By Dr. W. Gifford Jones
How many sun-worshippers will die of skin cancer in the future? This thought crosses my mind as I look out the window and see the same people day after day basking in the sun. It looks like a healthy pursuit. But looks deceive. The skin is like an elephant. It never forgets the amount of radiation it's received over a lifetime. Current estimates indicate that one adult in 90 will develop a malignant melanoma within his or her lifetime due to overexposure to ultraviolet radiation. So is a suntan really worth the risk?
Dr. Sidney Hurwitz, a dermatologist at Yale University School of Medicine, recently addressed The American Academy of Dermatology. He had frightening news for sun-worshippers; that it requires only one painful, blistering sunburn to double a child's risk of a malignant melanoma.
Dr. Hurwitz says we must get over the misconception that skin cancer is a disease of the elderly. He recently diagnosed malignant melanoma in two patients, one was 12 years old, the other 15. He predicted that if young children continue to overexpose their bodies to the sun skin cancer will reach epidemic proportions by the year 2000.
Nature didn't forget about the sun when designing the skin. Tanning is nature's defence against the sun's ultraviolet rays. How easily you tan depends on the amount of melanin in the skin. It's a brown pigment which helps to filter out the sun's rays. Blacks have the most melanin and are the least likely to get skin cancer. Among Caucasians brunettes have the most melanin, followed by blondes and redheads.
The person most at high risk is blonde and blue-eyed who tans poorly and burns with ease. But don't get too blase about the sun if you're one of the lucky ones who is loaded with melanin. Today skin cancers are also turning up in those with dark complexions.
Canadians would be well advised to take the sun in small doses. Don't be mislead by the tan. It goes away during the winter. But the ultraviolet radiation is never lost . It accumulates year after year causing premature aging of the skin and in some patients cancer. Today the evidence suggests that no tan is a safe tan.
Melanoma has a notorious reputation as a killer as there's usually a delay of one year in the diagnosis. But early diagnosis is easier said than done. Patients cannot routinely distinguish between a mole and a melanoma because the gradual change in the mole is imperceptible to most people. And doctors , including dermatologists, can and do discount the lesion as benign.
What should you look for? All melanomas have either an irregular border,an irregular colour, an irregular topography or a combination of all three. Colours that are suggestive of a malignant melanoma are red, blue, ink-black or white. In contrast benign moles are round with distinct borders and even -coloured.
The message is quite clear. We should all get to know our own skin. Both sexes should practice monthly skin examinations in the same way as women should routinely examine their breasts for lumps. Remember that a melanoma can develop from previous unblemished skin. So if you notice a new mark or a change in the look of a mole don't delay in seeing your doctor. Melanomas in the early stages are almost 100 per cent curable.
Prevention is better than cure. Remember that we can neither avoid the sun nor hide from it. But don't risk a melanoma by persistently baking in the sun's ultraviolet rays.
The Canadian Dermatological Association offers several tips on how families can avoid skin cancer. Keep sun exposure to a minimum particularly between 10am. and 2pm when the sun's ultraviolet rays are strongest. Use a sunscreen with a Sun Protection Factor (SPF) of 15 or more when working, playing or exercising outside. . Apply the sunscreen half an hour before going outside and reapply every two hours.
Wear a broad-brimmed hat, long pants and a long-sleeved shirt during prolonged periods in the sun. Be careful of reflective surfaces such as snow, sand, concrete and water which can reflect up to 85 per cent of ultraviolet rays.
Conduct monthly self-examinations to detect any changes in moles , freckles or skin discoloration. Examine your own and your children's skin at regular intervals. And teach your children that minimizing sun exposure in the first 18 years of life can decrease the amount of total lifetime exposure to ultraviolet light by 85 per cent. If we all develop an elephant's memory for these tips there'll be fewer cases of skin cancer.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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