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Sun and Skin

Protect Yourself

Randi Carlson of Alameda considered her diagnosis of melanoma a stroke of good fortune. "I was lucky I could see it. If it had been on my back, I wouldn't be alive today."

Blonde-haired, green-eyed Carlson never gave a second thought to the endless hours of sunning and swimming that were part of her experience growing up in Arizona. It was not until her mid-40s that Carlson would learn the awful legacy of her childhood in the sun.

Carlson, now 53, never suspected that the new mole on her thigh, which was small, round and pink--but growing rapidly-- was actually a reason for concern. After all, it didn't fit what Carlson knew about the ABCD's of melanoma cancer-- asymmetry (A), irregular borders (B), multiple colors (C), diameter larger than a pencil eraser (D)--which require immediate evaluation. She learned from her Oakland dermatologist, Dr. Christine Avakoff, that quickly evolving moles (E) also demand attention.Avakoff is emphatic about skin changes."If in doubt, check it out."

Dermatologists Leslie Hilger and Richard Graham, practicing in Alameda and Oakland, echo this sentiment. In his 30-year practice, Hilger has seen a three- to four-fold increase in melanoma among all age and ethnic groups. According to Hilger, "50,000 new cases of melanoma are diagnosed nationwide each year. 8,000 of those cases will prove fatal." Graham adds that, "Melanoma is the leading cause of cancer death for women under the age of 30."

Both physicians feel it is crucial to dispel the dangerous misconception that only fair-haired, light-skinned people over 50 are susceptible to skin cancer. "There has been a significant increase in skin cancer cases in Hispanic and African-American populations and in patients as young as 20," Hilger says. Basal and squamous cell cancers, although rarely fatal, constitute the largest number of skin cancers--over one million cases nationwide-- identified this year. Symptoms of these common cancers include small lumps or sores that don't heal and may appear smooth, waxy and shiny.

Most dermatologists urge the use of sunscreen products SPF 15 to SPF 30, opaque clothing and hats as the best way to protect the skin.The use of tanning booths is strongly discouraged. And although there is general consensus that excess sun exposure, particularly sunburn, can significantly raise the risk for developing skin cancer, sometimes years later, there is ongoing debate about the health benefits of totally eschewing the sun.

Lani Simpson, a Berkeley health care provider, is concerned that advocating complete avoidance of sun exposure amounts to a "backlash against vitamin D." Simpson says it is essential to remember the fundamental role vitamin D--manufactured in the skin in response to sunlight--plays in building strong bones; protecting against breast, colon and prostrate cancers; and in reducing depression.

Simpson agrees with the use of sunscreen products to prevent sunburn; but she suggests up to 10 minutes of sun exposure, before applying sunscreen, three times per week to assure healthy levels of vitamin D production.

Carlson says of her experience with melanoma, "I no longer feel like just a cancer patient. I talk about it all the time because I want to help raise awareness."