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Skin Cancer Awareness
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By Ernest Gurulé
Now that summer has officially arrived, thoughts might be turning to a new seasonal look. But, before that, it might be wise to think about another look, one that results from spending too much time in the sun. Sunburn is not just an uncomfortable condition, it could be a precursor to skin cancer, the most common and potentially fatal cancer in the United States.

Prolonged exposure to the sun can be dangerous, or worse, said Dr. Camille Stewart, Assistant Professor of Surgery at the University of Colorado School of Medicine. Studies have shown that most skin cancers---between 80-90 percent--- can be traced to ultraviolet rays from the sun. The sun’s radiation often causes permanent damage to skin cells which can, over time, lead to cancer. In other cases, said Stewart, skin cancer percentages are as simple as genetics. “There are patients born with a predisposition.”

Skin cancer, or melanoma, statistics are daunting. According to the American Academy of Dermatology, approximately 9,500 people are diagnosed with skin cancer every day; one in five Americans will develop skin cancer in their lifetime; and more than a million Americans now live with this disease. Women under age fifty, said the AAD, are more likely candidates for skin cancer than men, but the trend reverses after age fifty.

While skin cancer can be dangerous, most cases are not fatal. Still, said Stewart, it’s important to take any unusual appearances or skin abnormalities serious. “Sun exposed areas are the most likely to develop skin cancer,” Stewart cautioned. The first indications appear on areas most exposed to the sun, the head, neck, ears and, frequently, on the eyelids. These signs usually appear as painless lesions or nodules in these areas.

Stewart advises patients use an ‘A-B-C’ tool for assessing if a mole might be dangerous: ‘Asymmetry, Border, Color, Diameter and Evolving.’ “If you draw a line down the center” of the suspect spot and the two sides do not match, you may want to see a doctor. Other indications include the a “jagged or blurry” edge of a lesion. Look also for color. “Is the mole one color throughout or is there variation…melanomas have varying shades of pigment,” Stewart said. Other warning signs include lesions that seem to be growing, features on the spot that seem to be changing or bleeding or if it becomes injured and doesn’t heel.

The Alabama native, now Colorado resident, Stewart warns that time is important when one or more of these indications appear. “I would say if a person has a suspicion of skin cancer,” to visit a doctor. The most accurate diagnosis often requires a biopsy, taking a tissue sample in order to examine it more closely.

Who gets skin cancer can vary. People who work outside or spend a lot of time in the sun, are more likely candidates. But no one is immune, said Stewart. However, the highest risk category for getting skin cancer is fair complexioned people because they have less of the protective pigment or melanin. Still, African-Americans and Hispanics are also not immune and can die from the disease.

Stewart writes in a CU School of Medicine blog, “although melanoma accounts for only about 1 percent of all skin cancer diagnoses, it is responsible for the majority of skin cancer deaths because of its ability to spread to other parts of the body.”

The states with the highest rates for skin cancer are on either coast of the United States, but there a number of landlocked states where the incidents are high. Oddly, Utah, which borders Colorado, ranks in the top five states for the disease. Colorado ranks near the middle for the disease. Variables in these rankings, says the International Journal of Cancer, include strength of the sun’s rays, time spent in outdoor activities, including work, use of sun protection, indoor tanning and early detection.

Even though Colorado ranks near the middle in states for skin cancer, there are some inherent variables for the disease that come from living here, said Stewart in the CU blog, co-authored by her and CU School of Medicine associates. Colorado’s elevation and estimated 300 days of annual sunshine are factors in the rate of residents contracting skin cancer.

Though summer almost guarantees an occasional sunburn, none should be ignored because they’re all warning signs, said Stewart. The more sunburns a person experiences, the higher the risk for skin cancer in the future. Also, children should be monitored as closely, if not more closely, than adults. “If you get many sunburns as a child there’s more opportunity to accumulate mutations.”

Fortunately, said Stewart, there is a simple method for minimizing sunburn and, in the long-term, the chance of acquiring this sometimes fatal disease. “Randomized control studies show that routine application of sunblock decreases the likelihood (of skin cancer),” she suggested. Stewart suggested using a sunscreen with an SPF (sun protection factor) of at least 16. “You don’t need a lot,” she said. But it should be applied daily. Doing so can lesson the chance of getting skin cancer by as much as fifty percent.

It is important to note that a diagnosis of skin cancer is not a death sentence. Not only is it curable, but a five-year survival rate for stages one, two and three melanoma is 98.4 percent, according to the Melanoma Research Alliance. However, as warning signs are ignored, mortality rates rise dramatically. A five-year survival rate of stage 3 melanoma is 63.6 but drops to 22.5 percent in a stage 4 melanoma.

Stewart warns not to ignore suspicious spots on your body. Self-exams are important but even more important is establishing a dialogue with your primary care provider.

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