Melanoma rate rises sharply

FAIRMONT – We know more now about preventing skin cancer than our sun-loving predecessors, but do we truly understand what we’ve learned?

New data from the Minnesota Department of Health released this month shows that melanoma skin cancer is increasing at an alarming rate among Minnesotans, jumping 35 percent for males and 38 percent for females from 2005 to 2009, and doubling for both genders since 1988. Though basal and squamous cell skin cancers are more commonly diagnosed than melanoma, the latter is the more serious.

“If not found early, melanomas can spread to other parts of the body and can be deadly,” said Dr. Ed Ehlinger, state commissioner of health, in a written statement.

According to the Centers for Disease Control and Prevention, exposure to ultraviolet light causes about 65 percent to 90 percent of melanomas, but avoiding UV rays still does not seem to be a priority for many.

Martin County had 32 reported melanoma diagnoses from 2005-09, an incidence rate of 25.8 out of 100,000. Faribault County had 30 cases, a rate of 35.6 out of 100,000 – the third-highest rate reported in the state, topped only by Dodge and Olmstead counties.

Examining the rates based on gender and age has helped point to possible causes for the melanoma rates, since those most affected by this cancer seem to be older men and young women.

In both Faribault and Martin counties, the majority of the cases occurred in men, and it probably would not be unreasonable to postulate that many of these men were farmers.

Dr. Stephan Thome, a specialist in oncology and hematology with Mayo Clinic Health System in Mankato, has personally observed an increase in melanoma diagnoses in the area through the patients who walk through his door.

He has also detected a pattern: For young women, melanomas are often on the trunk and legs, whereas older men have more on their face and head.

“Think of the farmers sitting on tractors getting burned by the sun, and young ladies who want to look like a supermodel going to tanning booths,” he said.

While there has been some controversy in the past whether tanning booths cause cancer, in 2009, the International Agency for Research on Cancer announced that sunbeds are definitely carcinogenic to humans. The announcement was backed by research that found the risk of melanoma was 75 percent greater in people who started using tanning booths regularly before age 30.

Of the three types of UV rays people are exposed to, “A” is the least toxic, since it takes the longest to damage a cell. “B” is more toxic than “A,” and “C” is the worst, but it’s also the one we get the least exposure to.

“A tanning booth gives you more A,” Thome said. “… The problem is it gives a false sense of security, because your skin is not hurting, but the skin is getting damaged.”

The best way to prevent skin cancer is to avoid exposure to UV light, and that goes double for skin types that burn more easily. When you are out in the sun, especially between the hours of 10 a.m. and 4 p.m., Thome recommends wearing protective clothing, sunblock and sunglasses to protect the whites of the eyes – yes, there is such a thing as ocular melanoma.

And people should also be aware of other ways they’re exposed to UV rays. One example is the light used to dry gel nail polish. Those manicured nails could come at an unsightly cost, since Thome has found melanoma on a finger is particularly tough to remove, without removing the finger itself.

Another way people are exposed is ultraviolet wands used for disinfecting surfaces, and some black lights.

“If it’s UV light, they’re radiating their own skin,” Thome said.

Before anyone gets too paranoid about UV rays, the doctor brought up one positive.

“We do want people to get 10-15 minutes sunlight for Vitamin D,” he said. “… A little tan is not a bad thing. It’s a careful balance. You don’t want to overdose, but you don’t want to be a hermit and live in a cave.”

Snowbirds or vacationers heading to warmer climates this time of year should be on high alert against sun burns, warns the Minnesota Department of Health.

So is there anything to the idea of getting a “starter tan” before going out into the sun after a long winter break? For anyone unfamiliar with the concept, some people like to do a few sessions in a tanning bed to warm up their skin to UV light and ideally prevent a major burn when they go on vacation and spend hours in the sun.

“I cannot in good conscience recommend anybody go in a tanning booth,” Thome said.

On the flip side, if people do choose to get a starter tan, he suggests doing only a minute or two at a time, rather than 10 to 15 minutes.

“These modern lamps are so powerful, and they surround your whole body. That’s a whole bunch of radiation, and how are you going to dose it?” he said. “So if one is going to do it, I would go as short a time as possible.”

In order to detect melanomas, people should regularly do a full body check on themselves, or have a partner or physician help them.

Ask a physician about any suspicious spots.

“Know what your skin looks like so you know if something changes,” Thome said.

And remember the ABCs of skin cancer:

o A is for asymmetry, when one part of a skin growth is different from the other.

o B is for border irregularity, since melanomas can have borders that are vaguely defined.

o C is for color changes, as multiple colors or uneven distribution of color can indicate cancer.

o D is for diameter, referring to the size of a skin growth. Anything larger than a pencil eraser should be checked by a doctor.

o E is for evolution, since any change in a mole should be monitored.