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Don't get burned... Melanoma cases still on the rise - Ogden Clinic provided source, Standard-Examiner 5/12/2014

(Standard-Examiner) OGDEN -- One person dies from melanoma - the deadliest form of skin cancer - every hour.

It only takes a few bad sunburns or trips to the tanning bed to put a person at risk for skin cancer, said Dr. Chad Tingey, a board certified dermatologist and Mohs surgeon at Ogden Clinic. Protecting yourself with sunscreen and clothing is still the best way to lower your risk.

"Large studies have shown an increase in Melanoma and skin cancer. We seem to find it earlier, but we also have slightly higher death rates and serious complications from it," Tingey said. "We see it in younger and younger people too. We don’t exactly know why there is more, but the introduction of indoor tanning, heavy sun exposure, and childhood sun burns have been connected. It may also be worse in Utah with the high altitude exposure to ultraviolet light from the sun."

The American Academy of Dermatology estimates one in five Americans will be diagnosed with skin cancer in the course of their lifetime. The American Cancer Society reported 76,690 new cases of melanoma in 2013. In addition, 76 percent of melanomas found in women between the ages of 18 and 29 are associated with tanning bed use.

"Using indoor tanning is like drinking concentrated orange juice without mixing in the three cans of water," Tingey said. "The ultraviolet light is damaging to the DNA of the cells and can cause cancer with over exposure."

Currently in several states, people under 18 can’t go in the beds. They include California, Illinois, Nevada, Texas and Vermont. At least 33 states and the District of Columbia regulate the use of tanning facilities by minors. Utah has mixed or multiple restrictions.

Research also shows the DNA damage may be worse at the young age, and they may be too young to know how to moderate their exposure.

Getting a blistering sunburn as a teen can more than double a person's chance of developing melanoma later in life. Research also shows only 15 percent of males and 37 percent of females say they use sunscreen most of the time or all of the time.

The academy is strongly encouraging the public to learn how to detect skin cancer early through a new campaign launched earlier this month entitled SPOT skin cancer.

"We can cure the earliest melanoma 100 percent," Tingey said. "We are better at finding those than we used to be. Once melanoma has grown and spread in the body there are not great treatments."

Mohs surgery, named after Dr. Fred Mohs, is an ideal approach to many skin cancers, Tingey said. The procedure involves removing the tumor, mapping and color coding it, and then looking for extensions of the tumor under the skin.

"Older methods of removing the skin with a healthy margins of tissue around it showed the tumor would grow back in 10 to 15 percent of the patients, not cool if it’s your nose," Tingey said. "Mohs has less than 0.1 percent grow back, and leaves a smaller wound on the patient. Smaller hole, higher cure rate. It’s really a miraculous procedure."

Tingey said there are also some promising medicines in the future, but not at this time.

"One hope is to teach the immune system to hunt and find the melanoma cells that spread via a vaccine, but that is not currently available," he said.

For now, however, the best thing to do is use sunscreen, wear protective clothing and know how to spot skin cancer.

If you have a sore, or a small growth that pops up and doesn’t go away, please see a board certified dermatologist, Tingey said. Early is always better.

"I’ve had patients wait for things to go away, and the problem just gets worse," he said.

Also follow the A,B,C,D,E rule. A is for Asymmetry where one half of the mole does not match the other half. B is for Border irregularity in which the edges are ragged, notched or blurred. C is for Color that varies from one area to another. D is for Diameter. While melanomas are usually greater than the size of a pencil eraser, when diagnosed, they can be smaller. E is for Evolving. A mole or skin lesion that looks different from the rest or is changing in size, shape or color should be looked at.

The strongest sunscreens have either Zinc Oxide or Titanium Dioxide in them, Tingey said. Those should be used when really going to be outside for a long time.

"The daily sunscreen in the lotions and makeup do fine for average exposure," he said. "Usually anything with an SPF over 30 is helpful. I always say, however, that the best sunscreen is the one that you’ll actually use and reapply. I prefer the spray cans, mostly because I’m too lazy to rub the lotions."