A RISKY SKIN GAME TOO MUCH TIME IN THE SUN MAY RESULT IN DANGEROUS CANCERS YEARS LATER.

Byline: Nancy Dillon

Staff Writer

Cheerleading competitions. Spring break. The prom.

Payton Stone said the social pressure to maintain a glowing, caramel-colored suntan was relentless in high school.

So she hit the tanning beds on a near-daily basis.

"It was such a huge trend. I tanned like crazy," said Stone, now 28 and a fashion wholesaler living in Hollywood. "I just felt like people looked much more healthy, more beautiful, with a tan."

Stone visited tanning salons at least three times a week, baking under the blinding lights for 15minutes each session. When the weather was warm, the Arkansas native would lie in the sun with baby oil from 11a.m to 4p.m.

Two weeks ago, Stone was diagnosed with skin cancer. One area is on her right shoulder. Another is on her right chest.

Fortunately, both of Stone's tumors are basal-cell carcinomas, as opposed to the more lethal form of skin cancer called melanoma.

Basal-cell carcinomas account for about 75percent of all skin cancers and rarely metastasize. Melanoma, meanwhile, accounts for 75percent of all skin cancer deaths because it quickly spreads to other parts of the body.

Still, Stone now has a 40percent chance of developing more basal-cell tumors and will have to monitor her skin religiously, doctors said. Left untreated, basal-cell carcinomas can invade deep tissue and require disfiguring surgery.

"You think it's not going to happen to you, but it can," Stone warned.

"My dad already had skin cancer cut off his nose, and my sister had it cut off her forehead. ... I want people to know they should stay out of tanning beds and wear sunblock."

Melanoma up 690 percent

Overexposure to ultraviolet light -- whether from the sun or tanning beds -- is blamed for an alarming rise in skin cancer cases in the United States.

The incidence of melanoma has increased 690percent from 1950 to 2001, according to the American Academy of Dermatology, and the overall mortality rate also is on the rise.

An estimated 10,850 people will die of skin cancer this year (up 13percent from 2002), according to the American Cancer Society.

About 8,110 of these deaths will stem from melanoma, and 2,740 will result from other skin cancers, the cancer society predicts.

Culinary superstar Giada De Laurentiis knows firsthand the heartbreak of deadly skin cancer.

In a recent appearance on the "Today" show, the Los Angeles resident revealed that her younger brother Dino died three years ago of melanoma that metastasized to his liver. He was 30 years old.

The nightmare started in May 2001 with a mole in the center of Dino's back, she said.

First the mole started to itch, and all of a sudden it started to bleed. Dino had the mole removed, and a month later doctors found cancer in a lymph node under his arm. He started chemotherapy.

In January 2003, doctors found little spots on Dino's liver.

"Life was slowly being just completely sucked out of him," she recalled on national TV. "It was awful, and we literally sat in the hospital room and watched his heart stop beating. And it was the worst moment of all our lives."

De Laurentiis said she chose to share her story to warn people about the dangers of sun exposure.

"As children, we spent a lot of time on the beach. And sunscreen wasn't really a big part of our daily routine," she said. "Those were the days when my mom would take a mirror, hold it up to the sun and literally hold it to her face to get a really great, you know, Bain de Soleil tan."

Cancer showing up younger

Dr. Joyce Fox, Stone's dermatologist at Cedars-Sinai Medical Group, said skin cancer is showing up in younger and younger patients every year.

"I do believe it's our recreational practices, we're just outside more for leisure activity. And it's the tanning beds, the trends toward less clothing and all the driving we do," Fox said. "Even when we do use sunscreen, we don't use enough. You should use a shot glass serving to cover your whole body."

Carla Marting, a nurse at Tarzana Hospital, considers herself among the lucky ones.

Growing up in West Hills, Marting spent her summers basking in the sun at local beaches, including Zuma, Leo Carillo and Will Rogers.

"I didn't just go to the beach. I went to the beach and burned. I didn't suntan well. I would burn and peel, burn and peel," she said.

About seven years ago, Marting, now 49, noticed a dark freckle on her shoulder. She had it cut out. Then a spot popped up on her left nostril.

She had it frozen off multiple times, but it returned. Finally, she had a biopsy of the tumor. It was early-stage melanoma that hadn't yet metastasized.

Two weeks ago, Marting underwent Mohs Micrographic surgery, whereby her doctor removed her melanoma in a layer-by-layer process under a microscope and replaced the extracted skin with a ribbon of flesh taken from her forehead.

The ribbon, which remains connected at the base of her forehead, is stretched down her nose to fill the excavated area, maintaining a healthy blood supply from her forehead as it grafts over the next few weeks.

"I'm wearing my forehead on my nose. It's special," she said with a good-natured laugh. "It's not the prettiest thing, but if it gets it all, it'll be worth it."

Marting's Thousand Oaks dermatologist, Dr. Andrew Kaufman, said that, contrary to popular belief, not all melanomas come from pre-existing moles.

"Only about one in three melanomas probably develop from pre-existing moles," he said. "So everyone needs to get checked, not just people with moles."

'Don't bake in the sun'

For Hanoch Kohl of Encino, screening is a fact of life every three months. The former Israeli soldier burned his skin so severely during a 1969 mountain expedition in the Golan Heights, he spent several days in the hospital.

Almost 40 years later, Kohl has survived several carcinomas, including a squamous-cell tumor that spread to his lymph nodes and required a five-hour surgery and radiation.

Squamous-cell carcinoma spreads to other organs faster than basal-cell carcinoma but is generally slow-growing and less serious than melanoma.

"Sometimes I feel like I'm sick and tired of all this cutting and surgeries and pain -- and looking like Quasimodo," the 56-year-old said. "Don't bake in the sun; it's not good."

Kohl's dermatologist, Dr. Mark Guralnick of Kaiser Permanente's Woodland Hills Medical Center, is now treating Kohl proactively, targeting his pre-cancerous cells with topical chemotherapy, liquid nitrogen and photodynamic therapy.

"Given the number of cancers he's had, we're trying to treat him as aggressively as possible," Guralnick said.

"Anyone diagnosed with one skin cancer is at an increased risk of developing another skin cancer."

Nancy Dillon [phone]

nancy.dillon(at)dailynews.com

THE WARNING SIGNS

Dermatologists recommend doing a skin check monthly, so you'll be more likely to notice small changes in your moles or even find a skin cancer when it's still small.

The ABCD rule is a convenient guide to the usual signs of melanoma. Be on the lookout and notify your doctor about any changes in the following factors:

A is for ASYMMETRY: Half of a mole or birthmark does not match the other.

B is for BORDER: The edges are irregular, ragged, notched or blurred.

C is for COLOR: The color is not the same all over, instead exhibiting differing shades of brown or black, sometimes with patches of red, white or blue.

D is for DIAMETER: The area is larger than 6 millimeters (about (bul) inch -- the size of a pencil eraser) or is growing larger.

The most important warning sign for skin cancer is a spot on the skin that is changing in size, shape or color over a period of one month to one or two years.

Source: American Cancer Society

CAPTION(S):

5 photos, box

Photo:

(1 -- cover -- color) Skin deep

The high price of a golden glow 

(2 -- 3 -- color) At right, Carla Marting, a nurse at Tarzana Hospital, looks at herself in a mirror at her Camarillo home after having skin cancer surgery on her left nostril. Marting grew up in West Hills, basking in the sun, inset above, often burning and peeling.

(4 -- 5 -- color) Payton Stone, 28, likes to relax next to her apartment pool in Hollywood. She grew up lying in the sun and in tanning salons. Two weeks ago, she was diagnosed with skin cancer. Inset is Stone with her dad, who also has skin cancer.

Tina Burch/Staff Photographer

Box:

THE WARNING SIGNS (see text)