Date: Fri 21-Jul-1995

Publication: Hea

Author: KAAREN

Illustration: I

Quick Words:

skin-cancer-summer-sun-

Full Text:

Fry Now, Pay Later

Serious Summer Warnings About The Risks Of Skin Cancer

B Y K AAREN V ALENTA

Warnings about skin cancer have become a rite of spring but recently the

cautions are backed by ominous new research.

An estimated 900,000 to 1.2 million non-melanoma skin cancers occur each year,

nearly double the estimate formerly used by the American Cancer Society and

other educational groups, according to a study published in the Journal of the

American Academy of Dermatology. And although non-melanoma cancers are the

common, less serious type, they are expected to account for 2,100 deaths this

year. In addition, 34,000 new cases of melanoma will be diagnosed and there

will be 7,200 melanoma deaths. Malignant melanoma is so dangerous that

one-fifth of its victims die within five years of diagnosis.

"Melanoma has shown an alarming increase over the last 20 years," said William

A. Notaro, Md, a dermatologist who lives in Newtown. "There is now a 1 in 90

lifetime risk of developing melanoma. I see 20 to 30 cases a year in my office

and, since there are 5,000 dermatologists in the United States, I would think

that the number of cases might be underestimated."

Fortunately, skin cancer is one of the most curable forms of cancer - when

it's diagnosed early and treated. Better still, most skin cancer can be

prevented. The largest organ of your body, your skin interacts constantly with

the world around you. Ninety percent of all skin cancers occur on parts of the

body that usually aren't covered by clothing. The face, tips of the ears,

hands and forearms have been the usual sites, but in the past 50 years the

shoulders, backs, chests and lower legs have become more common as summer

clothing has became skimpier and sunbathers deliberately exposed themselves to

the sun's ultraviolent radiation.

"In recent years people have had more recreational time in the summer months,"

Dr Notaro said. "Depletion of the ozone layer also may have played a role in

the increase of skin cancers. Only in the last ten years have people started

to regularly use sunscreens. Since it only takes one sunburn during childhood

to put you at risk for your lifetime, there is ample reason for concern."

In May, Danbury Hospital sponsored a free cancer risk assessment and screening

at which Dr Notaro and seven other area dermatologists participated. Experts

recommend that everyone perform a self-exam for skin cancer each month and

have a full-body check by a dermatologist each year.

Malignant melanoma is the least common but most serious type of the major skin

cancers. It can occur at any age although risk usually begins after puberty.

It may originate in or near a mole. Melanomas involve the cells that give the

skin its color, and are often a mixture of black or brown, sometimes with red

and blue portions. They continue to grow larger and have irregular borders.

Basal cell carcinoma is the most common type of skin cancer. It is a

slow-growing cancer that usually begins with a small, shiny, pearly bump or

nodule on the head, neck or hand. If left untreated, the original nodule can

bleed, crust over and open up again. This kind of cancer usually does not

become life-threatening, but it can continue to grow, reach underlying tissues

and destroy them, causing disfigurement when eventually removed.

Squamous cell carcinoma may start as nodules or as red patches with

well-defined outlines. Typically these develop on the lips, elsewhere on the

face or on the tips of the ears because of exposure to the sun. Unlike basal

cell carcinoma, some squamous cell skin cancers tend to spread to other parts

of the body and can become life-threatening if they reach the internal organs.

Any unusual skin spots should be checked to rule out cancer, doctors say. And

don't think you can minimize your risk by opting for tanning parlors instead

of spending time in the sun.

"There's more evidence now that UVA light, used in tanning machines, increases

your risk for skin cancer," Dr Notaro said. "UVA plays a large role in

damaging the epidermal layers. No question about it, sun exposure and the use

of tanning parlors will increase your risk of skin cancer as well as make you

look older faster by causing wrinkling of the skin, spots, and pigmentation

changes - things that used to be attributed only to the aging process."

There are obvious precautions that you can take to help avoid skin cancer.

"The risks are highest during the peak hours of 11 am to 3 pm so try to stay

out of the sun then," Dr Notaro said. "Use sunscreens containing at least SPF

15. You can use higher, up to 50 SPF or more, although the amount of increased

protection is less significant. Make sure whatever sunscreen you purchase

works for both UVA and UVB - check the label."

"Wear a wide-brimmed hat when outside and clothing with tight fabric. A lot of

UV light will penetrate a T-shirt, even on a cloudy day. Mothers who put

T-shirts on children in the sun should realize the shirt provides only SPF 5

protection, and no protection at all if the shirt gets wet!"

Self-tanning agents which stain the skin are considered a lot safer than going

out in the sun. "But even if you look very tanned by using these, you must

remember that these provide no protection at all from UV light unless they

contain a sunscreen and then only on the day of application," Dr Notaro said.

Physicians have a number of methods to treat skin cancer depending on the size

of the cancer, its position on the body and risks to the patient. These

methods include surgery, electrical current, radiation therapy and freezing.

Sometimes a combination of these is used.

Doctors also have had some success in treating pre-cancerous skin conditions

with drugs like Accutane and Retin-a as well as various topical chemotherapy

preparations. Two studies found that Retin-A appeared to return precancerous

conditions of the skin and the cervix to normal, presumably eliminating the

risk of developing malignancy. But Retin-A can produce birth defects if women

become pregnant while using the drug and using it to reverse sun damage and

aging of the skin is considered a non-approved use.

Researchers also are trying to determine whether eating a low-fat diet may

also may help prevent skin cancer. In one study published in The New England

Journal of Medicine in May 1994, persons who ate a low-fat diet (dropping fat

consumption to 20 percent of the day's total calories) developed far fewer

instances of precancerous skin lesions (called actinic keratoses) than did the

group that continued their diets of 40 percent fat. But while a low-fat diet

has been demonstrated to cut the risk of colon and breast cancer, the jury is

still out on its effectiveness for your skin.