By Gary E. Barr
Special to the Rappahannock News
Basking on the beach.
Toiling in the noonday sun.
Covering our eyes from the glare.
Showing off our bronzed arms and legs.
Ah, summertime and those languid sun-drenched afternoons. Soaking in the sun to the point of being burning hot is not only uncomfortable but potentially lethal.
Melanoma (skin cancer) is the most common type of cancer with more than one million Americans contracting the disease each year. People who don less clothing at pools and beaches to escape the intense summer heat may be playing a deadly game of roulette with their skin.
“Untreated melanoma is universally fatal,” said Dr. Chauncey McHargue of Dominion Dermatology Associates in Culpeper. One week each month, he flies to the Henry Ford Hospital in Detroit to teach week-long courses on cutaneous lymphoma.
According to the American Academy of Dermatology (AAD), “Overexposure to ultraviolet light, especially if it results in sunburn and blistering, is the main cause of skin cancer.”
McHargue saud that melanoma usually results from years of overexposure to the sun.
“The majority of melanoma patients are over 65,” said McHargue adding “but their problems are the result of cumulative effects that can start at the age of 5.”
McHargue estimates that 80 percent of the harmful exposure to the sun occurs before people reach the age of 18. His advice to parents, “It’s very important to get kids lathered-up with sunscreen.” Skin cancer can take several years to develop or appear and protection should start early in life.
McHargue explained the normal two-step process for melanomas, “First, ultraviolet rays do direct damage to the skin. Early in life this builds and secondly, as aging occurs there is a reduced ability for our immune systems to fight off skin cancer — the skin dries and has less protection.”
Melanoma begins on skin surfaces and, if untreated, grows inward. Eventually cancers may reach the blood and lymphatic vessels and spread throughout the body. When this occurs, the melanoma becomes deadly.
People may look odd in long sleeves during a heat wave, but they are guarding their skin against overexposure to UV rays. Other important steps are: avoid the sun during the 10 a.m. to 4 p.m. hours when UV rays are most intense; wear light-colored, tightly-knit clothes, a wide-brimmed hat and sunglasses; and properly apply a good sunscreen.
“The biggest mistake people make is not putting on sunscreen properly,” said McHargue. “It needs to be put on dry skin — hot, sweaty skin causes it to wash off. And it’s best to put sunscreen on early in the day. One error is putting it on just prior to exposure or applying it at a time when people’s skin is moist.”
When asked about tanning salons, McHargue and the AAD both agree. McHargue said emphatically, “Tanning beds can definitely cause skin cancer.” And an AAD pamphlet titled Sunscreens/Sunblocks states, “Avoid tanning beds. UV light from the sun and tanning beds cause skin cancer and wrinkling.”
McHargue said that 20 years ago 20 percent of the patients he saw had skin cancer. Today, 60 percent of the patients he sees have it. This is primarily because of the higher population of older people, many of whom did not use sunscreen when they were young. The good news is that the melanoma death rate is actually declining because diagnosis is better, patients are seeking help sooner, and treatment during early stages of the disease is more effective.
Even with these encouraging signs, every year more than 7,700 Americans will die from skin cancer.
“The majority of cases occur on the face and backs of hands,” said Dr. McHargue. “They keep me busy.” He said the nose and tops of ears need to be protected with sunscreen or shaded as much as possible, and that UV rays are just as harmful on cloudy days and during winter.
As the long, hot summer with accompanying intense sunlight continues, precautions are vital. Parents can set an example for their children by preventing overexposure to the sun.
The AAD warns: “There is no such thing as a safe tan.” With this in mind, people have to choose between premature death from skin cancer or enjoying a longer life even if they are not “in-style.”
Warning signs of melanoma
Changes in the surface of a mole
Scaliness, oozing, bleeding, or the appearance of a new bump
Spread of pigment from the border of a mole into surrounding skin
Change in sensation including itchiness, tenderness, or pain
At risk group
A history of sunburns
More than 50 moles (average is 30)
Atypical moles (strange shapes and appearances)
Close relatives who have had melanoma
Dilated blood vessels
Older looking skin
Use generous amounts of sunscreen especially on children — SPF 15 or higher, reapply every two hours.
Wear long sleeved shirts, pants, wide-brimmed hat, and sunglasses.
Avoid sun from 10 a.m. to 4 p.m., seek shade when appropriate.
Avoid lengthy reflections of sunlight from water, snow, and sand.
Get vitamin D — through proper diet or supplements.
Avoid tanning beds, consider self-tanning products that don’t require sunlight (liquid applications).
Self-examination — watch for unusual changes, growths, bleeding of skin