Young Patient, Family Experience Shock of Childhood Melanoma

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By Lana Maciel, MD Anderson Staff Writer

PediMelanoma9_2010.jpgEvery summer, the Mireles family has enjoyed vacations at the beach, whether it was in Galveston, Texas, Destin, Fla., or somewhere else along the Gulf shores. And whenever they spent time soaking up the sun, they always kept a bottle of sunscreen handy. They knew about the dangers of sun exposure, and mom Lupe Mireles made sure to keep her family protected.

But one summer, when Lauren Mireles was 4 years old, her parents noticed a mysterious spot on her leg. It wasn't round, and it grew and darkened over time.

Lauren's pediatrician suggested that she see a dermatologist. They saw several. But every doctor assured them there was no cause for alarm. All they had to do was keep an eye on it.

As the years went by, the family continued to go on summer vacations, always wearing plenty of sunscreen. But two years ago, when Lauren was 11, the family grew alarmingly concerned over how unusual the mole looked. They again visited the dermatologist and requested a biopsy. The results left them speechless and shocked.

"When we returned for the follow-up, the doctor asked us to step outside so we could discuss the test results," Lupe says. "At that point, I knew it was serious. He said that Lauren had stage II melanoma. And I panicked. All I heard was 'stage II,' and I wanted to get a second opinion."

'It can happen to anyone'

Knowing that a melanoma diagnosis might entail long-term treatment, Lupe and her husband, Daniel, then brought Lauren to MD Anderson, where they met with Dennis Hughes, M.D., Ph.D., assistant professor in the Division of Pediatrics.

Hughes later confirmed that Lauren actually had stage I melanoma. Fortunately, the disease was gone along with the mole, and no post-surgery treatment was needed due to its early stage.

Regardless, Lupe says, the diagnosis sent the family into survival mode. They began educating themselves on everything related to childhood melanoma.

What they learned was that about 500 children a year are diagnosed with pediatric melanoma, and the numbers are growing. Researchers have found that in addition to excessive sun exposure, the disease can also develop from a combination of genetic predisposition and other unknown factors. What was unusual, Daniel says, is that Lauren doesn't have the fair skin and blond or red hair typically associated with a high risk of melanoma. (For more information, see link to related story below.)

"We're still in such disbelief that something like this could happen to her, not only because of her young age, but because of her darker skin tone," Daniel says. "Because of that, we didn't really see the dangers of it. But it's important for people to be aware of it, and to know that it can happen to anyone."

An overwhelming summer

Though Hughes was able to help Lauren understand what was happening, she admits she still couldn't comprehend what cancer was. The only thing she knew about cancer was that her grandfather passed away from multiple myeloma when she was 4 years old. Naturally, for an 11-year-old, this association made her afraid of what her own cancer might bring.

"I didn't really know what was going on because I was so young," Lauren says. "But I wasn't really that worried about it until we decided to get the mole removed. Then I was a little scared."

Lupe remembers her daughter being overly cautious after the diagnosis. She always wore protective clothing, and she didn't want to go out into the sun.

"That time was very tough for her, and even more so because after that summer, she was starting middle school, which was a big change," Lupe says. "Everything was just happening all at once."

Between the extensive doctor's exams and the experience of entering the sixth grade, it was obvious to Lupe that her daughter was having a hard time coping with the situation.

"At first, we noticed that her grades suffered a little, and she wasn't as outgoing as she was before," Lupe recalls. "But now with her second year, there's been a big change. She's more outgoing again, and she's doing much better."

Living a watchful post-cancer life

To this day, Lauren, who plays violin for her school orchestra, visits Hughes every six months for regular skin checks. Though the hard part is over, the family is aware of the fact that children who have melanoma are at greater risk of recurrence later in life.

"As Dr. Hughes explained to us, now that her body has learned to create this cancer, the harsh reality is that it can create it again," Daniel says. "So every time we see something new appear on her skin, we immediately think, 'What is this? Could it be another cancer?'"

But for now, the Mireles family is staying positive and moving forward. The key, Lupe says, is to stay aware and always be cautious.

"As long as we keep learning and staying informed, we'll be OK and we'll try to live a normal life."

Related story:

Q&A: Childhood Melanoma
Although melanoma is primarily a disease that occurs among adults, it is also seen occasionally in children, and the number of diagnoses increases each year. Read more about Childhood Melanoma.

MD Anderson resources:
Childhood melanoma
Dennis Hughes, M.D., Ph.D.
Children's Cancer Hospital

1 Comment

Fans of the MD Anderson Facebook page had this to say about this story:

S. Willheit Frederickson
These teenagers, not Lauren, she is much younger than most, but the older teenagers no matter how much you tell them about skin cancer the more they just ignore you. I don't understand how they can not care....14 hours ago · Like · 1 person · · 

M. DeRon
Unfortunately, teenagers think they're "bullet proof", and don't like to listen to anyone give "advice"!

We went thru this with our 5 year old and his was on his head (in his hair). I was VERY lucky to have known it was there and kept an eye on it and went straight to Texas Childrens when I noticed any change in it. Now we are about to go back for a second one I found, yet again, on his scalp.

Start them young, get them used to having sunscreen on, talk about the insanity of tanning beds, etc. Be proactive. Better yet, model your good, healthy behavior. Also consider genetic testing. My mother, brother, and I have all had melanoma; it's not to be messed with!

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