Experts Hit Streets to Urge Caution in Skin Cancer-Prone S.D.

Local dermatologists and the American Cancer Society, fearing that skin cancer may be reaching epidemic levels in San Diego, have been hitting the streets to screen citizens for the disease and push the importance of prevention.

Since April, the cancer society has dispatched about 60 volunteer doctors to makeshift clinics at beaches, surfing contests, retirement homes, Padres baseball games, golf tournaments and shopping centers to offer free screenings and information.

They have been successful, according to cancer society figures. As of Monday, about 2,013 people had been screened for skin cancer throughout the county, a record high annual rate.

Easily Cured at First

“Recognizing the severity of the problem, we went whole-hog several years ago and made a big campaign of this,” said Dr. Mitch Goldman, a La Jolla dermatologist and nationally recognized skin cancer expert. “One purpose has been to detect skin cancer. The other thrust is public awareness. The key thing is early diagnosis, because in the early stages, cancer usually can be treated and cured.”

Some statistics have been less than reassuring. So far, 105 cases of skin cancer, including 13 involving melanoma, the deadliest form, have been detected--another all-time high.

In fact, the incidence of melanoma has increased 60% in the past 13 years, and 500 new cases are expected to be diagnosed this year, according to Dr. Edward McClay, who heads a skin cancer treatment program at the UC San Diego Cancer Center.

Those findings, and a computer-generated study projecting that 25% of all light-skinned San Diego County residents will have skin cancer by age 55, have cancer experts alarmed.

“We’ve picked up more skin cancers per screen than at any other year so far,” Goldman said. “It has been amazing.”

Skin cancer of three types--basal cell carcinoma, squamous cell carcinoma, and melanoma--usually results from excessive exposure to the sun’s powerful ultraviolet rays. Light-skinned people with red or blond hair are more likely to be affected by the rays, experts say.

‘Any Tan Is Not a Safe Tan’

The majority of skin tumors arise on parts of the body most exposed to the sun, such as the face, tops of ears and backs of hands, as well as the scalps of bald men.

But the shoulders, backs and chests of men and the lower legs of women have become more common sites for cancer as sunbathers have exposed those areas.

“The sad fact is that tanning per se does damage to your skin cells. Any tan is not a safe tan,” Goldman said. “We don’t live in Southern California to hide in caves. But we should be smart in how we enjoy the sunshine.”

San Diego residents and visitors actually face a greatly increased risk of developing skin cancer, cancer society officials say. Because the area is close to the Equator, it receives a higher intensity of ultraviolet rays than most other places. A sandy beach, for instance, increases ultraviolet intensity by 25%. In fact, San Diego’s rate of skin cancer is at least 50% higher than San Francisco’s.

The depletion of the ozone layer, which offers some protection from ultraviolet rays, is also a factor, experts say.

But simple lack of awareness about suntanning and sun exposure remains a key cause for skin cancer, officials say.

Melanoma at 32

“I’m finding that people just say, ‘Oh, that’s too bad. But I’m being careful.’ Until something happens to them, people just don’t really stop and listen,” said Delorie Thomas, 32, who three years ago discovered she had melanoma. “I’d like to get in front of a TV camera and say, ‘Hey, stop it and listen!’ ”

Doctors found an irregular mole on the back of Thomas’ arm, and discovered it was in a late stage of melanoma, which usually is incurable, she said. They advised her not to have children, and told her she had a 35% chance of being alive in five years.

Thomas now works for the cancer society, offering emotional counseling for victims of skin cancer.

“Mine was just one of those things where you have a mole there from the beginning, and after a while, you don’t pay much attention to it,” she said. “Screening would have caught it in one second. That’s why it’s so important--because it can save lives.”

Last year, the cancer society conducted the largest skin screening campaign in the nation, checking 7,449 San Diegans at 75 sites for skin cancer and detecting more than 300 cases, including 25 cases of melanoma, officials said.

Doctors participating in this year’s program say they are hoping to catch the disease early with the screenings, in which they examine general areas, such as the arms, legs and backs. If some form of cancer is detected, volunteers encourage the person to visit a dermatologist, and distribute to him a list of all such doctors in the San Diego area.

Don’t Notice Symptoms

Many of those in whom cancer is detected have not noticed the symptoms, such as unusual growth or color change in the skin, or a mole that has changed size, shape or color. Such symptoms may take up to 20 years to appear. But discovering cancer in young people is an increasingly common phenomenon, experts say.

“Not a week goes by that I don’t treat a person in their 20s or 30s with skin cancer,” Goldman said.

Using sunscreen repeatedly and avoiding the sun during peak hours (10 a.m. to 3 p.m.) are the most effective ways of preventing skin cancer, doctors say. In fact, one application of a sunscreen with a protection factor of 15 offers 80% protection. Regular checkups with a dermatologist also are recommended.

But failing to take such simple precautionary measures can just as easily invite skin cancer, experts warn. For instance, one severe sunburn of a child, whose skin is more susceptible to ultraviolet rays, doubles his risk of getting skin cancer.