Fun in the sun: People are still not taking skin cancer seriously

The area under Lawrence Rogers’ little fingernail was dark and discolored.

Two doctors later confirmed: It was melanoma. Last November, about half of that finger was removed, along with lymph nodes under his arms.

“It’s very rare in people with pigmentation in their skin, and I happen to be an African-American man,” says Rogers, 70, Indianapolis. He says he hadn’t worried about skin cancer before and had only used baby oil. Now, he uses sunscreen.

Rogers is an example of what doctors keep trying to emphasize: No one is immune to skin cancer.

Still, the message doesn’t always sink in — and the result can be deadly.

“We’re seeing a big increase in melanoma in females 20 to 29 years old,” says dermatologist Keeter Sechrist. “I think all of us are concerned that the reason is the tanning bed behavior of teenagers.”

Even though health care experts have promoted protection against sun damage for years, skin cancer remains the most common form of cancer in the United States, with about 1 million cases diagnosed yearly. Of those, the American Cancer Society projects, nearly 60,000 will be melanoma, the most serious skin cancer. It will cause 8,100 deaths, according to projections.

Prevention is the goal in combatting sun cancer, although some risk factors, such as being light-skinned and having lots of moles, can’t be controlled.

Melanoma often starts as small, dark, molelike growths that increase in size and change color. Jeff Wagner, a plastic surgeon-surgical oncologist and director of the Community Network Cutaneous Oncology Program in Indianapolis, says the lesion’s area isn’t as critical as its depth. If detected early, it can be cured, primarily with surgery; however, it can spread quickly. Then, treatment is limited, he says.

The two most common types, basal cell or squamous cell cancers, are highly curable if detected and treated early, usually by freezing or burning the lesions off. They generally don’t spread.

Sometimes the damage is done years before results show up. One blistering sunburn in childhood more than doubles a person’s chances of developing malignant melanoma, according to a 2006 report from the Mayo Clinic.

Consider Bill Baker, 53, also of Indianapolis.

Growing up in the 1960s and ’70s, Baker spent a lot of time in the sun. He played golf and frequently visited a lake cottage. Yet he, like many in those days, rarely applied sunscreen.

“I’d always got blistered up. I had some painful evenings,” he says.
Now, Baker is fighting melanoma. It first appeared in a mole behind a knee in 1984 and was removed. For 20 years, he was clear. Now, it has metastasized to his lungs, lymph nodes and groin.

In the past three years, Baker has had a lump removed, undergone immunotherapy at a National Institutes of Health trial in Maryland and had a cell transfer operation for a groin tumor. He just finished chemotherapy and immunotherapy.

“I’ve gotten great care,” he says. “But it’s been rough. You have to grin and bear it. It’s not easy, but you make do with what you’ve got.”

He’s among the majority of people diagnosed with melanoma — white men older than 50. But melanoma can strike dark-skinned people, too. And when it does, it’s more deadly because it’s more likely to be detected later.

People of color, like everyone else, need to wear sunscreen, Sechrist says, and do self-exams, looking for changes in moles and other skin irregularities.

The sun causes 90 percent of skin cancers. But a plethora of products are on the market to guard against harmful rays.

Some new products, including a sunscreen from Neutrogena, are made with helioplex, which stabilizes protection against ultraviolet A rays. Many cosmetic products, such as moisturizer or foundation, also are equipped with skin protection ingredients. You also can buy protective clothing. Dye-maker Rit offers Sun Guard, a laundry treatment that adds UV protection to clothing.

Sechrist said the biggest mistake people make is not applying enough sunscreen. They should use an ounce — a shot glass full.

But the bottom line, according to Wagner: Avoid excessive skin damage, whether it’s from the sun or tanning beds, and stop habitual or purposeful tanning.

“It doesn’t mean you have to become a vampire and just go out at night,” he says. “You will get a little bit of a tan, even if you put on sunscreen. But you have to use common sense.”

CHANGING YOUR SUN HABITS

Shaping up your sun protection takes planning and practice. Here are a few ways to make today the start of healthy habits rather than the unofficial start to sunburn season.


Make sunscreen a daily routine



For a normal workday (working indoors): SPF 15 on the ears, face and backs of the hands — the most common areas for skin cancer.

When outdoors: Apply water- and sweat-resistant SPF 30 to all exposed areas, reapplied every 45 to 60 minutes.

For extended exposure on the face: An SPF 30 sunscreen that blocks a wide spectrum of rays, such as products with titanium dioxide or zinc oxide (like Zinka).

For vacations close to the equator: SPF 45 to all exposed areas.

Reapply every two hours, even on cloudy days, and after swimming or sweating.

Other habits to develop

Retreat to the shade during peak UV hours, from about 10 a.m. to 4 p.m. If unsure of the sun’s intensity, take the shadow test: If your shadow is shorter than you, the sun’s rays are at their strongest.


Get your vitamin D from a healthy diet and vitamin supplements, not the sun.

Avoid tanning beds, which emit ultraviolet light, which causes skin cancer.

Try a sunless tanner. Products are now available in several shades — including some that gradually darken and modes of application.

If you can see light through a fabric, UV rays can get through, too. A typical lightweight T-shirt usually provides less protection than an SPF 15 sunscreen. Dark colors, tightly woven and dry fabrics are generally the most protective.

Wear a hat with at least a 2- to 3-inch brim on all sides. A baseball cap can protect the forehead and top of the head, but not the ears and back of the neck, where skin cancers often occur.

Sources: American Cancer Society; American Academy of Dermatology; Dr. Brian Adams, department of dermatology, University of Cincinnati.

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