Do You Know the Signs of Skin Cancer?

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Do you know the signs of skin cancer or think that skin cancer isn't a problem? Do you think that actresses and actors in their bronzed glory don't care about skin cancer warning signs? What about sun-worshippers and models? Do you think that they care about the signs of skin cancer?

Have you seen the newest soap opera on television?

It's called the Young and the Wrinkled. It features former sunbathers who maximized their summer tans with winter-tanning beds.

Frankly, they'd be fortunate if wrinkles were their biggest health concern. In reality, while they may have thought they looked healthy with that great tan, they were actually causing slow but constant damage to their skin.

And then there's the weekend and holiday sunbathers. They don't get off the hook — not by a long shot. Researchers have determined that intense and occasional exposure to ultraviolet rays is more closely linked to developing melanoma later in life than is shorter, everyday exposure to the sun.

Whatever the exposure, the fact is this: Sun-related skin cancer is on the rise. In 2003, the American Cancer Society estimates that more than 1 million Americans will discover skin cancers (squamous and basal cell carcinoma), and another 54,200 will get melanoma, the most serious and potentially deadly form of skin cancer. See When Skin Cancer Strikes.

Sadly, melanoma is the No. 1 cause of cancer deaths in women age 25 to 30. But it can target anyone. That's why it's important to understand your risks. With that said, you're at increased risk for melanoma if:

• A member of your family has had malignant melanoma.

• You have fair skin, blond or red hair and blue or light-colored eyes.

• You sunburn easily and rarely tan. The risk of melanoma is 12 times greater for people with fair skin than for people with darker skin.

• You had sunburns as a child.

• You have a compromised immune system, or you're on medication to prevent organ rejection.

The Signs of Skin Cancer
Melanoma often develops in an existing mole of any size. If you notice an asymmetrical mole, a mole with an irregular border, a mole that has changed color, or a mole that has a diameter greater than five millimeters (the size of a pencil eraser), see your doctor. Not all mole changes signal melanoma, but it's important to have any changes checked out early.

• Bleeding, pain or ulcerations are usually a sign that a mole may have become a melanoma.

It's also important to know that the risk of melanoma increases with age. Make sure your health professional does a thorough skin exam at least once per year. That includes a look at the top of your ears and your scalp. If you are very fair, a twice-yearly exam may be in order. Your doctor will help you with that decision.

Sun Safety Tips
To decrease your risk of developing skin cancer, here are some all-around, good-sense recommendations:

• Ask your pharmacist or physician if any medications or supplements you're taking will increase your sun sensitivity. Certain antibiotics (i.e., cipro, floxin) and medications containing the sulfa group (i.e., bactrim) can do just that. And some blood-pressure medications like beta blockers and diuretics, especially thiazides (i.e., HCTZ), can make you more susceptible to heat-related illnesses. Even an herbal preparation like St. John's Wort can greatly increase your risk for getting a nasty sunburn.

• I know it can be difficult, but try and avoid sun exposure between 10 a.m. and 4 p.m.

• Use a sunscreen that has an SPF (sun protection factor) of at least 15 and protects against UV-A and UV-B light. Don't forget to apply sunscreen at least a half hour before going out in the sun. Most sunscreens evaporate or rub off fairly quickly, so reapply them according to the directions on the bottle. Generally, you need at least an ounce to cover your body effectively.

• Wear a broad-brimmed hat that keeps the sun off of your face and neck. For those who are follicle-challenged (thinning hair), protect your scalp by wearing a hat.

• Wear sunglasses that provide 100 percent UV-A and UV-B protection.

• Wear clothes with the UPF (Ultraviolet Protection Factor) label. They can reduce your UV exposure by 15 times. For style-conscious folks, there are some cool-looking designs by Solarweave and Solumbra. Clothing without UPF protection should be washed with laundry detergents (i.e., Rit Whitener and Brighteners, or Sunguard) that contain optical brighteners, which protect against UV rays. Also note that darker colors absorb more UV than lighter ones, and cotton offers little protection against the sun.

• Don't let your children get sunburned. Put sunscreen on them when they go outdoors (there are special formulations available for children age 6 and under). Infants 6 months and younger should be kept out of the sun altogether. Remember, children who get sunburned may experience the sun's damaging effects many years after exposure.

• Lastly, it's important to know that tanning salons can cause serious skin damage. My best advice is to put your health ahead of your vanity and stay away from them.

While skin cancer is serious business, remember that with early detection this disease is highly treatable and needn't be a death sentence. For further information on ways you can protect your skin, call the American Cancer Society at 1-800-ACS-2345.

Copyright 2003, Dr. Rob Danoff

Robert Danoff, D.O., M.S., is a family physician. He is program director of Family Practice Residency Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He also is a medical correspondent for The Comcast Network, CN8, contributing writer to the New York Times and writes a weekly medical column for the Bucks Courier Times, Bucks County Pa.