Melanoma Dangers During S/M Play by Jay Wiseman © 1994, author of the books "SM
101: A Realistic Introduction" and |
Note: For more information,
visit the Submissive Women Kvetch website at http://members.aol.com/oldrope/ and the Greenery Press website at http://www.greenerypress.com This article is being written as a fairly urgent public health warning to the SM community and to appropriate others. It concerns a potentially life-threatening aspect of SM play that is largely unknown. This article is being sent to numerous SM clubs, leather stores, SM professionals, and related others. It is also being posted on appropriate computer bulletin boards and to appropriate newsgroups on the internet. Please send comments and requests to reprint or publish this article to me by e-mail to oldrope@aol.com or by regular mail to Jay Wiseman, 3739 Balboa # 195, San Francisco, CA 94121. Quick Summary Melanoma is an increasingly common form of life-threatening
cancer, usually found on the skin, and known for its early and rapid
tendency to spread to other organs. Melanoma is frequently found on
the back -- a location often whipped during SM play. The back is also
a location not easy for a person to examine themselves. Studies have
shown that manipulation of a melanoma (and a whip stroke, spank, or
other type of blow would, obviously, be a form of "manipulation") definitely
increases the number of cancer cells that break off and begin to spread
to other parts of the body. It is therefore essential that SM practitioners
know how to spot possible melanomas, both on themselves and on their
partners, to avoid whipping or otherwise disturbing melanomas, and to
First Notice Earlier this year, my partner Lady Green taught one of
her workshops on The incident raises a number of concerns, both about
the disease itself Basic Facts Melanoma is a form of cancer that arises from a type of cell called melanocytes. Most of these cells are, obviously, in the skin, but melanocytes are also in the mucous membranes, under the nails, in the mouth, and in the eye (including the retina). Melanomas can develop from the sites of existing skin lesions or can develop on their own in areas of previously clear skin. Melanoma is the eighth most common form of cancer in
the United States The skin is by far the most common melanoma site. About
600,000 new Risk Factors The average overall lifetime risk of developing melanoma
is about one in Exposure to sunlight Exposure to large amounts of sunlight, both in childhood and as an adult, increases the probability of certain subtypes of melanomas appearing, but not of others. (There are four basic subtypes.) Melanomas are more frequent near the equator, and the population of Arizona has the highest frequency of melanoma in the United States. Cancer prevention authorities recommend the use of sun block with a SPF of 15 or greater. Melanoma and non-Caucasians Melanoma is distinctly rare in non-Caucasians, and all but unheard of in Asians. Non-Caucasians face about one-twelfth the average overall lifetime risk of melanoma that Caucasians face. (Still, 200+ non-Caucasians die of melanoma every year -- the majority of them either Black or Hispanic.) When a melanoma is found on a non-Caucasian, it is usually found on the palms or soles, under the nails, on a mucous membrane (including inside the mouth), or within the eye. Melanoma and people with HIV Melanoma is distinctly more frequent and more aggressive
in people who Location on the body Melanomas can appear anywhere on the body's surface, including the ano-genital region, the hair on the head, the inside of the mouth -- including the palate, and the interior of the eye. The back and lower legs are the most common sites in women. The back, chest, abdomen, and arms are the most common sites in men. (The issue of whether or not melanomas can be encapsulated with breast cysts -- and possibly released during heavy breast play -- was not itself specifically explored during the research done for this article; no mention of such a phenomenon was noted in the references consulted.) Appearance of Melanoma Melanomas are described according to the classic ABCD criteria: A. Asymmetry: Common moles are both round and symmetrical.
A line drawn B. Border: Common moles usually have smooth, even borders.
Melanoma C. Color: Common moles are usually a uniform shade of
brown. Melanomas D. Diameter. Common moles are usually six millimeters
-- a quarter of an Some authorities add a fifth ("E") criteria: E. Elevation: A dark nodule elevated above the rest of
the skin can be a Detection Experts recommend that each person conduct a monthly
self-examination of This monthly self-exam should be supplemented with an
unhurried annual Several different sources cautioned that moles which bleed relatively easily should be regarded with the traditional "high index of suspicion." Treatment Treatment is usually by excisional biopsy, which involves
removing the Complications and Prognosis Melanoma can metastasize by either the bloodstream or the lymphatic system. If found while still localized, the overall five-year-survival rate is in excess of 90%. If the disease has spread to the local lymph nodes but no farther, the five-year-survival rate is approximately 50%. If the disease has spread beyond the lymph nodes, typically to sites such as the liver, lungs, bones, or brain, the five-year-survival rate is less than 15%. Melanomas on the torso have a grimmer prognosis than do melanomas on the limbs because less "filtering" by the lymphatic system occurs in that region. Pathology Cancer cells do not bond to each other as strongly as healthy cells usually bond to each other. Therefore, many cancer sites "leak" cells, which then travel elsewhere in the body, to a greater degree than healthy tissues leak cells. This is known as increased friability. Studies have definitely proven that manipulating a melanoma increases the number of cancer cells that break off and "float downstream" (or is it "upstream"?). While the body's immune system consumes most such cells, preventing them from forming new cancer sites, it certainly cannot be assumed all such cells will be so consumed. Medical-related precautions Medical professionals are cautioned not to manipulate a suspected melanoma site any more than absolutely necessary. The treatment is excisional biopsy if at all possible. Incisional biopsies, and other cuttings of the site, are avoided unless clearly necessary. Electrolysists are trained not to stick their needles (which can give off heat, or electricity, or both) into moles. There could also be Sports Medicine aspects, particularly regarding contact sports such as football or the martial arts. SM-related precautions SM-related precautions include not whipping or otherwise striking a possible melanoma, not piercing or cutting through it, and noticing if a mole starts to bleed after being whipped. Those about to receive a whipping, piercing, or cutting should caution their partners about "suspicious" moles on their skin. In addition, subjecting the site to intense heat (from dripping candle wax, for example) or to jolts of electricity (from a cattle prod or violet wand) could also be much more risky than previously thought. For further information: The following organizations provide excellent educational literature for the general public, including relatively inexpensive color brochures that could be bought in large quantities and distributed to SM clubs and other groups. Small samples will be sent on request. I have looked over most of the available materials, and can be contacted at the addresses listed above regarding recommendations. National Cancer Institute, Cancer Information Center,
(800) 4-CANCER Skin Cancer Foundation, 235 Fifth Avenue, New York, NY
10016, (212) American Academy of Dermatology, P.O. Box 3116, Evanston,
IL 60204-3116, American Society of Plastic and Reconstructive Surgeons,
444 East The following academic references were consulted during
the preparation "Andrew's Diseases of the Skin" 8th edition by Arnold,
et al. "Clinical "Common Skin Disorders" 4th edition, by Epstein "Cancer Facts and Figures - 1994" by the American Cancer Society "Dermatology" by Obraun-Falco, et al. "Guide to History Taking and Physical Examination" 5th edition, by Bates "Malignant Melanoma: Diagnosis and Differential Diagnosis"
by Holzle, et "Manual of Clinical Problems in Dermatology" by Olbaylt,
et al. Conclusion While many sadomasochists like "on the edge" play, I doubt that many would want their submissive partners, no matter how self-sacrificing, to risk getting a fatal case of cancer. Like many other cancers, melanoma is almost completely curable if detected and treated early. Informed, monthly self-examination of the skin is the most important step. Check your partner's skin. If you spot a funny-looking
mole, don't whip |
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