ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, August 18, 1996 TAG: 9608160016
SECTION: EXTRA PAGE: 10 EDITION: METRO
SOURCE: JULIE APPLEBY KNIGHT-RIDDER/TRIBUNE
Dr. Patrick Hybarger has seen his share of tragic cases in his 20 years as a surgeon treating patients with skin cancer. Almost daily, he has to remove noses, lips, bits of ear.
And he's worried. His patients, it seems, are getting younger and younger.
``I'm seeing things I didn't see 20 years ago,'' says Hybarger, who works in a skin-cancer clinic at Kaiser Permanente in San Rafael, Calif. ``I'm seeing a fair number of teen-age girls and a lot of people in their 20s. That's new for me.''
He even has seen a 12-year-old who had basal-cell carcinoma, a type of slow-growing cancer that has a high cure rate. ``She's got green eyes, red hair and freckles, and she grew up on Maui,'' Hybarger says.
Although most children are unlikely to develop skin cancer before puberty, the years between birth and 18 are when most of us get our largest exposure to the sun.
Just one or two blistering sunburns during those years can significantly increase a person's chance of developing the most deadly form of skin cancer melanoma later in life, experts now believe.
And sun exposure has also been linked to two other forms of cancer, basal cell and squamous cell, as well as sagging skin, wrinkles and suppression of the immune system.
``What I tell parents is they need to religiously protect their children from sunburn,'' says Dr. Jon Starr, a surgeon at Kaiser Permanente's dermatology department in San Jose, Calif. ``Put sunscreen on them every day. It should be a routine, just like insisting that children brush their teeth or wash their hands.''
Other doctors agree, recommending that children also wear hats and sunglasses. Very fair children should take even more precautions, such as long sleeves or even clothing made specifically to screen out harmful rays.
``A kid with fair skin and freckles should never be outside in the sun without protection,'' says Dr. Renee Howard, director of pediatric dermatology at Oakland Children's Hospital in Oakland, Calif.
Exposure to the sun can start at a young age, but skin cancer does not generally appear until years later. It's not uncommon for people to develop skin cancer in their late 20s and 30s, although the peak for melanomas is generally later, in the late 30s to 50s.
There's been an alarming increase in the number of new cases of skin cancer reported each year. Possible reasons for the increase include the thinning ozone layer, the cumulative result of the tanning craze of the past 30 years and the aging of the population.
Between 800,000 and 1 million new cases of skin cancer will be diagnosed in the United States this year, and an estimated 9,430 people will die from the disease, says the American Cancer Society. By far the most deadly form is melanoma, which will claim 7,300 of those lives.
California and Florida, populous states with lots of sunshine and older residents, have the most deaths each year from melanoma.
``Skin cancer is usually an expression of sun exposure from 15 or 20 years before. We are living longer, so we're seeing more cases. We're also becoming more aware of the risk , so people are finding their own cancers and bringing it to the attention of physicians,'' says Dr. David Laub, a member of the board of directors at the American Cancer Society and a dermatologist based in Mill Valley, Calif.
Although many people have gotten the message in recent years that sun exposure can be damaging, many physicians say more needs to be done.
Doctors laud efforts like those in Australia, where schoolchildren don't go out for recess unless they're wearing sunscreen and hats.
``In Australia, they're way ahead of the U.S. They will kick kids off the beach if they're not wearing a hat and they hold recess out of the peak sun exposure hours,'' says Howard.
But efforts have run into one roadblock: Many schools in California don't want children wearing hats because they are sometimes used to signify gang membership.
In Florida, hats are not required, but youngsters in Palm Beach County public schools will hear a daily announcement of the day's ultraviolet index right after they say the Pledge of Allegiance. The index gauges the risk from sun exposure on a scale of 1 to 10. The alert is part of an education campaign that is aimed at students, their teachers and parents.
LENGTH: Medium: 80 linesby CNB