(Reprinted with permission by Health Connections, (c) Methodist Health System Spring 2002)

We all want to look our best, especially during the summer months, but research shows the healthy glow of a tan isn't so healthy after all. Whether you prefer a sun-kissed blush or a deep, dark bronzing, the effects of the sun can be physically harmful. The short-term cosmetic advantage of tanning can lead to negative long-term effects, like premature aging, dark patches, wrinkles and, most alarmingly, skin cancer.

The American Cancer Society lists cancer as the second leading cause of death in the United States; skin cancer is recognized as its most common form. Ultraviolet radiation (UV) is to blame for most of the more than 1 million cases of skin cancer diagnosed each year. A long day at the zoo, a leisurely round of golf or a lazy day at the pool can spell trouble if you don't protect yourself and those you love from harmful UV rays. This doesn't mean you should exclude or cut back on your outdoor activities. Simply arm yourself with the knowledge and tools necessary to enjoy the sun safely.

Protect the Skin You're In
Skin, the largest organ of the body, guards internal organs from injury, performs as a barrier for bacteria, protects the body's delicate balance of fluids and regulates body temperature. Normally, skin cells grow, divide and die in a cyclical fashion, making way for new, healthy cells. Cancer develops when some cells grow out of control and do not die. Instead, they continue to multiply and overrun normal cells surrounding them.

Skin cancer is divided into two major types: melanoma and non-melanoma skin cancers. Non-melanoma skin cancers, the most common cancers of the skin, include all forms of skin cancer except melanoma. The most common non-melanoma skin cancers are directly related to sun exposure and are often found on the head, neck, hands, lip, face and ear. Non-melanoma skin cancers rarely metastasize or spread to other areas of the body.

Melanoma is less common than non-melanoma skin cancers, but is much more serious. The American Cancer Society reports that melanoma accounts for approximately 4 percent of all skin cancer cases, but is responsible for nearly 80 percent of all skin cancer deaths. It begins in the cells that provide coloring and pigment to the skin, and is most commonly found in areas that are exposed to the sun. Like most cancers, melanoma is highly curable in its early stages. But unlike non-melanoma skin cancers, melanoma can metastasize, making early detection essential.

It is not known what causes skin cancer, but a number of risk factors have been identified. Individuals who have fair skin, excessive exposure to sunlight, radiation exposure, a large number of moles, family history of skin cancer, immune suppression and increasing age are more susceptible to contracting the disease.

Early Detection is Key
Because skin cancer is highly treatable when found early, it is important to know the warning signs and seek medical assistance as soon as a problem is suspected. "Early detection is the key to successful skin cancer treatment," says Paula Nanos, RN, BS, director of Community Networking at Methodist Health System. "It not only keeps health care costs down, but it also saves lives."

Nearly everyone has moles, freckles and other marks on the skin. While most are harmless, it is important to examine these areas for changes in color, size and shape. Kathy Christiansen, RN, oncology nurse coordinator at Methodist Cancer Center, says everyone over age 40 should have an annual head-to-toe skin examination performed by a qualified medical practitioner.

"It is also a good idea to conduct a monthly self-exam to become familiar with your own skin. These exams help determine what is normal for you," says Christiansen.

The best way to perform a skin cancer self-exam is to stand nude in front of a full-length mirror and look for signs that may signal a problem. Any unusual bump, sore, marking or change in skin texture should be taken seriously and examined by a doctor. Use a hand mirror for hard-to-see spots. Others can also help detect an abnormal looking mole or patch of skin. Don't be afraid to tell a friend or family member if you spot a suspicious looking mole.

Skin Cancer Screenings
Jennie Edmundson Hospital and Methodist Hospital offer annual skin care screenings free to the public. "We've been very pro-active on this issue by making a commitment to provide prevention and wellness education to the community. Methodist Health System cares about its community and is in this for the long haul," Nanos says.

Skin cancer screenings are performed by physicians who specialize in recognizing skin cancer. "The screening takes just 5-10 minutes and is much like a regular doctor's visit," says Christiansen.

Although the screenings are professional and thorough, Nanos says they do not take the place of a full examination by an individual's personal physician. "When a health care professional at the screening identifies a possible problem, we encourage the person to see his or her own physician," she says. "If people care enough about their health to attend a screening, they should be responsible enough to follow up." The hospital also offers on-going screenings for area businesses through its Community Networking Department.

For more information on skin cancer or skin cancer screenings, call Health Touch One at (402) 331-1111 or (800) 273 3737.

Treating Burns
1. To cool the affected area quickly, hold it under cool running water, immerse it in cool water or place cold, wet towels on the area (unless blisters are broken). Ice or a frozen bag of vegetables wrapped in a towel and placed against the skin can also help. Do this for about 10 minutes to help the skin cool down and continue for up to an hour, if necessary, to relieve the pain. 
2. Do not put anything oily, like butter or ointment, on burns because this can slow the healing process or lead to infections. 
3. If the burn is large or on skin that can be irritated by clothing, cover it loosely with dry gauze or a cloth bandage. 
4. If blisters appear, don't burst them. If they break, leave the overlying skin in place for protection. Keep the area clean until the skin toughens up. 
5. If there is an open wound, make sure your tetanus immunization is current.

Melanoma Monday
Melanoma Monday or "National Skin Self-Examination Day" will take place on Monday, May 6. Now in its eighth year the day was established by the American Academy of Dermatology to raise awareness about malignant melanoma, the deadliest form of skin cancer, and encourage Americans to begin regular skin self-examinations. Melanoma Monday also marks the start of the 18th annual National Melanoma Awareness Month. While new cases of most cancers declined between 1990-1996, melanoma is one of the few cancers that continues to increase, at a rate of approximately 3 percent per year.

What's the UV Ray of the Day?
0 to 2: Minimal
Minimal danger from the sun's UV rays for the average person: Most people can stay in the sun for up to one hour during the hours of peak sun strengths, 10 a.m. to 4 p.m., without burning.
3 to 4: Low
Low risk of harm from unprotected sun exposure. Fair-skinned people, however, might burn in less than 20 minutes.
5 to 6: Moderate
Moderate risk of harm from unprotected sun exposure. Fair-skinned people might burn in less than 15 minutes.
7 to 9: High
High risk of harm from unprotected sun exposure. Fair-skinned people might burn in less than 10 minutes.
10+: Very High
Very high risk of harm from unprotected sun exposure. Fair-skinned people might burn in less than 5 minutes. Outdoor workers are especially at risk as are vacationers who can receive very intense sun exposure.

You can access the UV Ray of the Day soon at our Web site, www.bestcare.org or contact EPA's Stratospheric Protection Hotline at (800) 296-1996 or the UV Index Web site at www.epa.gov/ozone/uvindex/uvover.html.

Sun Safety
The American Cancer Society offers the following sun safety suggestions to protect yourself against skin cancer: 
1. Limit direct sun exposure, especially during the hours of 10 a.m. and 4 p.m., when ultraviolet rays are most intense.
2. Refer to the daily UV index when planning outdoor events. Methodist Health System posts the daily UV index on our Web site, www.bestcare.org and sponsors daily announcements on WOWT-Channel 6.
3. Seek shade whenever possible. Shade structures such as trees and umbrellas provide year-round protection.
4. Wear a wide-brimmed hat, sunglasses, and long-sleeved, tightly woven clothing
5. Use broad-spectrum sunscreens whose active ingredients block UVA and UVB rays. The Sun Protective Factor (SPF) should be a minimum of 15. Sunscreens should be used every day, including cloudy days. They should be applied liberally and evenly before going out into the sun and should be reapplied frequently, especially after swimming. 
6. Avoid tanning salons. Artificial UV radiation is just as bad for your skin as sunlight. 
7. Limit exposure to reflective surfaces like snow and water. UV rays can also be reflected off sand, tile and buildings. It is important to practice sun protective behaviors even when you are in the shade.
8. Report any suspicious moles or skin areas to your doctor.

Spring, summer, fall or winter - sun safety is a concern for every season.