Not So Sunny Spots
You can still get skin cancer even if you haven't spent a lifetime outdoors
Erin Elovecky loves to feel the warmth of the sun on her body. Growing up, she spent many summer days on Long Island Sound, cruising around in her parents' boat and soaking up rays. Elovecky admired her mother, who could quickly develop a rich, brown tan, thanks to her Lebanese heritage. But Elovecky took after the Irish side of the family, with fair skin and green eyes, and got burned by the sun more often than not.
Hoping to give her skin a year-round sun-kissed glow, Elovecky started visiting a tanning salon near her Southbury, Conn., home a few times a week in her early 20s. She went for a couple of years. "It made me feel like I didn't need to wear a lot of makeup, and I thought I looked so much healthier with a tan," she remembers.
Two years ago, at the age of 27, Elovecky noticed a small red spot at the edge of her eyebrow. It itched, and the skin kept peeling off. She didn't do anything about it until her hairdresser said, "You have to get that checked out right away." One very painful biopsy later, Elovecky got the bad news: She had basal cell skin cancer.
Sun exposure. Cases like Elovecky's are becoming increasingly common. A recent study published in the Journal of the American Medical Association found that the incidence of basal cell carcinoma (a slow-growing tumor of the basal cells at the bottom of the epidermis) among women under the age of 40 more than doubled between 1976 and 2003, to 31.6 per 100,000. The rate for men increased only slightly during that time. The study also found that both women and men showed significant increases in squamous cell cancer, which occurs in the middle layer of the epidermis. Like basal cell cancer, squamous cell cancer typically doesn't metastasize and is rarely ever fatal. The reasons for the rise in skin cancer are clear, say doctors. "Either they're getting lots of chronic sun exposure because they're out all the time or using tanning beds, or it's these intense burns that they're getting," says Leslie Christenson, a dermatologic surgeon at the Mayo Clinic and one of the study's authors. Stepped-up screening for skin cancer and the thinning ozone layer, which allows more of the sun's ultraviolet rays in, may also play a role. The Indoor Tanning Association notes that the study didn't address whether the women tanned indoors or outdoors.
Basal cell carcinoma is the most common cancer in humans, with 800,000 new cases each year. Squamous cell cancer is the second most common skin cancer, with 200,000 new cases. Next in line is melanoma, a tumor that begins in the cells that produce the skin's pigment, which accounts for only about 100,000 new cases annually. But melanoma is much more lethal, killing 1 in 4 people who develop it. Ultraviolet radiation from the sun is a principal cause of all types of skin cancer, either from damaging sunburns or the cumulative effect of long-term exposure. Family history also plays a role, especially in melanoma. The typical sufferer used to be an older man who had either worked outdoors all his life or was an avid golfer or boat owner who spent long hours in the sun. But as the new study shows, that profile is changing.
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