When Maureen Reagan, daughter of
ex-president Ronald Reagan, died at 60 on Aug. 8, some people were
surprised at the cause.
‘‘Skin cancer? I didn’t think people died of that,’’ said
one Seattle resident.s
They do, of course, and more of them all the time. Skin cancer is
the fastest-growing form of cancer in the country - even though it’s
one of the most preventable and is the target of research on many
fronts, including the search for a vaccine. Scientists also just
announced identification of a gene for melanoma, the most deadly type
of skin cancer.
The incidence rate for melanoma - the kind that killed Maureen
Reagan - nearly quadrupled in the U.S. from 1973 to 1998. The American
Cancer Society estimates 51,400 Americans will be diagnosed with it
this year, and 7,800 will die from it. Though the percentage of
patients who die is falling somewhat with earlier detection, total
deaths are rising as more people get the disease.
Skin cancer’s impact is notable also because its victims tend to
be younger than those of most cancers. Average age of skin-cancer
diagnosis is 49, and victims in their teens, 20s and 30s are not
uncommon, says researcher Dr. John Thompson of the University of
Washington and the Fred Hutchinson Cancer Research Center.
Experts aren’t certain why overall skin-cancer rates are rising,
but they offer a couple of theories: People are spending more time, in
skimpier clothing, under the skin-damaging sun. And the atmosphere’s
thinning ozone layer allows more damaging ultraviolet rates to reach
us.
Supporting the latter notion is the fact that the world’s highest
rates of skin cancer occur in Australia and among Caucasians in South
Africa, where the ozone layer is more depleted, says Thompson.
Whatever the reasons for skin cancer’s increase, authorities say
far fewer people would die from it, or even get it, if everyone
followed widely accepted prevention and early detection advice.
When detected early, melanoma is 95 percent curable; diagnosed
late, it’s tough to beat, in part because this cancer can quickly
spread to distant parts of the body.
Less dangerous are the non-melanoma skin cancers, basal-cell
carcinoma and squamous-cell carcinoma, which almost never spread
beyond the original site. However, they can invade nearby tissue and
bone, and in rare instances can be fatal.
All three types originate in the skin’s top layer, the epidermis,
then grow deeper if not checked by treatment - primarily, surgery; in
later-stage cases, chemotherapy or radiation may follow. Melanoma
begins most often in an existing mole, usually one exposed to the sun.
Much more rarely, it begins in an area that’s not sun-exposed,
possibly indicating that genetics plays a role.
Still, excessive sun exposure gets the blame for most skin cancer.
Though scientists say a tan represents sun-damaged skin, it remains a
beauty standard.
‘‘We’re up against the ‘Baywatch’ effect,’’ says
Thompson. ‘‘People watch that and want to have a beautiful, tanned
body.’’
Increasingly, studies indicate that too much sun in childhood and
the early teens - especially repeated, severe sunburn - greatly raises
the risk of getting skin cancer later. As adults, we can’t undo the
sunburns we had as kids, but health experts warn parents to make sure
their children avoid too much sun.