Burned by the Sun (page 3 of 3)

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Why the Increase?

No one knows for sure why skin cancer is increasing so rapidly. Is it the ozone hole?

Dr. Christenson says, "Our study defined a problem but did not find a cause. Still, we know the main cause is sun exposure, UV rays. I think we're getting more intense, intermittent sun exposure. And in the young, there's more tanning for the prom than ever. Tanning beds are at least as bad as the sun!"

No, they're even worse, says Deborah MacFarlane, MD, associate pro-fessor of dermatology and a Mohs surgeon at M. D. Anderson Cancer Center in Houston. She mentions Paris Hilton on the reality show The Simple Life actually taking the camera inside the tanning bed. "That's being projected out to all these millions of young people as the cool thing to do," she says. "It's not just girls. Boys are doing it too. They think they're going to last forever." Dr. MacFarlane explains that many of the young people she sees with skin cancer have used tanning beds. This was especially true when she was practicing in Vermont, where tanning centers were very popular. One woman in her 20s had five basal cell skin cancers on her front and back in the same areas she'd been darkening at a tanning salon.

Another young patient had been using a tanning bed to get bronzed for a friend's wedding. Although she says this is only anecdotal evidence, Dr. MacFarlane discovered two "really nasty melanomas on her torso, exactly in the areas she'd been tanning, and they were deep. When you remove a melanoma, you have to take out a large amount of skin, and you have to go all the way down to the muscle. She was a pretty girl. So much for looking good for the wedding."

Studies have also linked squamous cell skin cancers to the human papillomavirus (HPV), the group of viruses that cause warts, genital warts and cervical cancer. "We will often see patients with a skin cancer in an area where, as they say, the sun don't shine," says Dr. Kriegel. "The comment is always 'Well, I get no sun there, so how can I have skin cancer?' There are tumors that perhaps have a greater HPV role than an ultraviolet radiation role. But we still have a lot to learn about it."

There's also the genetic link. The propensity to develop skin cancer is passed on genetically, but, Dr. Kriegel says, the cells need ultraviolet radiation to activate them to start to develop into a skin cancer. "So for those who have the genetic predisposition," he says, "if they are compulsive about using sunscreen and careful about not getting sunburns, they may never develop the skin cancer."

The experts like to remind us that skin cancer is largely preventable. As I write this, I can see the newly healing scar on my upper left arm, about an inch and a half long, the result of recent Mohs surgery for recurrence of that basal cell I had years ago. I hope this is the end of it. But I'm only 47.