The occurrence of skin cancer has been rising in recent decades and the problem is magnified at higher-elevation locations. An understanding of the risk coupled with a commitment to protect oneself from the main culprit – the sun – is critical to reducing the risk of this scourge.
Skin cancer occurs when the DNA of skin cells is mutated, resulting in abnormal growth of future generations of cells. It is most commonly caused by harmful ultraviolet rays of light from the sun and, in recent years, tanning booths.
While many types of skin cancer exist, the three most common ones are basal cell carcinoma, squamous cell carcinoma and melanoma. The first two, while potentially dangerous, rarely spread to other parts of the body. They usually occur in sun-exposed areas of the skin such as the neck, face, ears and hands.
Basal cell carcinoma affects nearly one million Americans each year. It most commonly appears as a waxy bump or flat, flesh- or brown-colored lesion. Squamous cell carcinoma hits 250,000 Americans annually and appears as a solid red nodule or flat, crusty lesion.
Melanoma, on the other hand, is more rare but also much more serious. It can occur in areas of the body not directly exposed to the sun and may spread to other parts of the body. It can take on a number of forms, including a mole that changes appearance or bleeds, a brown spot with dark spots, a small lesion with irregular edges, or a dark lesion. It causes the majority of the 48,000 worldwide skin cancer-related deaths each year.
Dr. Selma Targovnik, a noted Arizona-based dermatologist, says the incidence of melanoma and other skin cancers continues to rise because of people’s increased participation in outdoor sports and their love for pursuing the perfect tan, which means more time under the sun or in tanning booths. The depletion of Earth’s ozone layer, which protects us from the ultraviolet rays, is another troublesome cause.
Several factors control the likelihood of getting skin cancer, but elevation is of particular interest. Targovnik said, “For every 1.000 feet of elevation, there’s an eight percent increase in ultraviolet light. So being at a high elevation makes you incredibly more at risk than if you were at sea level.” This is bad news not only for hikers and outdoor workers, but also skiers, who absorb both direct sunlight and that reflecting off of the snow.
Targovnik earned her medical degree from Albert Einstein College of Medicine in New York and served on the staff at NYU Skin & Cancer – the largest dermatology center in the country – and Boston University before moving to Phoenix in 1969. She started the dermatology program at Maricopa County Hospital and has been affiliated with a number of medical centers since then.
In her 54 years of practice, she has dealt with countless skin cancer patients. She also has led efforts to educate people about the hazards of sun exposure and strategies for reducing the chances of getting skin cancer.
One of Targovnik’s goals is to correct common misconceptions. “About 85 percent of ultraviolet light comes through the clouds. You often hear people say they got their worst sunburn on a cloudy day. Well, that’s because they didn’t protect themselves because they thought the clouds would block that light.”
She adds that while the majority of skin cancer cases are found in older people, she has seen it affect some individuals in their 20s. Furthermore, skin damage is usually cumulative; poor habits repeated while young often add up to unhealthy long-term conditions.
In general, the lighter a person’s complexion, the greater his/her chance of getting skin cancer. Targovnik recommends these people receive a complete skin examination every six months and self-check on a daily basis. She said in the case of melanoma, “The earlier you catch it, the better the chances of survival.”
Her best advice regarding skin cancer, particularly for people at high elevations, is to spend the time and effort on simple preventative measures. When outdoors, she says, people should wear a hat with a brim of at least three inches. She stressed, “And a cap is not a hat – its brim does not go all the way around and so offers limited protection.”
Sun-protective clothing is also ideal, particularly for workers, hikers and other spending a lot of time outside. This type of outerwear is produced from a special fabric designed to inhibit the penetration of ultraviolet rays.
Sunscreen is another necessary preventative to use. Targovnik said, “Sun screen should be at least 30-50 SPF. It’s important to apply it every two hours, and if swimming, every one hour. This is because the lotion wears off by friction, clothing, sweat and water.”
As for the type of lotion, she said, “It’s good to get a sunscreen that has a physical blocker in addition to the chemical blocker – specifically zinc oxide or titanium dioxide. These are usually commercially packaged for babies and so found in this section of stores.” Chemical sunscreens absorb the sun’s rays while physical ones block the sun’s light. The combination of the two, applied at regular intervals, offers adequate protection to the skin.
While using this sunscreen and protective clothing does not eliminate the possibility of skin cancer, it does significantly lessen the odds, allowing individuals to enjoy the benefits of outdoor living in Arizona’s high country. QCBN
By Kevin Schindler
Quad Cities Business News