Josh Paschal, the Lions 2nd-round pick in 2022, will miss the upcoming game vs the Titans due to an illness. Thankfully, the illness appears to be unrelated to a serious medical issue he had in the past.
In 2018, Paschal was diagnosed with malignant melanoma which is a dangerous form of skin cancer. He penned a first-person article about his experience here on the American Academy of Dermatology website.
Paschal is far from alone as melanoma is the fifth most common cancer diagnosed in the United States. The top four are breast, prostate, lung, and colon.
Melanomas generally show up in those over the age of 50. Youth helps but does not provide total immunity. About 5% of melanomas are diagnosed in those under the age of 35 and less than 1% under the age of 20. Paschal, who was only 18 at the time of diagnosis, understandably wrote: “I was shocked. I had heard about melanoma but I didn’t think it would happen to me, especially at such a young age.”
Winning a battle over melanoma is no small victory. Melanoma is the biggest fear among skin cancers as it is by far the most fatal, accounting for about 75% of all skin cancer deaths. The high fatality rate is due to its aggressiveness and ability to metastasize (spread to other areas of the body).
The overall 5-year survival rate is about 94% but there is huge variability in survival depending on how far the melanoma has progressed. If it has metastasized, the 5-year survival rate drops to around 35%. Paschal is absolutely correct when he stated: “The good news is I was diagnosed early.”
Despite the importance of early detection, routine screening for melanoma is up for debate. The current recommendation by the US Preventive Service Task Force is that there is “insufficient evidence to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults.” Translated, this means it’s uncertain at this time whether it’s a good idea or bad idea to screen for melanoma in the general population. Paschal’s story makes it seem that melanoma cancer screening would make logical sense, but there are costs in terms of stress, unnecessary procedures, time, and money.
Whether you want to be screened for melanoma is worth discussing with your primary care doctor or dermatologist. Regardless of if you see a doctor, keeping an eye on your own skin is a good idea.
Paschal discovered his melanoma on his own describing it as “a tiny spot on the bottom of my right foot [that] kept bothering me. I would get a stinging sensation on my foot, and it basically felt like I had a bad blister.” Following up with a doctor to have it evaluated may have saved his life. Kudos to Paschal for opening up about his experience as it may have already saved other lives.
To evaluate your own skin, the British Association of Dermatology has some easy-to-understand guidelines about what to look for:
• A new mole appearing after the onset of puberty which is changing in shape, color or size
• A long‐standing mole which is changing in shape, color or size
• Any mole which has three or more colors or has lost its symmetry
• A mole which is itching or bleeding
• Any new persistent skin lesion especially if growing, if pigmented or vascular in appearance, and if the diagnosis is not clear
• A new pigmented line in a nail especially where there is associated damage to the nail
• A lesion growing under a nail
Treatment for melanoma can be a long, harrowing journey with an uncertain destination. As Paschal logged: “After three surgeries and months and months of [immunotherapy] treatment…I finally returned to the football field in November 2018.”
For unknown reasons, the incidence of melanoma has been increasing in recent years. Fortunately, the death rate has been decreasing, and Lions fans should take pride in being able to count Josh Paschal as one of the survivors.
