Black Cancer

From 1903 to the day of his death last October, Johns Hopkins' Dr. Joseph Colt Bloodgood. famed cancer pathologist, megaphoned to every human being with a mole upon his skin: "Beware of death-dealing black cancer! Watch that mole and, if it starts to grow, have it cut out before it is too late." Dr. Bloodgood believed with many another wise cancer specialist that it is worth scaring the wits out of 999 people in order to save the thousandth man from death by cancer.

Last week another Johns Hopkins pathologist, Dr. Dean Howard Affleck, 30, took up Dr. Bloodgood's megaphone and through the American Journal of Cancer sounded the same alarm.

The term mole refers to two separate kinds of growths in the body: 1) a soft, fleshy mass (Latin mola) in the womb, caused by an ovum which started to become a baby but failed; 2) a pigmented spot (Anglo-Saxon mael) in the skin. According to Dr. Affleck, Mole No. 2 "may occur anywhere on the surface of the body, in the mucous membranes of the upper and lower ends of the digestive tube, and in the eye." It may be covered with coarse hairs. In color it ranges from light brown to black. Color is due to a pigment called melanin.

Melanin is also the coloring matter of black cancer, one of the swiftest and most deadly forms of this disease. Since black cancers are malignant tumors and raised pigmented moles are benign tumors, pathologists call both Melanomas. What all cancer specialists know and what few laymen realize is that black moles sometimes turn suddenly into black cancers which are rarely recognized in time to save the victim's life.

To clinch the seriousness of this possible transition Dr. Affleck compared a group of Johns Hopkins patients who had benign melanoma (moles) excised with another group who suffered from malignant melanoma (black cancers). Four out of five of the cancers had started as moles. Dr. Affleck found that moles occurred most frequently on the face and neck, next most frequently on chest, back, arms, abdomen, legs. Black cancers appeared most frequently on the legs, arms, face, neck and back. "Highest incidence," noted Dr. Affleck, "is apparently in those areas most subject to trauma, the foot and the great toe being the most frequent sites." The dangerous years: 21 to 70. When a pigmented mole turns into malignant melanoma, the change may show in several ways:

1) "There may be no noticeable change in the primary mole. . . . But the clinical onset may be characterized by enlargement of lymph nodes draining the area. Advancement of the growth from this stage may be slow or rapid."

2) "Enlargement of the primary mole with subsequent ulceration that may heal incompletely and weep or bleed intermittently. This may lead the patient to consult a physician, who excises the lesion with a good margin of healthy tissue. The wound heals and the patient may remain well for a number of years. . . . Subsequently, however, recurrence takes place. Following this there is a rapid downhill course with widespread distant metastases [secondary cancers in other parts of the body]."

3) "First manifestation of malignancy is the occurrence of numerous pigmented growths in the skin about the primary mole. This represents the most malignant form. The onset is followed shortly by widespread metastases and death from visceral involvement."

X-rays and radium rarely have an effect in retarding the chainlike spread of black cancer, Dr. Frank Earl Adair of Manhattan's Memorial Hospital has found. Surgery is the only weapon, and then only as a prophylaxis.

Concluded Johns Hopkins' Dr. Affleck: "An important fact to note is that once a mole shows sufficient symptoms to cause a patient to consult a physician, it is already in an advanced stage and treatment, regardless of the type, rarely results in cure. The only hope for the present seems to lie in the removal of pigmented [moles] in their quiescent stage."

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