Could tanning be today’s glamorous cancer trigger, much like cigarettes that were, in their heyday, marketed as sexy and sophisticated?
Yes, say dermatologists and skin-cancer specialists.
Indeed, the rate at which people are getting malignant melanoma — the most aggressive and life-threatening skin cancer — has skyrocketed to one in 50 people, compared with one in 1,500 nearly 90 years ago, says Dr. Sigrun Hallmeyer, a melanoma specialist at Advocate Medical Group.
“It’s a striking increase,” she said. “It’s now the fastest-rising human malignancy, especially affecting young people.”
And the incidence rate is still on the increase.
How could this happen in an age of smartphones, chat bots and digital assistants that offer information overload? After all, the key ways to prevent sun damage in adults are to wear a hat and protective clothing and apply a sunscreen with at least a 40 sun protection factor (SPF) that includes active chemical ingredients such as oxybenzone, octinoxate, octisalate and avobenzone, says Trisha Calvo, deputy editor for health at Consumer Reports. The ingredients create a chemical reaction and work by changing ultraviolet (UV) rays into heat, then releasing that heat from the skin.
“We recommend this for two reasons: First, because in our [Consumer Reports] tests, we found that some sunscreens tested below the SPF number listed on the label,” Calvo says. “And second, because in our tests over the years, we have consistently found that mineral sunscreens perform less well than those with chemical active ingredients.”
The Consumer Reports sunscreen test results can be found here. Sunbathers should liberally apply at least one ounce of sunscreen — roughly the size of one’s palm — over their bodies and reapply it every two hours, the experts say.
For children from six months to three years old, Dr. Adam Friedman, an associate professor of dermatology, says it’s best to use a sunscreen with mineral blockers such as zinc oxide and titanium dioxide because chemicals can irritate babies’ and toddlers’ skin.
For children ages 3 and up, and for teens, use sunscreens with both chemical and mineral blockers to maximize the effectiveness, said Friedman, who also serves as residency program director and director of translational research in the Department of Dermatology at The George Washington University School of Medicine & Health Sciences in Washington, D.C.
The broad-spectrum sunscreens protect against both UVB and UVA exposure, as the latter penetrates the skin more deeply than does UVB exposure, says Dr. Lynne C. Napatalung, a dermatologist at the Illinois Dermatology Institute in Chicago and Buffalo Grove.
UVA is more important for contributing to wrinkles by degrading or breaking down collagen, Napatalung says.
The most effective protection is to stay in the shade, cover children’s strollers, protect children’s bodies with clothing as much as possible and be vigilant, the doctors agreed.
“Sun protection should start at the first moments of life,” Friedman says. “Caregivers need to be diligent. A bad sunburn can be life-threatening for a baby.”
Hallmeyer says the increase in malignant melanoma — a cancer with a life expectancy of just six months until treatment advances 10 years ago — has occurred in part because young people can easily travel to exotic locales to sunbathe.
“Chicago kids can fly down to Florida for spring break,” she said. “Sun worshippers — that’s our highest-risk population — kids who want to look like a photo from Vogue magazine, care our highest-risk population.”
“My biggest fear is that these young people may not make it to the age of 50,” she said, noting that the vast majority of Stage 4 malignant melanoma sufferers die from the malady.
The key is to get screening, since nearly 100 percent of people with Stage 1 melanoma are cured.
That’s particularly important for African-Americans and Latinos, who are more likely than whites to be diagnosed with late-stage melanoma — 52 percent of blacks and 26 percent of Latinos get an initial diagnosis of advanced-stage melanoma, according to dermatological research archives.
And despite a higher incidence of the most aggressive kind of melanoma in whites, overall survival for melanoma in non-whites is significantly lower, according to the Schaumburg-based American Academy of Dermatology.
Melanoma develops in the cells that give skin its color — cells called melanocytes — and spreads quickly to other parts of the body. Yet Immuno Oncology, which harnesses the body’s immune system to fight cancer, now gives melanoma patients new hope to live longer, Hallmeyer says.
“For me, as an oncologist, I think experiencing the effects of new FDA-approved Immuno Oncology drugs like Yervoy, Opdivo and Keytruda must have been how doctors felt when penicillin was started in terms of changing the outcome for so many healthy young people.”
Yet Hallmeyer says she laments the existence of any such diagnoses.
“Ultimately, all types of skin cancers can develop after exposure to (the sun’s rays) that cause genetic changes in skin cells,” she said. The other types of skin cancer are basal and squamous cell carcinoma, which grow slowly and generally do not spread.
Indeed, no tan is good, unless it’s sprayed on, the experts agree.
What else can you do to prevent sun damage? Experts say:
• Stay away from tanning beds. “There is absolutely no waiver. They increase the risk of skin cancer,” says Friedman.
• Read the labels of sunscreen carefully. Guidelines are at the American Academy of Dermotology website (www.aad.org).
• Protect your eyes. Long exposure to sunlight with no sunglasses may cause the skin to thicken over the eyeballs and can damage the lens and cornea.
• Don’t use spray-on sunscreens on children, and don’t spray them in your face — child or adult.
• Examine your skin regularly for changes in existing moles, freckles, bumps and birthmarks and for new skin growths or splotches.
• Use professionally installed window film to make sure your car windows are covered properly and so you get the best skin protection possible – blocking 99 percent of harmful UV rays.
Deep-penetrating UVA rays from the sun pass through ordinary glass and account for 90 percent of the sun’s most damaging rays.
Sandra Guy is a local freelance writer.