR
SLIGHTLY RAISED MOLE THAN IN FULLY RAISED MOLE
Ø MELANOMA CAN DEVELOP IN A MOLE YOU’VE HAD
FOR A LONG TIME
Ø MOLES WITH HAIR DO NOT POSE HIGHER RISK

31. WARNING SIGNS OF MELANOMA
Ø CHANGE IN A MOLE OR OTHER SKIN LESION
SIZE, COLOR, SHAPE, SURFACE, OR THICKNESS
Ø A NEW MOLE OR GROWTH THAT APPEARS SUDDENLY
Ø DON’T WAIT FOR ITCHING, BLEEDING, ULCERATION

32. TYPES OF MELANOMA
Ø RADIAL
u GROW IN DIAMETER AT FIRST
u OFTEN LOOK UNUSUAL - EASY TO DETECT
u ~ 80% OF ADULT MELANOMAS
Ø NODULAR
u GROW PRIMARILY DOWNWARD
u MORE DIFFICULT TO RECOGNIZE, MAY LOOK INNOCENT
u ~ 50% OF CHILD, TEEN, AND ADOLESCENT MELANOMAS
u DISPROPORTIONATELY HIGH FATALTIES IN ALL AGE GROUPS

33. PHOTOS OF RADIAL MELANOMAS
Ø TWO DIMENSIONAL GROWTH AT FIRST
Ø EXHIBIT TWO OR MORE “ABCD” PROPERTIES
A - ASYMMETRY: ONE HALF UNLIKE OTHER HALF
B - BORDER: UNEVEN, NOTCHED
C – COLOR: MULTIPLE COLORS AND/OR SHADES
D – DIAMETER: GREATER THAN ¼”

34. VERTICAL GROWTH PHASE
Ø ALL MELANOMAS EVENTUALLY GROW VERTICALLY
(MOSTLY DOWNWARD)
Ø DOWNWARD GROWTH ACCOMPANIED BY SURFACE BUMPS
OR ELEVATION
Ø VERTICAL GROWTH IS MOST DANGEROUS PHASE
Ø TIME BEFORE VERTICAL GROWTH BEGINS DEPENDS
ON TYPE OF MELANOMA

35. GROWTH OF RADIAL MELANOMA

36. GROWTH OF RADIAL MELANOMA

37. GROWTH OF RADIAL MELANOMA
- 2 mm

38. GROWTH OF RADIAL MELANOMA

39. NODULAR MELANOMAS
Ø MOST DANGEROUS TYPE
Ø NO RADIAL GROWTH OR ABCD SIGNS
Ø OFTEN START IN CLEAR SKIN
Ø APPEARANCE & COLOR MAY LOOK INNOCENT
Ø WINDOW OF OPPORTUNITY MAY ONLY BE 3 MONTHS
Ø EXHIBIT ALL 3 “EFG” SIGNS:
E ELEVATED
F FIRM TO TOUCH
G GROWING MORE THAN 2 WEEKS

40. NODULAR MELANOMA DEVELOPMENT

41. COMMON MELANOMA LOCATIONS
IN WHITE POPULATION
IN HISPANIC, ASIAN, AND BLACK POPULATIONS
FEET: SOLES, TOES, UNDER NAILS
HANDS: PALMS, FINGERS, UNDER NAILS

42. HOW TO CHECK YOUR SKIN
Ø Use wall mirror, hand mirror w/long
handle, hairbrush or dryer, flashlight.
Ø Be thorough: check head to toes, front,
back, sides, scalp.
Ø Have family member check back and scalp
if necessary.
CHECK ONCE EVERY MONTH

43. WHICH ONES WERE MELANOMA?
1 2 3
4 5 6
é
é é

44. SOLAR RADIATION SPECTRUM

45. UV RADIATION AND MELANOMA
UVB UVA

46. A TAN TO DIE FOR
Ø UVA INTENSITY OF TANNING BEDS
IS 10 – 13 TIMES STRONGER THAN
FROM SUN
Ø TANNING BED UVB INTENSITY
SAME AS SUN UVB
Ø EVERY TANNING BED SESSION
UNDER AGE 35 INCREASES
MELANOMA RISK BY 22%
Ø TANNING BED USE 10 OR MORE
TIMES PER YEAR UNDER AGE 30
INCREASES MELANOMA RISK 8X

47. SUNLESS TANNERS
Ø THE ONLY SAFE WAY TO TAN
Ø DYES DEAD SKIN ONLY
Ø OPTIONS
u OVER THE COUNTER PRODUCTS
u SPRAY BOOTHS
u CUSTOM AIRBRUSH
Ø TO AVOID ORANGE COLOR DON’T USE
DARK TANNER ON LIGHT SKIN
Ø WWW.SUNLESS.COM HAS DETAILED INFO.
Before sunless tanning
After sunless tanning

48. SUN PROTECTION OPTIONS
Ø SUNSCREEN W/BROAD SPECTRUM PROTECTION, SPF ≥ 30
u ZINC OXIDE PROTECTS AGAINST UVA & UVB
u USE SUNBLOCK STICK ON LIPS, NOSE, TOPS OF EARS
Ø PROTECTIVE CLOTHING
u HAT W/WIDE BRIM
u SUNGLASSES W/”100% UV PROTECTION”
u SUN-PROTECTIVE SWIMWEAR
Ø MINIMIZE EXPOSURE 10 AM – 4 PM
u STAY IN SHADE WHEN POSSIBLE
Ø PROTECT AGAINST REFLECTED UV
u FROM SAND, WATER, HAZE, SNOW, LIGHT BUILDINGS
( CLOUDS & COLD TEMPERATURES DON’T PROTECT AGAINST UV )

49. SUNSCREEN APPLICATION: GETTING IT RIGHT
Ø SPF RATING MEANINGLESS UNLESS APPIED HEAVILY
Ø NEARLY ALL USERS UNDER-APPLY, USING 25-50% OF REQ’D AMOUNT
Ø TRUE RATING OF SPF 100 SUNSCREEN APPLIED AT 25% IS SPF 3
Ø SUPPOSE YOU’RE IN A SWIMSUIT AT A BEACH OR POOL:
u HOLD OUT YOUR HAND AND CUP IT AS DEEPLY AS YOU CAN
u PRETEND YOU’RE FILLING IT WITH SUNSCREEN
Ø AVERAGE ADULT IN SWIMSUIT SHOULD APPLY ENTIRE 6 OZ
CONTAINER OF SUNSCREEN IN FULL DAY AT BEACH/POOL
APPLY FULLY CUPPED HANDFUL
• EVERY TWO HOURS
• AFTER TOWEL DRYING
• AFTER SWIMMING
• WHEN PERSPIRING HEAVILY

50. VITAMIN D
Dehydrocholesterol (in skin of all mammals)
Vitamin D3
UVB from sun exposure
Hydroxyvitamin D3
Liver Enzyme
Dihydroxyvitamin D3 (Biologically Active)
Kidney Enzyme
Supplements

51. STUDENT PERCEPTIONS & BEHAVIOR
Ø MOST BELIEVE
u SKIN CANCER NOT A BIG DEAL
u HAPPENS TO OLDER PEOPLE
u TANNING BEDS ARE SAFE
Ø DATA FROM NURSES CHILDREN STUDY (1999, ALL 50 STATES)
u 2/3 OF 12 – 18 YEAR OLDS NEVER USE SUNSCREEN
u 80% HAD AT LEAST ONE BAD SUNBURN IN SUMMER
Ø 2012 SLOAN-KETTERING STUDY: 50% DECREASE IN SUNSCREEN
USE FROM ELEMENTARY SCHOOL TO MIDDLE SCHOOL
Ø 2013 PUBLICATION FROM CDC: 44% OF AGE 18 WHITE FEMALES
USED INDOOR UV TANNING IN PAST YEAR

52. PUBLIC HEALTH EDUCATION “SYSTEM”
HEALTH
KNOWLEDGE
PARENTS
NON-PROFIT
HEALTH
ORGANIZATIONS
SCHOOLS &
COLLEGES
PRIMARY CARE
PHYSICIANS
MEDIA GOVERNMENT
AGENCIES

53. WHY ARE YOUNG PEOPLE UNINFORMED ABOUT MELANOMA?
Ø LACK OF PARENTAL KNOWLEDGE
Ø NOT TAUGHT EFFECTIVELY IN MOST SCHOOLS
Ø PRIMARY CARE PHYSICIANS
u LITTLE OR NO DERMATOLOGY TRAINING
u MOST DON’T CONDUCT COMPLETE SKIN EXAMS
OR EDUCATE PATIENTS
Ø LIMITED MEDIA ATTENTION
Ø NO ACTIVE OUTREACH BY GOV’T AGENCIES
AND LARGE NON-PROFITS

54. PRIMARY FOCUS OPTIONS FOR EDUCATING TEENS
ABOUT SKIN CANCER
Ø SUN PROTECTION (NOT!)
u NUMEROUS STUDIES AND SURVEYS PROVE INNEFECTIVENESS
u DOESN’T ADDRESS THE 30% OF MELANOMAS NOT CAUSED BY UV
Ø MELANOMA AWARENESS
u TEACHES STUDENTS WHAT MELANOMA IS ALL ABOUT
u THEY UNDERSTAND HOW DEADLY IT IS AND CAN HAPPEN TO THEM
u STUDENTS LIKELY TO TAKE UV PROTECTION MORE SERIOUSLY

55. STUDENT VIDEOS: THE HEART OF THE LESSON
Ø MIDDLE SCHOOL (23 MINUTES, 2008)
u “SHOULD’VE, COULD’VE, WOULD’VE”
• EXPERIENCES OF 3 YOUNG MELANOMA SURVIVORS
Ø HIGH SCHOOL (16 MINUTES, 2008)
u “MY MELANOMA VLOG”
• HIGH SCHOOL STUDENT ATTENDS HEALTH FAIR, GETS SCARED
ABOUT MELANOMA, SEARCHES FOR MORE INFORMATION
ONLINE AND SHARES WHAT SHE LEARNED
Ø MIDDLE SCHOOL AND HIGH VIDEOS COMPETELY DIFFERENT
Ø AAD GOLD TRIANGLE AWARD WINNERS (2009)
Ø 3 – MINUTE PREVIEWS AT MELANOMAEDUCATION.NET

56. CLASSROOM LESSON PLAN OUTLINE
Ø START BY ASKING HOW MANY:
u HAVE HAD BAD SUNBURN?
u USE TANNING BEDS?
u HAVE SKIN CANCER FAMILY HISTORY?
Ø SHOW STUDENT VIDEO
Ø FOLLOW-UP DISCUSSION: DID VIDEO AFFECT ATTITUDES?
Ø SHOW “SEE SPOT” DOCUMENT AND GO OVER W/STUDENTS
u PROVIDE DOWNLOAD INFORMATION
(melanomaeducation.net/seespot.pdf)
Ø HOMEWORK
u TEACH FAMILY ABOUT MELANOMA USING “SEE SPOT” DOC.
u STUDENT RETURNS PARENTAL-SIGNED CONFIRMATION PAGE

57. ONLINE “SEE SPOT” DOCUMENT FOR STUDENTS
SEE SPOT...
SEE SPOT CHANGE...
SEE DOCTOR...
A HEALTH ALERT
FOR TEENS
www.skincheck.org
If you think skin cancer is no big deal and only happens to
older people, think again. Melanoma, the deadliest skin can-
cer, can strike anyone - including you right now. And when
you reach your mid-20s you’re more likely to get melanoma
than any other cancer. The U.S. incidence is more than
double that of new HIV infections and is increasing rapidly.
An American dies of melanoma every hour but almost every
death could have been prevented by early self-detection.
Melanoma can start in moles or in clear skin, even unex-
posed skin. Moles may be flat or raised. Normal moles (left 2
photos) are round or oval with sharp, even borders, uniform
colors, and are less than 1/4” wide. Atypical moles (right 2
photos) have one or more of these features: fuzzy borders,
mixed shades, more than 1/4” wide, raised “fried egg” center.
Any of these factors increase your risk of melanoma:
Use of tanning beds, even once.
Any blistering sunburns under age 20.
Having any atypical moles, even one.
Having 50 or more normal moles.
Light eyes, freckles, red or blond hair.
Family history of any skin cancer.
If found early, melanoma is curable by painless removal
in a doctors office. No chemo or radiation is required. A
10-minute monthly self-exam is all it takes to find it early.
Use a wall mirror in a well-lighted room, a hand mirror with
long handle, flashlight, and a brush or dryer for parting hair.
Melanoma occurs more often on the back and legs than on
the face.
Reprinted with permission of American Academy of Dermatology. All rights reserved.
Check all areas of face, ears, neck, underarms, chest,
hands, and under nails. Females should also check
under breasts. Check scalp or have somone help. Check
upper and lower back carefully, then buttocks and genitals
including hidden areas. Sit on a small chair or stool and
check all sides of legs and feet including between toes and
under toenails.
There are two types of melanoma, radial and nodular.
Radial melanomas start by growing in diameter, may look
ugly, and usually have two or more “ABCD” properties as
in the photos below.
Asymmetry: One half unlike other half
Border: Irregular, notched
Color: Varies between areas
Diameter: More than 1/4 inch
All melanomas eventually start growing vertically but nod-
ular melanomas begin vertical growth immediately, often
look innocent, and may show no ABCD signs. Instead they
always have 3 “EFG” properties, as in the photos below.
Elevated: Not flat
Firm: Not flabby
Growing: More than two weeks
No matter what the appearance, be suspicious of
anything new or changing more than two weeks on
your skin and act immediately.
To decrease your melanoma risk avoid tanning beds;
using them 10 times or more in a year multiplies your risk
by 8. Models and TV stars use sunless bronzers, the only
safe way to tan. Visit sunless.com to find some that will
give you a natural looking tan.
Disclaimer: This informatiion is for educational purposes
only and should not be used to diagnose skin problems. If
you have a skin problem consult a dermatologist, plastic
surgeon, or other professional health care provider.
In Loving Memory
Daniel Noah Fine
1972 - 1998
© Melanoma Education Foundation,
a non-profit organization founded
by the family of Daniel Fine, who
lost his life to melanoma at age 26.
Mailing address: MEF, P.O. Box 2023,
Peabody, MA 01960. Visit www.
skincheck.org for more information
and photos.
Download Link
https://bit.ly/2BxTUAW

58. HOW TO ACCESS LESSON RESOURCES
Ø LOG IN OR REGISTER AT MELANOMAEDUCATION.NET
Ø FOLLOW INSTRUCTIONS TO ACCESS STUDENT VIDEOS
Ø DOWNLOADABLE TEACHER-RESOURCES AVAILABLE
WITHOUT REGISTERING OR LOGGING IN:
u Slides from this presentation
u Latest lesson plan
u How to do a self-skin exam
u What to do if a suspicious lesion is found
u Dangers of tanning beds

59. www.melanomaeducation.net
Produced and narrated by Steve Fine