================================================================== Dedication ================================================================== It started as a way to spend a rainy Saturday afternoon, and it ended up profoundly affecting the lives of tens of thousands of people. Howard Benner through TAPCIS brought to life for many of us the very idea of an online community. His legacy is a part of our work and our play every single day. ================================================================= Howard Benner died in June of 1990 at the age of 44 due to complications of malignant melanoma. Howard's pioneering work has made access to CompuServe easy for us. Unfortunately, much pioneering work in melanoma treatment remains to be performed. Malignant melanoma is a highly malignant cancer of the skin. It is the ninth most common cancer in the US and is now the most common cancer in women between ages 25 and 29. The incidence of melanoma has doubled in the past 10 years. In 1989, over 27,000 new cases of melanoma were diagnosed, and there were 6,000 deaths from the disease. There is a strong causal relationship between excessive exposure to sun and melanoma. Many investigators believe that the rise in the rate of melanoma is closely related to the desire for a perpetual sun tan. Depletion of the ozone layer and the consequent reduction in ultra-violet filtration has also been implicated in the rising rate of melanoma occurrence. Support for the conclusion that excessive tanning is causal in the development of melanoma is the site of onset, in men on the back, shoulders, or abdomen and in women on the legs, all sites that are only occasionally subject to sunlight and thus easily "sun-burned". According to the American Cancer Society, people who have had 3 or more blistering sunburns are at 5 times the risk for developing melanoma compared to people who have never been burned. There are many today who feel that even gradual tanning is not safe. Of considerable concern is the feeling that melanoma may remain dormant for many years. Thus melanomas initiated 20-30 years ago before strong sun-screens were available may first be coming apparent now. Risk factors also include fair complexion, family history, and a markedly freckled back or shoulders. The incidence of melanoma amongst Caucasians is significantly greater than that in Blacks or Orientals. In its initial stages, melanoma is treatable and curable. There is a definite cutoff point between the size and thickness of the melanoma lesion and its curability. In its early stage, melanoma is treated by surgical excision with almost 100% cure. However, beyond a very sharply defined lesion size (thickness > 0.75mm), melanoma becomes essentially 100% fatal today. Today, metastatic (spread) melanoma remains incurable. However, in the past few years several new approaches to therapy have shown considerable promise. New approaches include developing a vaccine which kills melanoma cells. An experimental melanoma vaccine has been derived by infecting melanoma cells grown in cell culture with a virus and then injecting material from these cells into melanoma patients to induce the production of antibodies to the viral/melanoma combination. In initial trials of this "vaccine", there has been a significant decrease in disease recurrence in patients with metastatic melanoma. It is possible that high-risk patients may some day be able to receive an anti-melanoma vaccine. Another promising approach includes the use of interferon and/or interleukin -2, biologicals which have shown reasonable success in melanoma patients but unfortunately, interleukin-2 is particularly toxic. This approach is not specific for melanoma but has been also used in patients with renal cell cancer. A third approach utilizes augmented "killer lymphocytes", which patients with melanoma frequently develop. These "killer lymphocytes" appear to seek and destroy melanoma cells. Alteration of these naturally occurring killer cells using recombinant DNA methods may actually increase their ability to kill melanoma cells. This technique is quite new and will not be available for many years. Currently, while there are several promising treatments for melanoma, prevention remains the most obvious way of combating the disease. An understanding of the long term risks of excessive sun exposure and taking steps to reduce that exposure is the single most effective way of reducing the likelihood of disease. Everyone should perform a regular self examination looking for these danger signs in moles on your skin. Check carefully under arms, between toes, back and top of your head, back... everywhere. Become familiar with the moles you have, then watch for changes: ASYMMETRY: One half the mole is unlike the other half. BORDER IRREGULAR: The mole appears ragged or scalloped. COLOR VARIED: The mole changes color from one area to another. Shades of brown and tan may contain red, white, and blue. DIAMETER: Moles larger than 1/4 inch (the width of a pencil eraser. Not all moles that fit into one of these categories is cancer, but they should be brought to the attention of your physician. Malignant melanoma often signals its presence by a change in an ordinary mole. A mole that grows darker, wider, thicker, becomes irregular, or starts to itch, hurt, or bleed should get immediate attention. If a melanoma is found early and removed, the disease can be completely cured. Do NOT put it off. Support Group, Inc., has made arrangements with the Eastern Cooperative Oncology Group (ECOG) to establish a research fund in Howard's name. The money in this fund will be devoted to supporting research aimed toward finding a cure for malignant melanoma using biological agents. An initial donation of $5,000 has been made, and Support Group's share of TAPCIS Forum revenues will be donated to this cause. Anyone interested in making a donation in Howard's name is encouraged to make a check out to ECOG and send it to Support Group, Inc., P.O. Box 130, McHenry, MD 21541. We will be sending details on each contributor to Howard's family, so feel free to include a note if you wish. If you would like more information about the ECOG, please feel free to drop a mail or forum message to Richard Wilkes, President, Support Group, Inc., 76701,23. Dr. John Wexler was a great source of information for Howard during his illness, and John has also offered to help answer questions you may have. John can be reached at user ID 71360,3070.