Skin cancer is the most common form of cancer in the United States, with research showing it is on the rise in adults as well as children. While doctors are uncertain whether its increase can be attributed to everyday sun exposure, an increase in indoor tanning bed use, or a depleting ozone layer, one thing is clear: 95 percent of skin cancer cases are curable if caught early. The three major types of skin cancer are the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma.

The signs

The American Academy of Dermatology recommends that we all examine our skin regularly. This means looking over your entire body, including back, scalp, soles of your feet, the skin between your toes, and even on the palms of your hands. If you see any changes in the size, color, shape, or texture of a mole, if a new mole develops, or if any other unusual change in the skin is found, check with your doctor right away. Dr. Kelle Berggren (DMG), MD, a dermatologist with the DuPage Medical Group in Wheaton, said she recommends an annual visit to the dermatologist to have your moles checked. “About 50 percent of people I see come in because they have a mole that has changed,” Dr. Berggren said. “It’s good to do self-checks, but the annual visit is important. You can look for signs, but I’ve taken melanomas off of 30 year-olds and they are saying, ‘Why are you taking that one off?’ because it won’t match the criteria they think they should be looking for.”

Breaking it down

When you break it down, there are two kinds of skin cancer – melanoma and non-melanoma, Dr. Berggren said. “Basal and squamous cell cancer are non-melanoma and they are so much more common,” she said. According to the American Cancer Society, at www.cancer.org, more than 1 million cases of non-melanoma skin cancer considered to be sun-related are diagnosed each year in the U.S. The incidence of malignant melanoma is one in 75 and has more than tripled in the past 20 years. This is the only skin cancer that is hereditary and it accounts for about 62,190 cases of skin cancer and most of the deaths due to skin cancer each year. Detected early, surgery can often destroy this deadly cancer. But when the cancer spreads it is often unresponsive to radiation and chemotherapy. Dr. Berggren said melanoma “has tons of risk factors, including red hair, freckles, a large number of moles, and sunburns early in life are all risk factors,” she said. “Not your cumulative sun exposure but the burns.” Also, remember that skin cancer can happen to anyone, including dark-skinned people.

Recommendations

Everyone should wear an SPF 30 or higher and try to avoid the sun’s peak hours of 10 a.m. to 4 p.m. “You are supposed to apply a shot glass-sized amount of sunblock each time, and people don’t put enough on,” Dr. Berggren said. “So if they put on a 30 they really are only getting a 15 and if they put on a 15 they are only getting an 8.” Other options include sun-protective clothing (check out www.coolibar.com) and Sunguard, a detergent that adds sunscreen to your clothing. As for avoiding the sun, she says, “It’s tough, but I do go in the sun. I just have adequate sun protection on and I don’t get burned. So you don’t have to be a hermit, just protect yourself.”

All about SPF

Exposure to the sun’s ultraviolet (UV) rays appears to be the most important environmental factor in developing skin cancer. That’s why SPF is so important. SPF means sun protection factor. The number that follows represents the amount of UVB protection the lotion provides. The higher the number the more the sunscreen provides. An SPF rating of 15 means the sunscreen blocks out 93% of the UVB rays and SPF 30 blocks out 97% of those same rays. So wearing SPF 30 doesn’t mean you can stay in the sun twice as long. Always look for a sunscreen that is “wide spectrum” since it will block both types of rays. As for which type to buy, Dr. Berggren says as long as it’s SPF 30, most brands will be the same. She uses Aveeno baby for her child. For herself she uses Neutrogena ultra-sheer for the face and Anthelios SX (sold in department stores and online at www.anthelios.com), which was only available in Europe until last year. Dr. Berggren says those who are sweating a lot, such as adolescents participating in sporting activities, will benefit from a gel-based sunblock. Also, be sure to wear sunglasses that provide 99-100% UVA and UVB protection to protect your eyes from sun exposure that can lead to eye damage.

The ABCDE model

The ABCDE model was developed to help people distinguish between a common mole and a melanoma.

Asymmetry:
Most early melanomas are asymmetrical: a line through the middle would not create matching halves. Common moles are round and symmetrical.

Border:
The borders of early melanomas are often uneven and may have scalloped or notched edges. Common moles have smoother, more even borders.

Color:
Common moles usually are a single shade of brown. Varied shades of brown, tan, or black are often the first sign of melanoma. As melanomas progress, the colors red, white and blue may appear.

Diameter:
Early melanomas tend to grow larger than common moles, generally to at least the size of a pencil eraser (about 6mm, or 1/4-inch, in diameter). However, they may also be smaller.

Evolving:
Melanomas also are associated with sensational changes like hurting, bleeding or itching.