The sun-baked lifestyle goes deep in Florida. So does melanoma, a cancerous consequence of soaking up rays without the right protection.
What’s right? Doctors say merely ramping up the SBF (sun-block factor) is not enough because the composition of the protection you use is probably more important than the numbers alone. Instead, they say, think zinc, as well as titanium.
Both come in compounds offering reflective nanoparticles that can thoroughly cover exposed skin. “Not like wrapping yourself in aluminum foil,” says Dr. William Frazier, board-certified plastic surgeon whose practice is Vero Cosmetic Surgery and MediSpa. “But the next best thing.”
Skin cancer is the most common cancer in the United States. Most cases of melanoma, the deadliest kind of skin cancer, are caused by exposure to ultraviolet (UV) light.
Melanoma is highly preventable, at least for the 60 percent who get it despite having no genetic predisposition. But one almost surefire line of defense – avoiding the sunshine – just won’t cut it for lovers of the outdoors.
For them, as for others under the sun, the key is a careful regimen of protective clothing, effective sun-blockers, indoor activities (not including tanning beds) in the middle of the day and vigilance when something on the skin raises any doubts.
“We are up against a very serious problem with melanoma because we don’t have many choices when it comes to treatment,” says Frazier. “We don’t have a way to cure it unless you can catch it early.”
The incidence of melanoma is increasing, dramatically so in environmental cases lacking a genetic component, and especially on people who have used tanning beds, he said. He’s routinely seeing melanoma in patients in their 20s and 30s; once it was rare in people under 60.
The suspected reasons are varied and range from better detection techniques to the rise of harmful rays from depletion of the ozone layer.
“The sun is a beautiful thing but it is not my friend,” says Chris DeLess, 69, of Vero Beach. “I’ve been a confirmed sun worshipper from age 12 until five years ago.”
Once a school teacher, she’d spend day after day on the beaches of the Jersey Shore, slathered with nothing but baby oil and some iodine. All of that caught up with her; she’s had three episodes that left scars on her leg, forearm and collarbone. “I have not been out in the sun in three years except to walk the dog with sunscreen on,” she said.
“I do love the sun but it’s uglier to get the scars than to get the tan,” she said. “If it’s that special to get a tan, I’ll get a spray tan.”
“People don’t get it – they don’t understand how I had a tiny dot the size of the head of a pin and it was removed and now I have a huge scar.”
The reason: The doctor has to dig deep and give wide enough margins to be sure to get all of the cancer cells.
Now, for the former sunbather who typically baked from noon until 5 p.m., methodically rotating from lying on her back to her stomach for the must-have even tan, it’s about finding a compromise with the sun, and time in it.
“People have complimented me since I stopped baking, they say that my skin looks so much better,” she said. “You get that alligator look. I found other interests other than sunbathing. I do some charity work, work out at the gym, have taken up needlepoint again, and have taken up art and jewelry-making.”
Cathie Callery, a fitness instructor in Vero Beach, had her rude awakening a few years ago at age 49.
“Having the melanoma was a life-changing experience for me,” she said of the suspicious freckle on her shin that turned out to be melanoma. “I now put on sunscreen religiously and buy it in bulk when it’s on sale at the store.”
Callery was a bit perplexed when she got melanoma because she spent most of her younger days indoors at the skating rink. “I was a skater, mostly wearing a coat indoors,” she said.
A few years ago, she noticed a freckle on her leg and asked her dermatologist to take a look at it. It had a “strange edge” to it, and biopsy results indicated melanoma.
“I’m lucky it was caught early,” said Callery, who is so vigilant about sun protection that she won’t even stand in the parking lot to talk to a friend unless she relocates to the shade or pauses in the conversation to grab some sunscreen out of the car and apply it.
The memory of healing from that melanoma surgery on her shin is far too vivid. “It was too painful, I would bend over the kitchen counter, sobbing. I couldn’t flex my foot. I had to walk on the back of my heel. It is the worst pain to date I’ve ever had.”
For the fitness instructor who walks 4 miles daily, it was a huge setback. Her blond hair, blue-eyed, fair complexion and possible genetic background could have been the big contributors to her melanoma.
People can be armed with all the vital information on the harmful effects of the sun, and ways to protect themselves from it, but it is up to them to actually do something about it.
“They are well intentioned but they often do not follow through,” Frazier said. “They complain, (sunscreen) burns their eyes, they smell like a banana, it’s greasy, all sorts of complaints.”
His recommendation: Find something with zinc or titanium or both, put it by your toothbrush so you won’t forget to apply it in the morning, and put it on 365 days a year.
Some 61,061 people in the United States were diagnosed with melanomas of the skin, including 35,248 men and 25,813 women, according to the most recent statistics from the Centers for Disease Control and Prevention. Deaths included 9,154 people, according to the 2010 figures.
It often starts on the skin and spreads to other parts of the body and it can start elsewhere, too – in the ear, eyeball, any place there are pigment cells.
In terms of treatment, the standard is surgical removal. Taking action to avoid sun exposure is critical, Frazier said. He recalled the fuss over seat belts 50 years ago. “No one wore them. Now we buckle up because we now know the way to save our lives is to buckle up.”
“Same with melanoma,” he said. “Protect from sun rays, cover up, put on sun block, don’t go out in the middle of the day. (That) will save people a lot of heartache.”
To lower your skin cancer risk, CDC recommends these options:
- Stay in the shade, especially during midday hours.
- Wear clothing that covers your arms and legs.
- Wear a hat with a wide brim.
- Wear sunglasses that block both UVA and UVB rays.
- Use sunscreen with SPF 15 or higher and both UVA and UVB protection.
- Avoid indoor tanning.