Is Melanoma Over and Under Diagnosed?

Duality: Water gives life and takes it, so is it true of food, air and sun – moderation is the rule.

How can a disease be both over and under diagnosed at the same time?

This is the duality of the UV theory of malignant melanoma and the tragedy.

On the one hand, according to the World Health Organization, 47% of the world's melanomas are diagnosed in the United States while 4.5% of the world's population lives there. This disparity certainly cannot be explained by the theory melanoma is caused by any UV exposure. If that were the case then countries like Australia and Israel should have a disproportionate number of diagnoses. How can the U.S. have ten times the number of melanomas diagnosed in relation to its population? Health insurance fraud is one reason. Removing a mole is a cosmetic procedure not covered by health insurance, but removing a mole that is "cancer" is covered. Greed, as it turns out, is motivation for over diagnosing melanoma. That is just one half of the tragedy.

The current, and incorrect, dogma theorizes any UV exposure is a leading risk factor for melanoma. It is worth noting, after millions spent in research dollars, no scientist has determined the mechanism by which UV causes melanoma. Some would call it academic fraud to move forward a medical theory as fact without establishing a mechanism. As well, cosmetic dermatologists still do not understand why outdoor workers get fewer melanomas than indoor workers. Confounding even further, most melanomas occur on body parts where the sun doesn't shine. And still additionally frustrating and revenue killing to cosmetic dermatologists, the use of chemical sunscreens do not reduce your risk of melanoma and may even increase your risk. When cosmetic dermatologists ignore data that disproves their UV theory of melanoma they risk under diagnosing the disease.

It was a recent trip to the gym and a frank discussion with fellow Pilates student, Libby, that I realized the UV theory of melanoma almost killed her husband. A year prior Libby's husband had a mole removed from his back. He avoids the sun and has no family history of the disease. His cosmetic dermatologist removed the mole but did not test it, even though the mole was almost the size of a quarter. The mole returned several months later. This time they went to an oncologist and the mole was diagnosed and treated as melanoma. Libby's husband was lucky, for now.

I remember reading a similar story last year, but with dire consequences. A doctor died from melanoma after his cosmetic dermatologist determined he had nothing to worry about since he avoids the sun. The additional irony is the dead doctor's wife is also a doctor who, because of incorrect dogma, also advised him he had nothing to worry about because he never exposes himself to the sun.

Do not allow your cosmetic dermatologist to falsely diagnose you with skin cancer or pre-cancer so your mole removal is covered by insurance. That is fraud and you are now a cancer survivor. Good luck getting life insurance. Regardless of what your cosmetic dermatologist claims about your risk factors, demand that any mole removed be tested. There is no clear evidence that sun avoidance means you are not at risk for melanoma, in fact the opposite is true. The most likely truth borne by the data is that heredity, sun abstinence, chemical sunscreen use and frequent and severe sunburn are risk factors for melanoma. You need sunshine like you need food, air and water. Never sunburn.