As the days get longer and the weather nicer one can’t help but run outside and take in the summer sun.  Its warming rays help melt away frosty winter memories.  But hidden behind its happy glow lies a dark side.  

“Every time we’re in the sun we damage DNA, the body’s blueprint for healthy cells.  The body is able to repair DNA almost every time,” said Dr. Robert McDonald, a dermatologist with the Dean Specialty Clinic at St. Clare Hospital, Baraboo, “but sometimes it can’t and a group of cells goes off in the wrong direction.”

Those cells can grow out of control turning into spots or bumps on your skin which are cancer.  Sun not only causes DNA damage, it also helps the cancer grow.

“Your body has the ability to find small cancerous growths and kill them.  But sun suppresses your immune system’s ability to do that,” said Dr. McDonald.

It doesn’t take much exposure.  Just two to three blistering sunburns in your life can double your risk of developing skin cancer.

In general, Americans have a one in five chance of developing skin cancer in their lives.  For malignant melanoma, the rarest and deadliest of these cancers, the risk is up 20 fold from the 1930s.

“Part of it is we live longer and part of it is people in the 1930s would wear long sleeve shirts and hats anytime they went outside,” said Dr. McDonald.

Skin Cancer is Common

Skin cancer is the most common form of cancer.  If you add together all the breast, lung, prostate, colorectal and kidney cancer cases, there are still more people diagnosed with skin cancer.  These cancer cases fall into three main types: basal cell, squamous cell and melanoma.

Basal cell carcinoma is the most common of skin cancers accounting for about 75 percent of all cases.  It appears primarily on highly exposed areas to the sun including the face, ears, lips and especially the nose.  It can take a variety of shapes: it might look like a scab or it could be a shiny bump; in some cases a sore that won’t heal.  Rarely does it spread to other parts of the body.

Squamous cell carcinoma is second most common of all skin cancers making up 20 percent of the cases.  It is a bit more aggressive than basal cell and can in some rare cases spread, resulting in death.  These cancers show up as a scaly patch or warty growth usually on over-exposed areas to the sun.  With treatment, there is more than a 95 percent cure rate for both squamous and basal cell cancers.

Malignant melanoma is the rarest of all skin cancers but it’s by far the deadliest.  Just 5 percent of all skin cancers fall into this category and one in ten diagnosed will die from it.  These cancers are identified as dark brown or black mole-like patches with irregular edges. 

“With men, melanoma tends to occur on their backs; for women it’s the upper thighs,” said Dr. McDonald. “Anywhere you have skin pigment, even between the toes you can get a melanoma.  But you’re playing the odds in places you’ve been burned.”

Treatment Options

With all three types of skin cancer, surgery is the main treatment.  And, in most cases these cancers can be cured.  With malignant melanoma timing is the key.  Once it grows deeper into the skin, it has a greater tendency to spread to other parts of the body.  The differences in depth are not very great.

“Most lesions are less than 1 millimeter.  A bad prognosis is three to four millimeters, so we’re not talking very thick,” said Dr. McDonald.

Reducing your Risk

How do you minimize your risk of skin cancer?  Dr. McDonald says know the risk factors.  These include exposure to the sun, a history of blistering burns, a family history of melanoma and a large number of moles and atypical moles.

Minimizing your sun exposure is the best way to cut down your risk of skin cancer.  But Dr. McDonald says that doesn’t mean you can’t enjoy time outdoors.

“I’m all for moderation.  I have patients who say they wear sunscreens every day of the year.  I don’t.  I don’t wear sunscreen when I go to work,” said Dr. McDonald. “I wear sunscreen when I’m out golfing for a long time. I’m all for a little bit of sun.  The problem is some take that as license to go out and fry themselves.”

On the topic of sunscreen Dr. McDonald says it’s not a magic bullet.  In fact he points out that since many people started relying on it, the number of skin cancer cases in the country has actually risen. 

“There’s really not much evidence sunscreen prevents cancer,” he said. “What we think is people don’t burn, so they stay out longer and are exposed to more UV rays.  Sunscreen may block the burn, but not all the damaging rays altogether.”

And Dr. McDonald says in most cases, sunscreen isn’t applied properly.

“That’s why we don’t know if sunscreen works because most people don’t use it right,” said Dr. McDonald, “They use too little, rub it in and only get a little protection.”

But that doesn’t mean you shouldn’t use it said Dr. McDonald. “Sunscreen is like an airbag in a car: you ought to have it but don’t rely just on that one form of protection.”

ABC’s of Melanoma

 Think your mole is out of the ordinary?  Make an appointment with your family physician.  Here are some signs you may need to have it checked out:

A – Asymmetry: if you draw a line through the mole, both sides do not match.

B – Border: the edges of the mole may be uneven, scalloped or notched.

C – Color: moles with red, white, brown, black and blue patches are a warning sign of trouble.

D – Diameter: if the mole is larger than the diameter of a pencil eraser have it checked out.

E – Evolving: any change in size, color or elevation could be signs of melanoma. 

Sunscreen Stats: When an SPF 30 Isn’t a 30

Most sunscreens are tested in laboratories using large amounts of the lotion.  In reality, when scientists look at how much people actually use, it’s about 1/5 that used in the test.  So an SPF 30 really is more like SPF 6.  To get the full protection put a thick coat on your skin, leave it white, and let it soak in.

The Skinny on Skin Cancer

• Men get two times more skin cancer than women.
• In 2007: 59,940 will be diagnosed with melanoma and 8,110 people will die from it.
• Skin color is the most important factor in determining your risk for skin cancer.  The lighter the skin, the greater the chance.  No one is immune.
• African-Americans are more likely to develop skin cancer on areas not exposed to the sun.  32.1 percent of this group is diagnosed at stage 3 or 4, a more advanced stage that is usually fatal.
• Lighter colored clothing may feel better but darker colors absorb more UV rays and offer better protection.

Risk Factors

People with the following traits are at greater risk for skin cancer:

• Family history of skin cancer
• History of severe sunburn
• Freckles from sun damage
• Many moles
• Blue, green or hazel eyes
• Fair skin
• Light brown, blonde or red hair

Additional Resources

www.cancer.org – American Cancer Society

www.skincancer.org – Skin Cancer Foundation

www.coolibar.com – for clothing with extra UV Protection

www.stmarysmadison.com – health & wellness information