Blocking Skin Cancer
Americans have a love affair with the sun. Despite recent warnings about the dangers of ultraviolet sunlight and the damage it can do, we continually expose ourselves to the sun's powerful rays. But sun worshipper beware; basking in the warm rays that give us an attractive tan each summer may lead to cancer in later life.

That's the message from Dalton dermatologist John Chung, MD, who has received medical fellowship training in skin cancer detection and treatment. "The incidence of skin cancer is increasing yearly-especially malignant melanoma, which is rising at an alarming rate," he says.

He notes that by the year 2000, estimates are that one in 75 Americans will develop melanoma (the most aggressive and deadly of the three skin cancers) in their lifetime. It currently results in 7,000 to 8,000 deaths annually. Major risk factors are sunburn, the presence of skin moles, and an inherited disposition to the cancer.

Melanoma may appear suddenly, sometimes beginning near a mole. A very aggressive cancer, it can metastasize, or spread, to other parts of the body, leading to terminal illness. "For men, the likeliest spot for the cancer is the back; for women, the legs," says Dr. Chung. It affects not only fair-skinned people, who burn easily, but dark-complected people and African Americans.

The second most lethal skin cancer is squamous cell carcinoma. It appears as a nodule or red scaly patch and, like melanoma, can spread by metastasis to other part of the body.

"If someone dies for a non-melanoma, it is probably squamous cell," says Dr. Chung, noting it results in 2,300 to 2,500 deaths annually.

Basal cell carsinoma is the most common and least dangerous of the skin cancers, comprising 75 percent of all reported cases. It appears as a small fleshy bump or nodule, and fair-skinned people are the most vulnerable to the cancer. Though it can cause considerable local tissue damage by extending below the skin to the bone, it rarely metastasizes and is seldom fatal.

The good news, says Dr. Chung, is that all three cancers are highly curable if discovered and treated early. For this reason, he recommends that everyone be thoroughly checked at least once by a person who can recognize skin cancer and then receive periodic exams or administer self-exams.
To properly examine yourself, you need a full-length mirror, a hand-held mirror and a brightly lit room. Check not only the front, back and sides of your body, but such hard-to-see spots such as the scalp and back of neck, back of upper arms, soles and spaces between the toes.

"Sun avoidance is the best defense against cancer," Dr. Chung says. He advises patients to cover up as much as they can when exposed to the sun, wearing clothes that protect arms and legs and a hat to protect the scalp and face. To protect exposed skin, apply a sunscreen with an SPF (sun protection factor) of 15 or higher, he says.

Why does the incidence of skin cancer continue to climb despite the warnings about sun exposure that now abound? Dr. Chung believes it's due to a lag effect.

"Most skin cancers arise from sun exposure before the age of 20, but the cancer itself doesn't show up until later in life," he notes. When most people getting skin cancer today were in their 20s, the dangers were not understood, he adds.

He expects that as information about the sun's harmful effects spreads and people act on it, the incidence of skin cancer will begin to decline.
As the most virulent skin cancer, malignant and melanoma is extremely important to recognize. Four characteristics of the cancer are: Asymmetry, Border Irregularity, Color & Diameter.
* Asymmetry-One half doesn't match the other half.
* Border Irregularity-The edges are ragged, notched or blurred.
* Color-The pigmentation is not uniform. Shades of tan, brown and black are present. Dashes of red, white and blue add to the mottled appearance.
* Diameter-It appears about the size of a pencil eraser. Any growth of a mole should be of concern.

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