The LookOut  
Health News  A service of Saint John's Health Center


Living in Southern California has many benefits, including a temperate climate that permits outdoor activities nearly all year round. But soaking up the sun can be harmful to your skin, and can dramatically increase your risk of skin cancer.

About one in six Americans will develop skin cancer during their lifetime, with most medical experts placing the blame on increased sun exposure and depletion of the earth’s protective ozone layer. The three most common types of skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma.

Fortunately, most people with skin cancer will develop the non-melanoma types, which are usually benign and can easily be treated. But for a growing number of people, the risk of developing melanoma is becoming a real threat.

Melanoma has the most rapidly increasing incidence of any cancer, according to the American Cancer Society, and is currently the eighth most common malignancy in the United States. It is an extremely serious skin cancer that can be fatal if not treated promptly.

The American Cancer Society predicts that there will be 59,000 new cases of melanoma in the U.S. in 2005, and approximately 7,700 people will die from the disease.

“The majority of people experience the most sun exposure during the ages of 15 to 20 years old, and the average age of people getting melanoma is 45,” says Richard Essner, M.D., a surgeon and melanoma specialist at the John Wayne Cancer Institute (JWCI) at Saint John’s.

“But it is still unknown what the latency period is following skin damage from the sun because melanoma can also strike patients when they are fairly young. In fact, melanoma is the most frequent cancer in women ages 25 to 29 and the second most common in women 30 to 34,” Dr. Essner says.

People who face the highest risk of developing melanoma include:

  • People with a large number of moles or freckles on their body
  • Blondes or redheads with light complexions
  • People who have excessive exposure to the sun and ultraviolet radiation
  • People with a family history of melanoma
  • People ages 50 and over

“One of the greatest risk factors for melanoma is moles,” says Dr. Essner. “The more moles you have, the greater the risk.”

Any change in the size, shape or color of a mole should be considered a warning sign and checked by your physician. Basal cell cancers are pinkish in color and can bleed as they grow bigger. Squamous cell cancers have a scaly rash appearance.

Individuals at risk are also warned to be on the lookout for any irregular shaped moles or moles with a non-uniform color, but Dr. Essner says that advice may be deceiving to some.

“If you look at any mole, you’ll notice that they all have some irregularity to them,” he says. “In fact, most moles are not perfectly round in shape. A very large, dark mole or moles that change and appear to be growing are better indicators of a potential melanoma or other type of skin cancer.”

Surgery is still the first course of treatment for treating primary tumors such as melanoma, says Dr. Essner. Basal and squamous cell carcinomas can be treated by a variety of methods, including surgery, freezing and laser treatment. There is also an FDA-approved topical cream available to treat early skin cancers.

Vaccine programs are also being developed by investigators at John Wayne Cancer Institute to treat advanced melanomas, according to Dr. Essner, as well as new treatments based on studies targeting particular genes that may stimulate the body’s own immune system.

Prevention is always the first line of defense, however. To protect yourself from skin cancer, Dr. Essner offers the following tips to help lower your risk:

  • Avoid intense sun exposure during the hours of 10 a.m. to 2 p.m.
  • Always wear protective clothing and a hat in bright sunlight
  • Wear plenty of sunscreen, particularly on the face, neck, hands and arms
  • Re-apply sunscreen if swimming or sweating heavily

For more information, call JWCI at (310) 315-6111.

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