SUNBURN

Press, 28 December 1988, Page 13

SUNBURN

Stories:

DONNA CHISHOLM

The death rate from skin cancer doubles every 10 years. This

year, 200 have died from a disease which is now the greatest cancer killer of people

between 20 and 39. This summer, beaches , will still be full of tanners.

SO YOU reckon you’ve heard it all about skin cancer. Those annual messages from the Cancer Society about slopping on sunscreen and slapping on a hat don’t really sink in anymore because they’re getting a bit hackneyed, really. You probably figure you’re safe because your skin hasn’t acquired the prune-like texture of some sunlovers you’ve seen, and you don’t get out too much anyway — you just get a good dose of the sun on the occasional week-end. Surely that’s nothing to worry about. You certainly won’t have given much thought to dying of skin cancer. How could anyone die from a disease of the skin, for heavens’ sake?

And, if it does get you, it must be better than some of the other cancers mustn’t it? You might even be lying on the beach right now, gratefully feeling the slight sting as the first pink tinge of the season spreads over your pasty limbs. You think you can probably put up with a bit of pain for a start ... after all, you’ve been dying for a tan. But is a tan worth dying for?

Like most cancers, skin cancer attracts its share of MYTHS. Among them: • You can protect yourself from damage just by getting really brown. It may stop you getting so burnt, but you have already incurred considerable damage while you were tanning.

• You won’t get skin cancer unless you look like an old leather boot. • You are safe as long as you tan slowly. • Tanning clinic tans are completely harmless — clinic lamps still use ultraviolet B rays, even if at one tenth of the strength of natural sunlight. • Hats totally protect the face from burning.

• Standing in the shade of a tree gives total protection.

Now for the real story. FACT: People who tan (or burn) in intermittent bursts are more likely to get skin cancer than those who spend all day, every day in the sun. FACT: People in higher socioeconomic groups have higher rates of malignant melanoma, possibly because they sit in their offices all week and abandon caution when they take to the beach, boat or tennis court at week-ends.

FACT: Fair-skinned people are more prone to skin cancer. But remember, you can still be dark haired and fair skinned — look at the shade of the skin on the inside of your wrist to determine your complexion.

FACT: You can be burned even when wearing a hat by reflected rays which bounce off the ground.

FACT: Even 10 minutes in the midday sun is enough to damage the fairest-skinned people. A

swarthy person may take 20 minutes.

FACT: Only the sun’s ultraviolet B rays cause sunburn and tanning, therefore even tanning clinic lamps must emit some harmful light. Malignant melanoma, one of three main types of skin cancer, is the leading cause of death in the 20-39 age group in New Zealand.

New Zealand Dermatological Society president, John Wishart, an Auckland specialist in skin diseases, says this country’s worrying rate of malignant mejanoma is probably caused by our clear air, outdoor lifestyle, and large number of fair-skinned people. Dying from the disease is a nasty way to go, he says. "People reach almost a stage

of malnutrition. It tends to do nasty things like going into the brain and the effects are like a brain tumour, causing strokes, nausea, vomiting and headaches. In general, the victims just fade away.” Some victims die only a year or two after the melanoma is first removed, he says. The outlook is obviously better if the cancer is caught early — but that’s not always easy if the melanoma occurs on less visible parts of the body, particularly the back.

Dr Wishart says if melanomas are under o.Bmm thick when removed, the chances of death are virtually zero. If they are between o.Bmm and up to

I.smm, the risk increases to 1020 per cent, between I.smm and 3mm it jumps to 20-40 per cent, and over 3mm the outlook is bleak, with a 60-80 per cent chance of death. Melanomas of the trunk and head tend to do worse than those on the limbs, he says. And, surprisingly, though women have a higher rate of contracting the disease, they do better than men when fighting it. The melanomas do not always appear at the site of greatest sun exposure, he says. Once activated by sun damage, the cancer cells may circulate through the body and settle on a site that has not even been burned.

Some sufferers, more particularly non-Europeans, have even had melanomas on their palms or under their fingernails. Fashion has dictated the thinking that brown is in and pale is out, says Dr Wishart, but New Zealand women seem to have followed the trend more slavishly than others. “The average European or English woman looks much younger than the average New Zealand or Australian women of the same age. There is no doubt a lot of what we call ageing is due to the sun.

“Many women here look beat up, wrinkled and ghastly. They really look their age. It is a bit of waste.”

Dr Wishart says even getting badly burned once can increase the risk of contracting melanoma

in two or three years. It has a relatively short incubation period. The skin has repair systems to cope with some of the damage but they get exhausted if the sunlover overdoes it.

By the time the skin looks pink in the sun, damage has already started, he says. “If you look at the cells through a microscope you can see they look shrunken and old. The blood vessels open and start to leak and the defensive cells come out and start trying to repair the cell scaffolding — the supporting fibre network — which is being broken down.” By the time the skin is red, he says, “you’re in a certain amount of bother.”

Skin specialists believe continued exposure triggers an already abnormal melanin producing cell to “turn on” and become cancerous. “It starts zooming through the

blood vessels and lymphatics before picking a site to form the melanoma,” says Dr Wishart. “By the time it becomes visible it has already been developing for several months.”

Factors affecting sun’s strength

The sun’s strength is affected not only by the time of day but also by the season, latitude,and altitude. Rays are strongest between noon and 3pm during the summer.