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Giving a closer look to skin and other cancers

Saturday, May 4, 2002

By RACHEL WEBB, rawebb@naplesnews.com

They're there when you go to the beach.

They're there when you tee off at the country club.

They're there when you walk out to the mail box and they're even there when you ride in your car.

Anywhere there's daylight, harmful UV rays that are the leading cause of skin cancer are always present, and local physicians and cancer groups hope to bring that to the attention of more residents of the Sunshine State.

"I hear all the time 'That's the reason I came to Florida,'" said Dr. Cynthia Hensley, a board-certified dermatologist working in Bonita Springs

Hensley said the majority of her practice involves skin cancer screening and treatment. Many of those she diagnoses are unaware they have skin cancer and come in for other problems. This month, which is Melanoma/Skin Cancer Detection and Prevention Month, she hopes even more people will be aware of the damage they may be getting when they go outside.

Skin cancer comes in two main forms. The less harmful are squamal and basal cell carcinoma. This type of cancer does not spread and is treatable, but the affected area should be removed. Hensley said she can do the procedure quickly in her office.

More serious, and more rare, is melanoma. This cancer can spread to other organs and is sometimes fatal, Hensley said.

Sun exposure is the main culprit for both types of skin cancer, Hensley said. Convincing Florida residents they need to protect themselves from the sun is the tough part.

In Florida, the American Cancer Society plans to use the month to encourage people to use sunblock, wear protective clothing and eyewear, and discover the benefits of shade, said Melissa Peacock, cancer control coordinator for the organization's local chapter.

According to the American Cancer Society, Florida will rank second in new melanoma cases this year; an estimated 4,100 Floridians will be diagnosed with the cancer this year. Only California is expected to have more.

Protecting yourself from the sun is relatively simple. Cancer advocates and physicians say people should wear a hat and protective clothing when they are going to be exposed and stay in the shade as much as possible.

But perhaps the most crucial is sunblock. Hensley advocates people choose sunblock with a sun protection factor (SPF) against UVA and UVB rays of at least 15. According to the Skin Cancer Foundation, sunblock with an SPF of 15 blocks out 93 percent of UVB rays. An SPF of 30 or more filters out 97 percent of UVB rays and is recommended for people who are sun-sensitive, have skin cancer or are at a higher risk for skin cancer.

Sunblock should be applied liberally, evenly and often, according to the foundation. It should be applied within 30 minutes before going outside and every two hours after that.

The routine can be rigorous, but Peacock said people need to make it a part of their day, just like putting on make up and brushing their teeth.

"It needs to be a part of getting dressed in the morning," Peacock said.

The sun's rays can be damaging even if you're not out at the beach or teeing off at the country club. Hensley advocates people wear sunblock for their daily routine, even if they're just checking the mail.

"You get sun walking to the mail box or driving in your car," she said. "Those increments of 10 to 15 minutes add up."

Though physical barriers can help prevent melanoma, dermatologists also recommend frequent screenings. The American Academy of Dermatologists encourages people to closely examine their entire body, including arms, elbows, feet and back.

Any changes in moles or other lesions should be noted. Troublesome features include asymmetry, irregular or poorly defined borders, color variations and unusual size. Anything larger than six millimeters, about the diameter of a pencil eraser, should raise suspicion.

Those who notice any of these warning signs should contact a dermatologist. Dermatologists can also do screenings in their office.

Once discovered most skin cancers are treatable. Squamous and basal cell carcinomas can be removed. Melanomas can also be removed, but catching melanoma is important as that type of cancer can spread to other organs.

Allan Morgan, 77, now lives in Estero and estimates he's had about 50 basal cell carcinomas since the early 1970s. In his younger days, Morgan spent countless hours soaking up summer sun in his native Boston.

"If it got warm, I was outside," said Morgan, a retired maintenance supervisor for a chain of New England supermarkets. "Years ago it was deemed that to be out in the sun would be healthy."

Morgan sees Dr. Hensley every six weeks for a screening. If she finds anything, the carcinoma can usually be scraped off. Lesions in some areas, like the eye, must be cut out, Morgan said.

Morgan considers himself lucky. He has never been diagnosed with melanoma, but lost his 48-year-old son to the disease about a year ago. His son's melanoma spread to his liver.

Since his first carcinoma 30 years ago, Morgan has changed his lifestyle. He spends less time out in the sun and wears sunblock. With fair skin, he's at a higher risk for skin cancer than his Italian wife, Franca.

"The first time I went the doctor told me I'd have them til the day I died," Morgan said.

Reduce your risk ...

Reprinted with permission from the American Academy of Dermatology. All rights reserved.

To lower the risk for skin cancer, the American Academy of Dermatology recommends that people:

·  Wear sunscreen with an SPF of at least 15. Reapply sunscreen every two hours when outside, even on cloudy days.

·  Wear protective, tightly woven clothing.

·  Wear wide-brimmed hats and sunglasses when outside.

·  Stay in the shade.

·  Do not sunbathe or use tanning beds.