By Julie Karen, MD
My husband, Jon, loves to fish. A few weeks ago, he returned from a September afternoon of fishing the way he always returns from a fishing expedition - relaxed (in the way that only fishing achieves) and sun-kissed. Despite his family history of melanoma, despite his knowledge of the oftentimes devastating tumors I treat as a skin cancer surgeon, despite our closet full of elegant and effective sunscreens, and despite (or perhaps due to) my preaching, Jon, like so many young healthy adults, has always felt invincible.
It was, to be fair, pure coincidence that his suntan coincided with my observation of a new pearly papule on his chest (the classic appearance of a basal cell carcinoma (BCC)). Nonetheless, the biopsy results a few days later confirming the diagnosis of BCC strengthened my argument that he, in fact, is not invincible.
It is not a coincidence that Jon grew up on the Jersey shore where G-T-L (gym-tan-laundry) is strictly adhered to. He frequented the beach and admits to occasional tanning salon abuse (is there any other word?) during his teenage years. And while he would never step foot in a tanning booth now, he remains mediocre at applying sunscreen and remedial at reapplication.
As an avid runner and a proud soccer mom/coach, I strongly embrace the notion that enjoying outdoor activities is critical to a healthy lifestyle. However, Jon's recent diagnosis highlights the importance of protecting oneself against the sun's harmful UV rays while outdoors.Jon has now joined the more than 2 million Americans who are diagnosed with a non-melanoma skin cancer each year. And while his BCC will not kill him, he does have to undergo treatment to remove the tumor's roots and he faces a greater than 50% chance of developing additional skin cancers.
I applaud the Surgeon General's recent declaration that outdoor venues should be better equipped with structures that afford sun protection. While a healthy lifestyle is largely antithetical to absolute sun avoidance, the addition of pavilions, canopies and awnings to schools and parks will enable the public to enjoy outdoor activities without a heightened risk of skin cancer.
Too many adults justify their irresponsible behavior by saying "the damage is already done." And yes, this is to some extent true - 5 or more sunburns during youth increases one's lifetime risk of melanoma by 80% (skincancer.org) However, only approximately 22% of the damage is done by age 18. Each decade thereafter, we acquire an additional 10% of our cumulative lifetime exposure. Therefore, it is not too late for Jon and the rest of us to make a difference.
Here's to hoping he continues recent efforts to protect himself from further damage - a broad-spectrum sunscreen generously and frequently applied, a hat, sunglasses and sun protective clothing.