| Skin cancer is reaching almost epidemic proportions, with one in six Canadians developing some form of the disease, Canadian dermatologists say.Close to 70,000 cases of skin cancer were diagnosed in 2001, compared to 40,000 in 1989, according to Statistics Canada. Most of these cancers are directly related to sun exposure, says Toronto dermatologist Dr. Paul Cohen.If left untreated, skin cancer, depending on the type, can kill. Close to 3,900 Canadians are projected to develop melanoma, the deadliest form of skin cancer, this year, says Cohen. According to Cancer Care Ontario, 840 people will die from melanoma this year.An estimated 72,000 Canadians will develop non-melanoma skin cancer this year. In Ontario, the most recent figures show that about 1,500 new cases of melanoma were diagnosed in the province in 1999; 330 people died from melanoma that year. That's a scary fate for boomers — who used to lie on the beach wearing nothing but a bikini and baby oil — to contemplate.It's equally troubling for any of us, young and old alike, who venture out in the hot sun without sunscreen, sunglasses or a hat.The truth is, says Cohen, that skin cancer can kill, but it is preventable."People have to remember skin cancer is a condition that affects all ages. It is commonly diagnosed in people between 20 and 50. The majority of skin cancers can be prevented as long as you adopt safe sun behaviour. "This type of cancer we have control over, unlike ovarian cancer or breast cancer. We can, and should, be very proactive."But it appears the message is not being heard by one and all.One of the fastest growing cancers in Canada is melanoma, says Cohen. Melanoma does not have to be deadly. It is 95 per cent treatable by surgery if it is caught early enough. But if it has spread to other parts of the body, there is effectively no treatment for it, Cohen says. The other two major forms of skin cancer — basal cell skin cancer and squamous cell carcinoma — are also treatable with surgery. To protect yourself from getting skin cancer in the first place, Cohen and the Canadian Dermatology Association recommend that, with the beginning of summer and for that matter all year round, Canadians should wear sunscreen. "We think about 60 to 70 per cent of cases of skin cancer can be avoided by a safer lifestyle," Cohen says. "People should use a sunscreen of at least SPF 15 and it should be applied in a thick layer."Studies have found that most people who use sunscreen don't use enough of it, he says. "We recommend at least 30 millilitres or the size of a shot glass to cover an entire adult body." Sunscreen should be applied frequently throughout the day, especially if you are sweating, swimming or participating in sports. As well, people shouldn't rely only on sunscreen for protection. They should also wear a hat, sunglasses and seek shade when outside. Perhaps most important, Cohen and others stress, avoid the mid-day sun.There are two types of ultraviolet light that damage the skin, Cohen says. Sunscreen can protect the skin against the harmful effects of both. UVB light causes damage to the epidermis, or outer layer of the skin, causing sunburns and skin cancers. UVA light is also dangerous and is responsible for premature wrinkling and aging and skin cancer. It can also suppress the immune system. Because it takes 10 to 25 years after exposure before any sign of skin cancer or damage develops, many are fooled into a false sense of security. Some people are more susceptible to skin cancer than others and have a genetic predisposition to it. Those people have to take even more care. Those who face an increased risk include: people with a family history of melanoma, people who burn easily when they go out in the sun, those with fair skin and/or freckles or a lot of moles."Even if you've had a childhood sunburn, that puts you at an increased risk of melanoma," says Cohen. Is there any difference between men and women when it comes to skin cancer? Men begin to have higher rates of melanoma than women after the age of 45, says American doctor and author Marianne Legato. They are more affected on the neck and ears, says Legato, who has written Eve's Rib, about gender specific medicine. Women, meanwhile, have more cancerous lesions than men before the age of 40 and tend to be affected on their legs and hips, she says.She recommends that an experienced dermatologist check out the whole body once a year. She has seen cases of melanoma on the vulva, between the toes and in the hair, she writes. One physician used a hair dryer on patients' scalps to make sure he could see the underlying skin and detect a lesion. So Legato recommends that your doctor checks between your toes, your genitals and the soles of your feet. People who are at high risk, and for that matter anyone who has moles, should check them at least once a month, Cohen says. Make it part of your health routine, like checking for breast cancer, he says. "Moles that are asymmetrical should be looked at more carefully, as should moles with an irregular border or irregular colour." While many Canadians are vigilant when it comes to using sunscreen on the beach, they are often remiss when it comes to using it generally in the outdoors. According to a study by the Canadian Dermatology Association, 80 per cent of Canadians use sunscreen when they hit the beach, but only 42 per cent apply it when they're participating in outdoor activities like golfing, running, tennis or swimming.Parents must encourage their kids to use sunscreen, Cohen says. They should make it part of their daily routine like brushing their teeth. "It's especially important to protect the skin of children, young adults and teenagers. These are people that don't worry about skin cancer because they won't see the effects for 10 to 15 years."A lot of damage is done in childhood years and can have serious effect years later," he adds.
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