Protecting Your Skin from Cancer

Maureen Reagan died from it. Her father, President Ronald Reagan was diagnosed with it. So were former President Bill Clinton and Arizona Senator John McCain. They survived, as did I. We are the lucky ones.

"It" is skin cancer, a disease that more than one million sun-worshiping Americans are diagnosed with each year. Fortunately, most types of skin cancer are easily cured when discovered, diagnosed and treated early.

But, like too many men, I wasn't exceptionally quick to have a bump on my nose and a long-weeping scab on my ear examined. When I finally did get around to seeing Dr. (Lt. Col.) Matthew Ricks at Scott AFB, Ill., he immediately suspected skin cancer on both trouble spots. A quick biopsy and a few days later, his diagnosis was confirmed.

Dr. Ricks: "It's just as I thought; basal cell carcinoma."

Me: "Uh, I have cancer?"

Dr. Ricks: "Yes, but if you have to have cancer, this is the only way to go."

Me: "Whew!"

Dr. Ricks said there are three main types of skin cancer: Basal cell is the most common and is usually found on the top level of the skin in areas that have extensive exposure to the sun. Basal cell cancer is slow moving and the most curable.

Squamous cell involves the flat, scaly cells on the skin's surface and often appears as a small bump or a scar. Commonly found on the nose, forehead and hands, it can spread but it is rarely fatal.

Melanoma attacks the skin's color-producing cells. One of the most serious forms of cancer, The American Cancer Society estimates that about 51,400 new melanomas were diagnosed in the United States during 2001 and nearly 8,000 people died. But even melanoma is survivable if diagnosed and treated early enough-just ask Senator McCain, who was dangerously exposed to the sun during his many years as a prisoner of war in Vietnam.

There are three types of treatment for non-melanoma cancer: surgery, chemotherapy and radiation therapy. Surgery is the most common, and the type prescribed for me. Dr. Ricks performed the outpatient surgery on my nose, but he referred me to a microsurgeon in St. Louis for the more delicate ear procedure. Although I wouldn't describe either operation as pleasant, there was little pain and I took home two nearly invisible scars as souvenirs.

Dermatologists label me as a "high risk" candidate for skin cancer. As a never tanning, always burning, 50-something, fair-skinned, blue-eyed white golfer who, when younger, could have matched freckles with Alfalfa, I filled every block on the skin cancer probability checklist. Blond and red-haired people are the highest risk, dark-skinned Hispanics and African-Americans are the least susceptible.

The National Cancer Institute says that the intensity of sunlight you receive over a lifetime is directly related to your risk. Because sun damage is accumulative, youngsters who are blistered by the sun have a greater chance of getting skin cancer as they age. Dangerous childhood exposure to the sun may be the most important factor in developing skin cancer.

Doctors agree that regular self-examinations between check-ups with your doctor are an all-important factor in discovering skin cancer in its early stages. Keep your eyes open for moles and freckles that grow or change in shape or color. The College of American Pathologists suggests we use its "ABCD Rule" to distinguish a normal mole from one that is cancerous:

Asymmetry: Half of the mole doesn't match the other half.

Border irregularity: The edges of the mole are ragged or notched.

Color: The color of the mole lacks uniformity. There may be differing shades of tan, brown or black and sometimes patches of red, white and blue.

Diameter: The mole is wider than 6 millimeters, or about the size of a pencil eraser.

Because most people receive 85 percent of their lifetime exposure to the sun by age 18, it's important that children learn not to burn. How do we prevent skin cancer in the first place? Use and reapply a waterproof sunscreen with an SPF of 15 or higher (see sidebar), protect your skin with a wide-brimmed hat and long-sleeved clothing when outside, and be extra careful when you're outside between 11 a.m. and 3 p.m. when the sun is at its strongest.

As for me, I draw a few double takes when I take to a broiling St. Louis golf course with my droopy, wide-brimmed hat, long pants and long sleeves these days. Definitely not Tiger-ish, but I like the odds.