Despite risks of melanoma, many still tan unprotected skin Posted Sunday, May 29, 2005 by arjuna


Wednesday, May 25, 2005
By Alana Semuels, Pittsburgh Post-Gazette

People take risks with their health every day. They go jogging without reflective gear. They eat fast food more than they should. They don't floss. And they love to lie out in the sun.

Doctors say that despite numerous warnings about the dangers of skin cancer, Americans still are willing to risk it through unprotected exposure to the sun, and that cavalier attitudes towards the sun could cause many more deaths from skin cancer in the coming years.

Marjorie Gross of Oakland and Wiley Master of Seven Fields are good illustrations of this. Gross did not heed the warnings of her physician father when she was young, and has battled skin cancer for the past 20 years. Master tried to do the good thing by introducing people to sunless tanning, but they just weren't interested.

Their dual experiences might help explain why the lifetime chances of getting melanoma, the deadliest form of skin cancer, are now about 1 in 65. By 2010, that risk will rise about 1 in 50, said Dr. John Kirkwood, director of the Melanoma Center at the University of Pittsburgh.

"That is an epidemic of untold proportions," he said.

Melanoma often hits people at a younger age than do other common types of cancers, affecting people in their 30s and 40s. More productive life years are lost to melanoma than to any cancers after pediatric and testicular cancers, Kirkwood said. And it's beginning to affect people who are even younger.

Some doctors even say that the incidence of melanoma in children, which previously was rare, is increasing. The two most common types of skin cancer, basal cell and squamous cell, are rarely deadly, so an increase in melanoma means more deaths caused by it.

Melanoma is dangerous because it is often not caught early enough. If diagnosed and treated early, it is not deadly. But if not caught, it can spread quickly to other layers of the skin and onto other organs in the body, at which point it's very difficult to treat.

Research suggests that sun has a negative effect on the immune system. It can damage the Langerhans cells in skin, which are essential in helping initiate immune response. With damaged cells, the immune system's response to foreign invaders is often delayed or subdued.

Skin cancer also preys on people with already weakened immune systems, said Dr. John Zitelli, a Pittsburgh doctor who is also on the medical board of the Skin Cancer Foundation.

Kidney transplant patients taking drugs to suppress their immune systems are susceptible to skin cancers.

Skin cancers are caused when UV light penetrates the skin and welds genes together to such a degree that the body cannot repair them.

While a bill has been introduced in the state legislature that would require anyone under 18 to get parental consent to use a tanning bed and would further regulate those establishments, no bill can stop teenagers or anyone else from lying out in the sun on a warm day.

Most doctors acknowledge that it is an individual's decision to tan, and that they can't force people to get smart about sun exposure. Despite all the warnings and horror stories about people dying from skin cancer, sun worshippers often don't think it will hapen to them.

Master opened a tanning salon in Seven Fields in January that offered spray-on tanning only. Within three months, he had to add tanning beds because his customers kept asking for them. He estimates he sells 100 tans in the beds per week, and only about three spray-on.

"I was very hesitant," to buy tanning beds, he said. "I wanted to be in the tanning business in a safer, smarter way."

Customers weren't interested.

Some chalk it up to the invincible feeling of youth.

Even when she was very young, Marjorie Gross, who is now in her 60s, knew that there was a high chance that she would get skin cancer. Her father was a doctor, and he pleaded with his fair-skinned, blue-eyed daughter to cover up.

"But I didn't," she said from the office of her skin cancer doctor. "I was concerned about getting a tan. I was a sun-worshipper."

She first got basal cell cancer 20 years ago, and has had surgeries about a dozen times since then to remove cancerous cells. She's also a breast cancer survivor, and takes medication that weakens her immune system, further making her susceptible to cancer.

"I'm paying the price now," she said. "It was a shock since you always think that it's not going to happen to you."