Skin Cancer Rates Rise Among Young

Story first appeared in USA Today.

Young women are eight times more likely to develop skin cancer today than they were 40 years ago -- and young men are four times as likely to battle the disease, according to a study from Mayo Clinic researchers.

In a study of Olmstead County, Minn., residents, Mayo Clinic researchers discovered that first-time diagnosis for cutaneous melanomas -- a dangerous skin cancer with a high probability of spreading -- has soared among 18- to 39-year-olds since 1970.

The increasing popularity of indoor tanning beds could be largely to blame for the spike in the incidence of skin cancer among that age group. Despite public health education campaigns designed to decrease behaviors that lead to excessive UV light exposure, children, adolescents and adults continue to put themselves at risk.

What causes teens and young adults to risk their health for a healthy glow? Peer pressure might be a driving factor.

The number of girls who visit tanning salons increases each year before prom and the start of summer. Dermatologists say contemporary body image ideals do little to help.

Though dermatologists constantly warn patients of the dangers of tanning and reminds them of proper sunscreen use, it's tough to get through to younger patients.

Basal cell carcinomas usually appear as a round, raised patch of pink or white skin. They are usually less dangerous than skin melanomas, which are more likely to spread. Both types of skin cancer have been linked to UV exposure.

Skin melanomas require a more intensive treatment plan. If the cancer is in the early stages, the mole and surrounding tissue is removed.

But if the cancer is diagnosed in a later stage, patients also must undergo up to six weeks of radiation treatment because the cancerous cells can move to lymph nodes surrounding the area. Maryland Melanoma Personal Injury Lawyers say that proper identification and treatment in the early stages can avoid legal and health problems down the road.

The Indoor Tanning Association, a Washington-based group that promotes use of tanning beds, disputes the findings of the Mayo Clinic's study because it says the population of Olmsted County does not fairly represent the U.S. population. Because such a high percentage of the study's population is of "Scandinavian/Nordic ancestry," residents already are at a higher risk for skin cancer, its press release said.

The fact is there is no consensus among researchers regarding the relationship between melanoma skin cancer and UV exposure either from the sun or a sunbed.

A dermatologist who works at the Fox Valley branch of Dermatology Associates of Wisconsin, says a stockpile of scientific studies link excessive UV exposure to an increased incidence of skin cancer.

The population of Olmstead County doesn't perfectly represent the U.S. population, but it is a perfect representation of the type of people flocking to tanning salons.

Everyone -- especially younger generations at risk for skin cancer -- should be more cautious during their time outdoors and should examine their skin for changes in appearance early.


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No Laps for Warm Laptops; Skin Damage Possible

Associated Press

 

Have you ever worked on your laptop computer with it sitting on your lap, heating up your legs? If so, you might want to rethink that habit.

Doing it a lot can lead to "toasted skin syndrome," an unusual-looking mottled skin condition caused by long-term heat exposure, according to medical reports.

In one recent case, a 12-year-old boy developed a sponge-patterned skin discoloration on his left thigh after playing computer games a few hours every day for several months.

"He recognized that the laptop got hot on the left side; however, regardless of that, he did not change its position," Swiss researchers reported in an article published Monday in the journal Pediatrics.

Another case involved a Virginia law student who sought treatment for the mottled discoloration on her leg.

Dr. Kimberley Salkey, who treated the young woman, was stumped until she learned the student spent about six hours a day working with her computer propped on her lap. The temperature underneath registered 125 degrees.

That case, from 2007, is one of 10 laptop-related cases reported in medical journals in the past six years.

The condition also can be caused by overuse of heating pads and other heat sources that usually aren't hot enough to cause burns. It's generally harmless but can cause permanent skin darkening. In very rare cases, it can cause damage leading to skin cancers, said the Swiss researchers, Drs. Andreas Arnold and Peter Itin from University Hospital Basel. They do not cite any skin cancer cases linked to laptop use, but suggest, to be safe, placing a carrying case or other heat shield under the laptop if you have to hold it in your lap.

Salkey, an assistant dermatology professor at Eastern Virginia Medical School, said that under the microscope, the affected skin resembles skin damaged by long-term sun exposure.

Major manufacturers including Apple, Hewlett Packard and Dell warn in user manuals against placing laptops on laps or exposed skin for extended periods of time because of the risk for burns.

A medical report several years ago found that men who used laptops on their laps had elevated scrotum temperatures. If prolonged, that kind of heat can decrease sperm production, which can potentially lead to infertility. Whether laptop use itself can cause that kind of harm hasn't been confirmed.

In the past, "toasted skin syndrome" has occurred in workers whose jobs require being close to a heat source, including bakers and glass blowers, and, before central heating, in people who huddled near potbellied stoves to stay warm.

Dr. Anthony J. Mancini, dermatology chief at Children's Memorial Hospital in Chicago, said he'd treated a boy who developed the condition from using a heating pad "hours at a time" to soothe a thigh injured in soccer. Mancini said he'd also seen a case caused by a hot water bottle.

He noted that chronic, prolonged skin inflammation can potentially increase chances for squamous cell skin cancer, which is more aggressive than the most common skin cancer. But Mancini said it's unlikely computer use would lead to cancer since it's so easy to avoid prolonged close skin contact with laptops.

1 in 10 Teens using Sunless Tanning Products

USA Today

About one in 10 U.S. teens slather on sunless tanning products, and those who do are more likely to get sunburns and engage in other skin-damaging behaviors such as indoor tanning, a new study finds.

Looking into the use of sunless tanning lotions and sprays among 1,600 U.S. adolescents aged 11 to 18, researchers found that 10.8% of them had tried the products in the past year. Those who did so tended to be older and female, to have a parent or caregiver who also used such products, and — not surprisingly — to view a tanned appearance as desirable.

The researchers also found that the use of sunless tanning products by teens was associated with higher frequency of sunburn and the use of indoor tanning beds, which have been found to expose users to harmful levels of ultraviolet radiation.

Ultraviolet radiation exposure was recently upgraded to the highest cancer risk category and is also the most common preventable cause of skin cancer, according to background information in the studies.

"Our findings are that in adolescents, use of sunless tanning products appears independently correlated with risky UVR exposure behaviors (indoor tanning and having sunburns in the previous summer) but not with routine use of sunscreen," wrote Vilma E. Cokkinides, of the American Cancer Society, and colleagues, in a news release.

Adolescents, therefore, must be educated about these products and the importance of avoiding indoor tanning and practicing sun-protective behaviors," they added.

The study appears in the September issue of the Archives of Dermatology.

Another study in the same issue of the journal found that adult women sunbathers who were encouraged to use sunless tanning products sunbathed less often, had fewer sunburns, and wore more sun-protective clothing than those who didn't use the products.

"These findings have implications for public health and clinical efforts to prevent skin cancer. Promoting sunless tanning to sunbathers in the context of a skin cancer prevention public health message may be helpful in reducing sunbathing and sunburns and in promoting the use of protective clothing," wrote Sherry L. Pagoto, of the University of Massachusetts Medical School, and colleagues.

"Further research should determine how to further convince tanners to switch to sunless tanning," she added.

Most sunless tanning lotions and sprays contain a chemical called dihydroxyacetone, which combines with amino acids in the skin to produce a tanned color.

Avoid Getting Burned by Sunscreen Ratings

The Baltimore Sun

Temperatures are rising and beach season is in full swing — which means consumers are stocking up on sunscreen.

But it's not as easy as S-P-F.

Store shelves are loaded with sprays and lotions with SPFs, or sun protection factors, approaching triple digits. Some protect against sunburn but not long-term skin damage. Then there's recent research that found all but a sliver of sunscreen products less effective than manufacturers claim — and even potentially dangerous.
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And with all that confounding consumers, medical experts worry that claims of high-level protection could lull consumers into a false sense of security or fears about safety could deter them from using sunscreen altogether.

"Basically, having any kind of protection is better than no protection," said Dr. Ali Hendi, a board-certified dermatologist, surgeon and skin cancer expert in Chevy Chase.

SPF is a measure of protection against UVB rays, which cause burns. If your unprotected skin burns after 10 minutes of exposure, an SPF of 30 that's recommended by many experts would theoretically increase your protection to about 300 minutes. The protection could be shorter-lived, though, as sunscreens become less effective as they rub off with activity, according to the American Academy of Dermatology.

In a study released last month, the Environmental Working Group, a nonprofit public health advocacy group, recommended only 8 percent of 500 sunscreen products it evaluated for effectiveness and safety.

While one in six products now features SPFs higher than 50, EWG research analyst Nneka Leiba contends that most people never put on enough to reach the intended protection level. Nor, she says, do most people reapply every two hours as recommended. The amount of sunscreen manufacturers use in testing is four to five times what people normally use, Leiba added.

"They have a false sense of security of how much protection they're getting and stay out in the sun a lot longer," Leiba said. Her recommendation to consumers on the amount of sunscreen to apply: "Just use two or three times what you think would be enough."

The industry defends the labeling on sunscreens and says the EWG report had serious shortcomings because of questionable scientific methodology.

"The [manufacturers'] testing and SPF number takes into account that real-life use," said Farah K. Ahmed, chair of the sunscreen task force for the Personal Care Products Council, which represents the manufacturers.

Beyond the debate over sunburn protection is the sometimes-overlooked need to also protect against UVA rays, which account for the vast majority of UV radiation to which people are exposed and can lead to premature wrinkles and age spots.

Consumer Reports, in the July issue of its magazine, tested sunscreen sprays and how well they provide what is called "broad spectrum" coverage against both UVA and UVB rays.

The nation's annual toll of skin cancer is more than 1 million cases and more than 11,000 deaths from the disease. UV radiation, much of it from the sun, is the biggest cause of the condition, according the American Cancer Society.

The Detroit skin cancer treatment rate, in addition to concerns about ingredients and labeling, has prompted calls for the federal government to develop better rules to govern the sunscreen industry.

Without better federal oversight, manufacturers "have a long rope with which they can run," said Leiba, the EWG research analyst.

Sunscreens are currently regulated by the Food and Drug Administration as an over-the-counter drug, which covers ingredients, doses, formulas and labeling. New rules involving testing and labeling about UVA protection are expected to be approved in October; manufacturers would have a year to comply.

FDA spokeswoman Shelly Burgess said a 1993 FDA rule never went into effect because it only addressed UVB rays, not UVA rays. And a rule proposed in 2007 that covered UVA exposure generated a lengthy public debate. "It's just taken longer than originally anticipated and more FDA resources to get that done," she said.

Last month's EWG report involves an ingredient designed to slow skin's aging process — a vitamin A derivative called retinyl palmitate — that is found in many sunscreen products. The EWG research points to an FDA study that indicates the ingredient can promote the growth of cancerous tumors.

That drew protests from the Skin Cancer Foundation that the EWG report could discourage people from using sunscreen altogether. That organization's photobiology committee reviewed the data and determined that retinyl palmitate is not a photocarcinogen, according to a statement on its website.

Beyond the debate over sunscreen's science and regulations, consumers should still defer to common sense by wearing protective clothing and avoiding peak sun hours, medical experts advise.

Hendi, the surgeon and skin cancer expert in Chevy Chase, recommends people use densely woven sun-protective clothing to cover their chest, back and arms when they know they will be out in the sun.

He added that "sunscreens do a great job of blocking out the rays." Consumers just need to use them — and reapply, he said.

By the numbers

30: all the SPF you need

39: number of sunscreen products recommended out of 500 evaluated by the Environmental Working Group

4: number of sunscreen sprays among 12 tested and recommended by Consumer Reports

68,720: number of new cases of melanoma, the deadliest form of skin cancer, reported in 2009

1 in 50: number of Caucasians who will get melanoma. The rate is 1 in 1,000 for African-Americans and 1 in 200 for Hispanics.

Source: American Cancer Society, the Environmental Working Group and Consumer Reports

Sunscreen tips

Buy a broad-spectrum sunscreen that protects against both UVA and UVB rays.

Apply sunscreen to exposed skin on a daily basis, even when it's a cloudy day or when you plan to stay mostly indoors.

Avoid the sun during the peak hours of 10 a.m. to 4 p.m. When outside, wear a hat, sunglasses and sun-protective clothing.

Apply sunscreen 15 to 30 minutes before going outside, so the product can adhere and absorb into your skin. And use plenty — at least one ounce, about a shot-glass full.

Reapply sunscreen every two hours, or after swimming, drying off or sweating a lot.

Tanning Beds Triple Melanoma Risks

Minnesota Daily

Research by University professor Dr. DeAnn Lazovich showed that indoor tanning tripled one’s likelihood of developing melanoma.

Using any type of tanning bed for any period of time may increase the likelihood of developing melanoma — the most deadly form of skin cancer — by 74 percent, the study said.

The study showed that frequent patrons of indoor tanning salons were 2 1/2 to three times more likely to develop melanoma than those who have never used indoor tanning beds.

The study defined frequent users as those who spent at least 50 hours, 10 years, or more than 100 sessions using a tanning bed.

“What is remarkable about our results are that they are very consistent," said Dr. DeAnn Lazovich , an associate professor of epidemiology at the University and the principal investigator of the study.

These results fly in the face of past studies, which showed that using tanning beds increased the likelihood of developing melanoma by just 15 percent.

While previous studies suggested that the age of an individual is an important risk factor, Lazovich’s study indicated that frequency of use is the biggest determinant. Those who begin using tanning beds at a young age are likely to use them more frequently, she said.

“While the data has already been quite strong, there were parts of the question that were not answered to all of our satisfaction,” said Dr. Allan Halpern , a dermatologist at Memorial Sloan-Kettering Cancer Center in New York City.

“This study addresses them very well,” he said.

The study examined more than 2,200 Minnesotans — roughly half of whom were diagnosed with melanoma — and gathered information on their tanning habits and compared that data to the cancer-free control group.

“Doing it in Minnesota where we know we have a lot of indoor tanning use really makes a study like this possible,” Lazovich said.

Even Treatable Skin Cancer is no Sunny Experience

USA Today

 

The most common cancers known to humankind are not, fortunately, the most deadly. The vast majority of non-melanoma skin cancers can be cured in a single day, in a single procedure.

But they still have a major impact. More than 2 million Americans were treated for 3.5 million non-melanoma skin cancers (mostly basal cell and squamous cell carcinomas) in 2006 — and the numbers are growing steadily, one new study says.

"It's a huge public health problem" clearly linked to too much sun exposure and tanning, says Brett Coldiron, a dermatologist in Cincinnati and a co-author of the study, published in the March Archives of Dermatology. The study, which counted skin cancer removals among Medicare recipients and estimated cases in the rest of the population, found twice as many of the cancers as a 1994 study (done with different methods). It also found skin cancer removals in Medicare patients increased 4% a year from 1992 to 2006.

It's possible the new study overcounted some cancers that required multiple treatments. But it also missed cancers fully removed during biopsies, the authors say.

"In any case, we're talking about large numbers of individuals," says Robert Stern, a dermatologist at Beth Israel Deaconess Medical Center in Boston. He conducted another study that concluded one in five white, non-Hispanic Americans has at least one non-melanoma skin cancer by age 70.

Many have had experiences like these:

• Kristin Epps, 32, of Houston says she got in her car and "bawled like a baby" the day a doctor told her the spot on her collarbone and the persistent pimple on her cheek were skin cancers. Returning for surgery on her face "was one of the scariest things I've ever been though in my life," Epps says. She wore bandages for weeks and needed a laser procedure to reduce scarring.

• "I'm embarrassed by it," says Jim Curtis, 72, of Lafayette, Colo. The otherwise-healthy retiree runs, hikes and plays golf. His four skin cancers were souvenirs of a careless youth, he says: "I used to try to get as sunburned as I could." Now he dutifully wears hats and sunscreens and checks in with his dermatologist every three or four months.

• Pat Henneberry, 48, of Austin saw her grandmother lose her nose to skin cancer treated too late and has had so many of her own skin cancers removed that she has lost count. She blames years of combining oil-slathered sunbathing with pale Irish skin. "I love the sun, and I wish it wasn't damaging. ... But now I know my skin is an organ, like my liver or my kidney, that I have to treat right." She still spends lots of time outside, but she wears long sleeves, wide-brimmed hats, big sunglasses and plenty of sunscreen.

The fact that the face is the most common place for these cancers increases their profile, says Deborah Sarnoff, a dermatologist in New York City and vice president of the non-profit Skin Cancer Foundation. "Your face is the first thing people see. It's your billboard. It's your identity."

Modern surgery can do wonders, "but you almost always end up with a scar," Coldiron says.

And, even today, some people fare much worse. "I've seen people lose their eyes," says Howard Rogers, a dermatologist in Norwich, Conn., and co-author of the Medicare study. "And there are rare cases of death," he says, usually from squamous cell carcinomas, which are most dangerous for people with suppressed immunity.

Regardless of outcome, "people don't like hearing the word 'cancer' at all," Coldiron says.

It comes as an especially big shock to young people, Sarnoff says: "It used to be unusual to see teenagers or women in their 20 or 30s with skin cancer. It's not that unusual anymore."