Not So Sunny Spots
You can still get skin cancer even if you haven't spent a lifetime outdoors
Dermatologists who treat skin cancer aren't surprised. "A week doesn't go by that I don't see a woman in her 20s or early 30s with skin cancer," says David Leffell, a professor of dermatology and surgery at the Yale School of Medicine. And although basal cell and squamous cell cancers hardly ever kill, those who develop them are at higher risk for melanoma. Among 25-to-29-year-old women, melanoma is more common than any non-skin cancer, including breast and colon cancer.
When you're young, though, health concerns often take a back seat to more pressing worries, like having a tan for prom. That's how Erika Smith felt. Her grandmother died of melanoma, so Smith knew she was at higher risk for the disease, but that didn't stop her from sunbathing in the backyard of her family's home north of Seattle or going to the tanning parlor regularly. "I felt invincible," says Smith.
But then melanoma struck her family again. Her uncle's wife died of the disease last year at age 35, and Smith, then 19, was devastated. Because she wasn't a blood relative her risk didn't change, but her perspective did. She went to the dermatologist, who biopsied a mole on her calf that looked normal but for a tiny black speck on it. Diagnosis: melanoma, at a very early stage. Now she goes to the dermatologist every six months for a full-body skin exam and avoids the sun.
Leffell and other skin cancer experts believe tanning parlors are one of the major culprits in the rise of skin cancer among young women. A study published in the journal Pediatric s in 2002 found that 40 percent of 17- and 18-year-old girls reported visiting a tanning parlor in the past year (compared with just 11 percent of boys in the same age group). Twenty-three states now restrict minors' use of tanning beds in some way, according to the American Academy of Dermatology. Many states either require parental consent or restrict use to certain age groups.
Fewer scars. How skin cancer is treated depends on many factors, including the type of cancer, whether it's confined to the top layer of the skin, and how important it is to achieve the best cosmetic result. Superficial cancers on the trunk, arms, or legs can often be scraped and burned: The affected skin is gently scraped off with a sharp curette, and then the area is cauterized. Patients with more invasive cancer or with skin cancer on their face may choose to undergo a surgical excision in which the cancerous cells as well as some tissue surrounding the area are removed. This option is more precise than scraping and burning and scars less. Mohs micrographic surgery is the most thorough method for treating basal and squamous cell cancer and also yields the best cosmetic result. It involves removing the diseased tissue layer by layer and mapping the affected area to pinpoint cancer cells.
Even though most sun worshipers no longer aim for the deep, nut-brown tan that was popular in the 1970s, it's still fashionable to get a "healthy" tan in the summer. But there is no such thing, say dermatologists. People tan when the melanin in their skin darkens to protect it from the sun's rays. "The fact that you're making a tan is a sign that you've had an injury to your skin," says John Carucci, director of Mohs micrographic and dermatologic surgery for Weill Medical College at Cornell University.
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