Sheldon Riggs said his right forearm started itching one day and continued to do so the next morning when he woke up.
He scratched and felt a sharp nerve pain shoot up his arm. Sensing something was not right, he called his doctor who told him to come for a check-up.
Riggs’ days out in the sun working on his family’s crop farm in Chandler and two summers as a lifeguard for Big Surf in Tempe caught up with the 35-year-old.
He became is one of the 1,880 new melanoma cases estimated for Arizona this year, according to the American Cancer Society. Of the top 10 cancers in the state, melanoma ranks No. 6.
“I was always outdoors but I wore long-sleeve shirts and do what I can,” Riggs said. “I was lucky.”
He is now cancer-free, said Dr. Mark Gimbel of Banner MD Anderson Cancer Center in Gilbert, who excised the melanoma from Riggs’ forearm and removed a lymph node from his armpit for a biopsy to ensure the cancer hadn’t spread.
Arizona has the highest melanoma death rate in the country, according to doctors at Banner – which opened The T.W. Lewis Melanoma Center of Excellence in November for diagnosis, treatment and research.
By the end of its first full year of operation, the center will have treated 450 melanoma patients, spokesman Corey Schubert said.
Patient case load is projected to grow 5 percent to 10 percent a year, Gimbel added.
“What we have here at the Center of Excellence is a multi-disciplinary setting,” Gimbel said. “What we offer is unique.”
Surgical oncology, radiation and pathology are just some of the medical specialties working together in a holistic approach to treating a patient, he said.
The center also offers a prevention, outreach and education program, survivorship care and support and clinical research.
Gimbel said the center’s program includes going into the grade and high schools, educating children about sun safety and the importance of screening.
“The core objective of the center is outreach and education,” he said, crediting more than 20,000 lives saved from the center’s outreach efforts.
Since the center’s opening, six new melanoma clinical trials have begun with four currently open, according to Schubert.
“Clinical trials give patients access to the most promising treatments not yet available to the public, and help advance medical discoveries to benefit future patients,” he said.
Ten days after the operation, Riggs last week was having the staples removed from a 3.5-inch incision. Had the melanoma gone deeper into the skin, more skin would have needed to be removed and the larger the incision, Gimbel said.
Of the three major forms of skin cancer – basal cell carcinoma, squamous cell carcinoma and melanoma – the latter causes the most deaths, claiming an estimated 9,320 lives in the United States annually, according to the Skin Cancer Foundation.
Nationwide an estimated 178,560 cases of melanoma will be diagnosed this year. Melanoma accounts for about 1 percent of skin cancers.
If melanoma is recognized and treated early, it is almost always curable, but if it is not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal.
The nonprofit foundation says one person dies of melanoma every hour and from 2008-2018, the number of new melanoma cases diagnosed annually has increased by 53 percent.
Because Arizona is close to the sun and close to the equator, high altitude and low latitude means less atmospheric protection from the sun’s damaging rays, according to the University of Arizona Cancer Center. The year-round warm climate also means more time outdoors with less clothing – putting Arizona residents at a high risk of skin cancer.
Melanoma is typically an affliction of older adults after lifelong sun exposure but Gimbel is seeing younger patients with it from being out in the sun or using tanning beds.
“I’m seeing teens and people in their 20s,” he said.
Ninety to 95 percent of melanoma cases are due to ultraviolet rays from the sun, which destroys skin cells, the doctor added.
Although Riggs was outdoors a lot, he had other risk factors going for him.
He, like his other siblings, has a fair complexion, blond hair and blue eyes, said mom Ahtanya Riggs, who added her husband had a melanoma removed from his back.
The Skin Cancer Foundation said one in every 10 patients diagnosed with the cancer has a family member with a history of melanoma.
And the risk of melanoma is much higher for whites than for blacks, with whites with red or blond hair, blue or green eyes, or fair skin that freckles or burns easily at increased risk, according to the American Cancer Society.
Riggs also mentioned he got sunburnt and developed blisters when he was 8 years old, which increased his risk for developing melanoma, Gimbel said.
Another tell-tale sign of a melanoma that Riggs ignored for a year was a mole on his arm that changed in shape and color. He also had a melanoma removed from his back years about a decade earlier.
Every time Riggs becomes exposed to the sun’s rays means his risk for developing a melanoma continues to increase, Gimbel said.
To minimize the risk, he should, for instance, stay out of the sun’s reaches between 10 a.m. and 4 p.m. when the UV rays are the strongest, Gimbel said.
“Don’t be afraid of the sun but be sensible,” he said.
Reducing ultraviolet exposure
■ Wear protective clothing such as long-sleeved shirts, long pants or skirts, dark colors and tightly-woven fabrics.
■ Wear a hat with a two to three-inch brim all the way around to shield areas of the head and neck that are often exposed to intense sun.
■ Use sunscreen and lip balm with a sun protection factor (SPF) of 30 or greater every day, regardless of whether the sun is shining; reapply frequently to maximize efficacy. Because children often spend more time outdoors, extra precautions should be taken.
■ Wear sunglasses that wrap around the sides of the face and have at least 99 percent UV absorption to protect the eyes and surrounding skin.
■ Seek shade to help limit exposure to UV light, particularly between 10 a.m. and 4 p.m., when UV rays are strongest.
■ Avoid tanning beds and sunlamps
Source: Banner MD Anderson Cancer Center
Signs of melanoma
Melanoma most commonly appears on the trunk area of the body in fair-skinned men and on the lower legs of fair-skinned women. In dark-skinned individuals, it is most prevalent on the palms, the soles of the feet and beneath the nails.
Melanoma usually develops as an irregular brown, black and/or red spot or and existing mole that begins to change color, size or shape. While signs and symptoms vary from person to person, the following ABCDEs provide an easy way to recognize the signs of melanoma:
Asymmetry: One side of a mole is different from the other.
Border irregularity: The edges of a mole are ragged or irregular.
Color variation: The mole gets darker, changes color or contains several colors.
Diameter: It is bigger than the diameter of a pencil eraser.
Evolution: It grows in width or height.
Source: Banner MD Anderson Cancer Center