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July 13, 2005

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Publication Date: Wednesday, July 13, 2005

Health & Fitness: Taking cover -- Skin-cancer risk to kids prompts senator to push for more education, prevention measures Health & Fitness: Taking cover -- Skin-cancer risk to kids prompts senator to push for more education, prevention measures (July 13, 2005)

By Katie Bearman

Special to the Almanac

Although thousands flocked to California in search of gold during the mid-19th century, the Golden State is now widely known for the sunshine that tans Hollywood stars and shimmers on the crests of Pacific waves.

But blissful weather does not come without consequences, as is reflected by the increasing incidence of skin cancer among California residents.

Concerned about this increase, state Sen. Jackie Speier, D-Hillsborough, recently introduced a bill aimed at encouraging schools to teach kids about skin cancer and its prevention, and to build shade-making structures over school playgrounds and outdoor eating areas.

The bill, Senate Bill 688, is dubbed the Skin Cancer Prevention Act for California Schools and is awaiting Gov. Schwarzenegger's signature.

More than 1 million new cases of skin cancer will be diagnosed in the United States in 2005, and 10,590 people will die of it this year, says the American Cancer Society (ACS). Melanoma -- the most deadly of skin cancer's various forms-- will account for approximately 7,770 of these deaths, according to the ACS.

SB 688 requires the Department of Education to make skin cancer education guidelines and resources available to California public schools, says Elise Thurau, principal consultant to the senator.

The schools would then be urged to incorporate these supplements into programs for first- through sixth-graders, whether by adding them to the curriculum or using them in assemblies, activities, and newsletters to parents, she adds.

In addition, SB 688 obliges the Office of Public School Construction to report to the Legislature the costs and options for building shading structures over certain outdoor areas on school campuses, according to Tracy Fairchild of Sen. Speier's office. Schools will be encouraged, but not required, to build the structures, she says.

Many SB 688 proponents wanted to require schools to adopt skin cancer education programs and to build shade structures, but the state's financial situation proved too large an obstacle, says Ms. Thurau. The state estimated that mandatory compliance would cost the schools $14 million, she explains.

Among advocates of SB 688 is the Charlie Guild Melanoma Foundation, a grass-roots organization pushing for wider public awareness of skin cancer. The foundation was initiated by Valerie Guild of Tiburon after her daughter, Charlie, died of melanoma at age 26, Ms. Guild says.

Melanoma has become the most common form of cancer among women between 25 and 29 years old, according to the American Academy of Dermatology (AAD).

Risks of sun exposure

While one in five Americans runs the risk of developing any form of skin cancer in his or her lifetime, the risk factor for Californians may be about one in four due to higher-than-average amounts of sun exposure, says Dr. Hayes Gladstone, a dermatologist and assistant professor of dermatology at Stanford University Medical Center.

In 2003, for example, California saw 5,200 new cases of melanoma, while Rhode Island reported an incidence of 200, according to the ACS.

The bill also has ample justification for encouraging skin cancer prevention efforts at early ages, according to Dr. Gladstone and the other dermatologists interviewed for this article.

Americans rack up about 80 percent of their total sun exposure by their 18th birthdays, says the ACS. Pediatric cases of melanoma are extremely rare, but melanoma and other forms of skin cancer increasingly affect younger people due to this early sun exposure, Dr. Gladstone adds.

"Skin cancer and melanoma germinate in childhood," he warns.

A child who has had excessive sun exposure faces an increased likelihood of developing cancerous moles as an adult, says Dr. Susan Swetter, associate professor of dermatology at the Stanford medical center and assistant chief of dermatology service of the VA Palo Alto Health Care System. Blistering sun burns from childhood also increase the risk factor for the disease, she says.

Support for SB 688

Dr. Amy Adams, a researcher at Stanford University and pediatric dermatologist at Lucile Packard Children's Hospital, says she is in favor of SB 688. "I think it's really critical to have legislation like this because many kids go out at noon for recess with little sun protection," she says.

Dr. Gladstone and Dr. Adams say they hope schools will actually implement the guidelines in SB 688.

"Communities and grass-roots organizations are going to have to get schools to support and follow through with the legislation," Dr. Adams says.

Whether or not a large number of schools embrace elements of SB 688, Dr. Gladstone says he thinks the legislation is a step in the right direction.

"The bill is long overdue," Dr. Gladstone told the Almanac. "Hats off to Senator Speier -- or, hats on."

Information

For more information on skin cancer, visit the American Cancer Society at www.cancer.org or the American Academy of Dermatology at www.aad.com.

Melanoma prevention

The American Academy of Dermatology and the American Cancer Society suggest taking these measures to reduce the risk of developing skin cancers, including melanoma:

** Wear sunscreen containing titanium dioxide or zinc oxide at all times when outside, and reapply it every two hours, even on cloudy days.

** Avoid the sun between 10 a.m. and 3 or 4 p.m., when the UV radiation is at its most intense.

** Whenever possible, wear protective clothing such as wide-brimmed hats and long sleeves while in the sun, and remember to protect your eyes and lips from sun exposure as well.

** Avoid tanning beds.

** Keep babies under 6 months out of the sun; sunscreen is not safe for them.

Signs of melanoma

Mind the ABCDEs, advises Dr. Susan Swetter of the Stanford medical center.

** Asymmetry: half of the mole may appear different from the other.

** Borders: a melanoma may have irregular or blurred edges.

** Color: a cancerous lesion may have different shades of tan, brown, black, white, or even red or blue throughout.

** Diameter: a melanoma often has a diameter of greater than 6mm.

** Evolving: unusual changes in a mole or lesion can signify melanoma.

Other signs of melanoma can include itching, pain or bleeding.

Risk factors for melanoma

Dr. Susan Swetter of the Stanford medical center highlights the following as conditions that can increase one's likelihood of developing melanoma and other forms of skin cancer.

** Ultraviolet radiation through sun exposure or tanning beds

** Fair-skin phenotype: blue or green eyes, blond or red hair, light complexion, and sun sensitivity

** Numerous moles

** A family history of melanoma

** Those who have already had a melanoma

Self-examination and early detection

The depth of melanoma and other cancerous lesions in one's skin usually increases with time, and both the gravity of skin cancer and the cost of treatment increase with thickness, according to Dr. Susan Swetter of the Stanford medical center. Thus, early detection of melanoma and other skin cancers is crucial.

Melanoma usually occurs in exposed areas such as the chest and back on men, and the back of legs on women, says Dr. Hayes Gladstone of the Stanford medical center. But melanoma can occur anywhere, he warns.

The American Academy of Dermatology and the American Cancer Society offer these tips:

** Conduct self-examinations frequently, paying attention to every area of the body including the scalp, soles of feet, spaces between the toes, and the palms of the hand.

** Use a mirror or ask a friend or partner to look at hard-to-reach places such as the back.

** Consult a dermatologist immediately if a sign of melanoma is detected.


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