Bush’s Skin Cancer Common in Sun-Exposed

By CHRISTINE DELL’AMORE

Squamous cell carcinoma, the type of skin cancer Laura Bush was treated for in November, can strike anyone who spends long hours in the sun or in tanning beds, experts say.

The second-most common form of skin cancer after basal cell carcinoma, squamous cell affects more than 200,000 Americans a year. Although less deadly than melanoma, the least common form, squamous cell can spread through the body aggressively if not treated.

About 2,000 Americans die every year from squamous cell cancer, said Dr. Darrell S. Rigel, clinical professor of dermatology at New York University. More than 1.3 million Americans get some type of skin cancer every year; one in five will develop skin cancer in their lifetimes, according to the Skin Cancer Foundation.

If caught early — as the first lady’s was — squamous cell can be easily treated, said Rigel, also the president-elect of the American Academy of Dermatologic Surgery.

Bush’s experience unfolded in a typical fashion, said Rigel: She noticed a sore on her right shin that was not healing, so she got a biopsy. Women often get skin cancer on their legs, head and neck, spots most vulnerable to the sun; men tend to develop skin cancer on their backs.

Bush’s diagnosis is not surprising, given her Texas roots and possible exposure to the sun during her younger years, he said. Chronic, day-to-day time in the sun drives squamous cell the most, although the effects may not surface for decades. Ninety percent of skin cancers can be traced to sun exposure, according to the SCF. A person’s risk for skin cancer doubles after getting five or more sunburns.

It’s possible Bush’s twin daughters could be at risk, but the gene for squamous cell is still unknown, according to Rigel. Melanoma seems to have more of a genetic grounding than squamous or basal cell.

More likely, Rigel said, is that a combination of fair skin, light eyes, genetic susceptibility and a history of sun exposure could put her daughters at higher risk.

Skin cancer occurs when the sun’s ultraviolet radiation damages skin cells, causing the body to constantly go back and repair the problem, said Dr. Erin M. Welch, an assistant professor of dermatology at UT Southwestern Medical Center in Dallas.

She likens the process to fixing a typographical error — if a person gets enough sun, eventually a few typos slip through, and the cells begin to grow abnormally. Before long, they grow out of control and don’t stick together like normal skin — creating small sores that bleed easily.

Everyone exposed to UV rays on a regular basis — especially those with fair skin — should watch for any new growth or little spot on their bodies, like a pimple, that do not heal. Because squamous cell can progress quickly — and lead to potentially disfiguring, serious surgery — people should act immediately if they see an odd growth.

It’s just like a cavity in your tooth — time is of the essence, Welch said.

An existing mole that is bleeding or changing in any way should also be examined by a dermatologist, said Rigel.

Once detected, the most common treatment is to cut out the growth locally.

Luckily, both squamous cell and basal cell cancers are preventable by using sunscreen and avoiding tanning beds, said Welch.

She advises her patients to wear moisturizer with a minimum of SPF15 sunscreen daily, and to make it a daily habit, like brushing teeth. She even suggests a patient place her moisturizer next to her toothbrush.

Yet many of these messages have bounced off young Americans, particularly the ever-growing legions of bronzed teens who frequent indoor tanning salons. Women who use tanning beds more than once a month are 55 percent more likely to get malignant melanoma, skin cancer’s deadliest form, according to the National Cancer Institute.

Many teens and young adults may know about the premature aging and the possible disfigurement of their faces from skin-cancer surgery, but they persist in tanning nonetheless, said Rigel. Many states have imposed bans or limits on teenage indoor tanning to try to quell the rates in skin cancer.

Indeed, Welch is seeing women in their 30s and 40s with squamous and basal cell cancers, historically cancers of older adults. Women under 40 are getting basal cell cancers faster than any other group. Melanoma is the leading cause of cancer death for women ages 25 to 30, according to the Melanoma Research Foundation.

Welch said she has sadly even treated pregnant women with skin cancer.

Tanning, whether in the sun or in the salon, is the antithesis of making you look better, Rigel said. I can’t tell you how many patients say to me, ‘I wish I knew then what I know now.’

For more information:

http://www.skincancer.org/self_exam/spot_skin_cancer.php

http://www.aad.org/professionals/SkinCancerScreenings/skincancerscreen.htm