Nicole Smith said she will never forget the day she woke up and noticed the small spot on her right calf had changed. The left side appeared to have grown an irregular border and was varied in color while the right side had become very dark and thick. \nSmith said she became very concerned with how quickly the spot was changing, so she showed it to her father. He immediately took her to see a dermatologist. Once there, Smith received her diagnosis.\nShe was 21 years old, and she had skin cancer.\n"I think it really hit home to me what had happened when my doctor told me that if I had not caught this melanoma in time, I could have died within a year from other cancers that had spread from the spot on my leg," Smith said.\nToday, as a 27-year-old graduate student at IU, Smith is cured. But as students anxiously await the warm, sunny destinations of spring break, local experts explain how an understanding of the causes and risks of the potentially deadly cancer can help protect a person from getting the disease.
What causes skin cancer?\nThere are three major types of skin cancer: the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma. When melanocytes, cells that give pigment to the skin, become cancerous, melanoma forms. Although it is less common than the other two types of skin cancer, melanoma is much more likely to metastasize, meaning it will spread to other organs, and to be fatal, according to the Journal of the American Medical Association.\nTreatment options for melanoma often depend on the size, depth and spread of cancer. Most commonly, melanomas need to be surgically removed, according to the Journal of the American Medical Association. In addition, other \ntreatments for advanced or metastatic melanomas include chemotherapy, radiation therapy and immunologic therapy -- a treatment that uses medicines to boost the body's natural immune response to the disease. \nFortunately, the American Cancer Society states about 82 percent of melanomas are diagnosed before they have spread. For people with localized melanoma, the five-year survival rate is 96 percent.\nSkin cancer is the most common type of melanoma, according to the American Journal of Preventive Medicine. The American Cancer Society estimates there will be more than 59,580 new cases of melanoma and 10,590 deaths related to skin cancer this year in the United States. Experts claim cases of melanoma are increasing while rates of most other cancers have been declining. \nDespite this, some experts believe college students are an exception to the ever-rising rate of skin cancer cases in the United States because they are so aware of the dangers.\n"For the most part, skin cancer is a disease of older individuals (late 60s to 80s). In reality, today's college students are on the cusp of experiencing dramatically reduced skin cancer rates," said John Foley, an associate professor of anatomy and cellular biology for the IU School of Medicine. "The sunlight-skin cancer connection was not completely worked out until the 1970s. From that point on, dermatologists have gotten the word out to virtually everyone about the dangers of tanning and sun exposure."
Are you at risk?\nSeveral factors can help certain individuals determine whether they are more prone than others to developing skin cancer. Doctors look at factors such as the darkness of skin, hair or eye color, family history and certain types of moles when determining if an individual may have a high risk for developing the disease. \nBecause of a lack of pigment called melanin, Foley said people with light skin are at a greater risk for skin cancer. Melanin reflects the sun's harmful ultraviolet, or UV, rays. Without it, the skin cannot protect itself.\n"(Melanin) has the ability to absorb UV radiation before it hits DNA, preventing mutations as well as normal cell suicide (sunburns)," Foley said. "Lighter-skinned people simply don't effectively store melanin in the epidermis, and this means they are very vulnerable to UV radiation from the sun."\nFor decades, dermatologists have recommended people wear sunscreen to protect their skin from the sun's powerful UV radiation. Without protection, these rays can cause sunburns, premature aging and increased risk of skin cancer. Anne Reese, the health and wellness director at the IU Health Center, offered several other recommendations to help students lower their risk of contracting skin cancer.\n"Students should limit their time in the sun, since UV rays are strongest between 10 a.m. and 4 p.m.," Reese said. "Students should use sunscreen with a sun protection factor of at least 15, wear a broad-brimmed hat, sunglasses and cover up with tightly woven clothing. Finally, students should avoid tanning beds and check on their skin regularly."
Understanding the danger\nSmith is working with IU to educate students on the dangers about skin cancer and has helped organize a free skin cancer screening for students at 2 to 4:30 p.m. Thursday in the Hoosier Room of the Indiana Memorial Union. Compared with when she was younger, she said she believes today's students are more aware of the risks and dangers of skin cancer than previous generations.\n"The question really is whether or not students believe that they personally could develop skin cancer and whether or not they are willing to take precautions against the sun," she said. "It's the little changes that can make a difference."\nDespite the risks, Foley said there are still many students who trade in safety for sun-kissed looks at local tanning salons. Tanning, he said, is like smoking. Both can cause cancer, and both are highly addictive. He offered the following advice to students who attend tanning booths on a regular basis:\n"Your college education often teaches how short-term fixes have devastating long-term effects," he said. "Being slightly more pigmented (tan) may make you feel more beautiful at the moment, but that artificial color comes at the expense of wrinkles and possibly skin cancer later in life."\n-- Contact Staff Writer Michael \nSavitt at mpsavitt@indiana.edu.
