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Burning down the sun.


Although the use of sunscreens to prevent sunburn has substantially risen in recent years, there has been an ominous rise in another statistic related to the American passion for sunbathing--i.e., the incidence of malignant melanoma. Fifty years ago, only one in 500 Americans fell victim to this disease; for most, such a diagnosis was a death sentence. Today, that rate has risen to one in 120, and experts estimate that more than 25,000 people will develop malignant melanoma this year alone. Although the prognosis is much better with early detection and treatment, the disease is still deadly; one in four is expected to die from it.

Recent studies leave little doubt that this increased rate of disease is directly related to excessive sunlight exposure. One frightening aspect is that 20 to 30 years may elapse before melanoma finally appears. Given the fact that persons under age 40 now show the greatest rate of increase, it may be assumed that exposure occurred early in life.

A recent study at the Melanoma Research Unit of the Massachusetts General Hospital found that children who burned easily, often with blisters, and who spent long vacation periods in sunny climates were far more likely to develop malignant melanoma. Other studies have shown greatly increased rates for those who worked outdoors for three or more years during their teens and for persons who have had three or more severe sunburns with blisters before age 20. Therefore, parents would do well to teach their children at a very early age that tanned skin is not healthy skin by not permitting them to play in the sun between 11 a.m. and 2 p.m. Parents should also require that their children wear headgear.

Heredity also seems to play a role, and persons with a family history of melanoma should be especially careful to avoid undue exposure, as should those with light skin. For persons who must work or play outdoors, sunscreens are the best defense; the higher the SPF (sun protection factor), the better. Number 15 is good, but number 30 is probably better. In order to give the protective ingredient time to bind itself to the skin, apply the sunscreen about 15 minutes before exposure, and reapply it every hour or so. "Waterproof" products are good for no more than an hour and a half in the water; "water resistant" ones, for about half as long.

Early detection and treatment is essential to survival with any disease, and malignant melanoma is no exception. To distinguish melanoma from an ordinary mole, the "ABCD" method is helpful:

Asymmetry--moles are usually symmetrical; melanomas are not.

Border--moles usually have sharply defined borders; melanomas are irregular.

Color--whether dark or light, moles all tend to be the same color on the same person; melanomas tend to be of mixed coloring.

Diameter--by the time a melanoma has developed the above characteristics, it will probably be about one-quarter inch in diameter.

Look also for changes in moles, and when the possibility of malignant melanoma is suspected, consult a professional. A prompt diagnosis and removal of the lesion is essential.
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Title Annotation:malignant melanoma
Publication:Medical Update
Date:Aug 1, 1990
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