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Sun & Skin Cancer

Have you noticed that deep, dark tans look decidedly out of place these days? In fact, they look like a holdover from the 1970's, when bronzed sun worshippers graced the covers of the leading fashion magazines. Luckily, those days are long gone: Lovely un-tanned skin is now chic. The reality is that up to 90% of all skin cancers are caused by exposure to the sun's harmful UV rays, and the effect is cumulative. Each unprotected exposure incerases one's lifetime risk of developing skin cancer.

Fortunately, most skin cancers are visible and can be diagnosed and successfully treated before they spread (metastasize) to other parts of the body. In fact, many lesions can be detected and treated at a precancerous stage, the point at which their cells may be close to turning cancerous but have not yet.

Actinic keratosis (AK), also known as solar keratosis, is the most common type of precancerous skin lesion. The more time individuals spend in the sun over the years, the greater their odds of developing one or more AKs. An AK is evidence that sun damage has occured and that the individual is therefore at greater risk of developing skin cancer. AKs typically occur on the face, lips, ears, scalp, neck, back of the hands, shoulders, forearms, and back - the parts of the body most often exposed to the sun. Ranging in size from 1mm to 1inch (most often about 2-4mm) in diameter, AKs usually appears as small crusty, scaly, or crumbly bumps or horns. The base can be dark or light skin-colored and may have additional colors such as tan, pink, and red.

Treated early, almost all AKs can be eliminated before becoming skin cancers. Based on the growth's characteristics and the patient's age and health, various treatments can be used effectively with little or no scarring.

If not treated early, AK's can develop into cancerous lesions that can require more in-depth treatments and surgeries.

Here's a rundown on the three major types of skin cancer than can develop, what they look like and what you can do about them.

Basal Cell Carcinoma
Basal cell carcinoma is the most common form of skin cancer, accounting for 80% of all skin cancers diagnosed in this country. Last year, some 900,000 new cases were diagnosed. If caught early, though, the cure rate is better than 95%.

  • What it looks like: Pearly nodule, sometimes with an area that won't heal. It can be translucent and gradually grow, or can look like a sore that won't heal.
  • Who gets it: People who have received chronic sun exposure throughout their life.
  • How it's treated: Basal cell carcinomas can be removed by freezing or surgery.

Squamous Cell Carcinoma
Numbering 200,000 cases in 1998, squamous cell carcinoma is the second-most common form of the disease, representing 16% of all skin cancers. Like basal cell carcinoma, this disease is 95% curable if caught early. But squamous cell carcinoma can spread and is potentially lethal if left untreated.

  • What it looks like: Crusty, scaly patch with a hard, callused surface.
  • Who gets it: People who have had chronic sun exposure throughout their life.
  • How it's treated: If caught early, squamous cell carcinomas can be removed by freezing or surgery.

Though melanoma is the least common form of the disease, it's the most deadly. "The odds of getting melanoma are 1 in 79," Dr Rigel notes. In fact, adds Dr. Ceilley, "someone dies of melanoma every hour." And if you have a family history of the disease, you're at risk even if you've never been out in the sun, Dr Ceilley explains.

  • What it looks like: Usually a pigmented mole, sometimes with an uneven border. The color and diameter may change over time.
  • Who gets it: People who have had several blistering sunburns in their youth or adolescence, or those with a family history of the disease.
  • How it's treated: Removal of the tumor (excision). The amount of tissue that needs to be cut out depends on the tumor's thickness, so early detection means less invasive surgery. If the cancer has spread, the patient may need chemotherapy, radiation, or other treatments.

Prevention and Early Detection
Skin cancer, if not completely preventable, can at least be successfully treated if caught early. Here are some ways to protect yourself.

  •  Cover up - Wear long pants and shirts with sleeves. If the sun can't get to you, it can't damage your skin.
  • Wear a cap - Wear a hat with a 4-inch brim to protect your face and neck.
  • Use a high-SPF sunscreen - If you'll be outside for any length of time, use a sunscreen with an SPF of 15.
  • Look for changes - growing, bleeding, crusting, or otherwise changing spots on your skin could indicate a problem.
  • Make it routine - use a broad-spectrum sunscreen every day and start putting it on your kids at age 6 months.
  • Reapply often - even waterproof sunscreens need to be re-applied every 2 hours for maximum protection in the midday sun.
  • Stay indoors - avoid the sun between 10 a.m. and 4 p.m., when its rays are strongest.

Safe-Sun Tips for Young and Old
Here are some sun-savvy tips from Steven E. Hodgkin, M.D., Medical Director, High Desert Skin & Laser Medical Center.

  • Avoid reflective surfaces, such as sand or water, which can reflect up to 85 percent of the sun's damaging rays.
  • Make applying a broad-spectrum sunscreen with a minimum SPF of 15 as much a part of your year-round daily routine as brushing your teeth.
  • Make sure there's a tube of sunscreen in your car, golf bag or backpack for last-minute sun activities.
  • Reapply sunscreen every two hours after you've been in the sun or water - even if it claims to be "waterproof."
  • Check the UV Index in the morning paper or on the TV or radio before you go out. Then take the necessary steps to stay sun-safe.
  • If you're in the sun and there's shade nearby, stand under it. If there's no shade, bring your own (i.e., a hat with a 4-inch brim).
  • Wear sunglasses and tightly-woven protective clothing. Dark colors give more protection.
  • Let the sunscreen dry on your skin for 20 to 30 minutes before going outside. It takes that long for the chemicals to start working; this also helps ensure that it stays on your skin where it belongs. And try to avoid being in the sun between 10 a.m. and 4 p.m.
  • Put your sunscreen on yourself when you slather it on your kids. Not only will you also be protected, you'll be a good role model, too.
  • Spread the word about sunscreens and the dangers of skin cancer to friends and family members. You could save a life!
  • Sunscreens combined with other skin-care products (such as moisturizers) are real time-savers. Just make sure that the sunscreen in the product has an SPF of at least 15.


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