Over the past three decades, instances of skin cancer have increased significantly. In 1973, there were just five-and-a-half cases per 100,000 individuals. Now, one in every five men and women will be diagnosed with skin cancer in their lifetime, according to the American Melanoma Foundation.
"It's a greater issue than it used to be," says Dr. Hazel Vernon of Commonwealth Dermatology. "I don't think people think of skin cancer as the highest diagnosed cancer." Melanoma, a cancer of the pigment cells, called melanocytes, is the third most common of the skin cancers and the most fatal. Normally, melanocytes are responsible for the healthy color of one's skin, but when melanoma develops, melanocytes turn bad and begin to invade other tissues. Melanoma is usually evidenced by a mole that darkens or morphs into an abnormal shape.
Dr. Algin B. Garrett, chair of VCU Medical Center's Department of Dermatology, says the development of skin cancer is due to a combination of sun exposure and a breakdown of one's natural immune system that would normally dispose of sun-damaged cells. "The question is why you have an increase in melanoma when we have been on a campaign [of awareness]," he says.
Dr. Eileen C. Kitces of Richmond Dermatology & Laser Specialists says that patients are coming in quicker when they notice skin abnormalities. "We are diagnosing melanoma at a more early stage." She says she diagnoses at least one case each week.
Vernon, who has been a local dermatologist for 20 years, also points to tanning booths and the cultural emphasis on sporting tan skin. "That tanning booths don't cause melanoma is probably the biggest misconception." She adds that for people ages 25 to 29, melanoma is the most common cancer.
Victoria Hebb, a 20-year-old VCU School of Nursing student, is one of these young diagnoses. Fair-skinned and red-haired, Hebb says she started going to tanning beds several times per week in the summer of 2008. "It gave a pale girl the chance to be tan," she says with a laugh.
Hebb went to the tanning salon only in the summer. But by early July 2009, the Chesterfield County resident noticed an oddly shaped mole on her stomach. Hebb at first discounted it as a mosquito bite but later decided to get it biopsied.
Two weeks later, she learned that she had melanoma in two spots. "Just one trip to the tanning bed triples your chance of melanoma," Hebb says, adding with a sigh, "Good grief! I millionthed my risk." A plastic surgeon removed her malignant growths, but the approximately 3-inch scars on her hairline and stomach are reminders of her need to be cautious.
"If you have one melanoma, you are more likely to develop another one," Garrett says. Vernon adds that that's why surgical procedures always include the removal of a radius of 1 to 3 centimeters of tissue around the malignant spot as a step to prevent recurrence or spreading.
Although chemotherapy is used to treat patients with more progressed forms of melanoma, it sadly does not offer much hope. "That is the only cure — to get them early," Kitces says. Garrett adds that recurrence also depends on the tissue depth of the melanoma and risk factors, such as family history of skin cancer, multiple sunburns throughout one's life and having more than 50 moles.
Through a painful dye procedure, Hebb received the good news that her cancer had not spread. For her and other patients, though, skin cancer must be treated as a chronic condition. She gives herself a full skin exam every month and every three months receives a full-body exam by her dermatologist. She also dons a shirt made of SPF material, a big, floppy hat, sunglasses and sunscreen if she's outdoors.
Vernon recommends generously applying SPF 30 sunscreen, an ounce every two hours, and checking skin for changes in moles' shape, size or color. People older than 35, Vernon adds, should not be getting new moles.
Hebb, who volunteers at local schools to spread the word about melanoma, urges people to stay away from tanning beds. "One person per hour dies of melanoma," she says. "It's not worth risking your life for."