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Something Malignant Under California Sun : Experts 'Alarmed' by the Increase in Skin Cancers

April 15, 1986|BOB SIPCHEN | Sipchen is a Costa Mesa-based writer. and

This is about people who bought the notion that "life is a beach," but now realize how badly they got burned.

It's about the fact that on these radiant spring days, as thousands of folks sprawl on the sand catching rays, dozens of others are sitting in dermatologists' offices, waiting to be treated for skin cancer. It's about the growing number of people who are finding out that the Southern California coast, long known as the realm of the mellow, is also the realm of melanoma--the most serious form of this sun-related disease. In fact, UC Irvine Medical Center (UCIMC) today is opening a Melanoma Center to deal with what many experts are calling "an epidemic."

What's sadly ironic is that people with skin cancer usually seem so robust.

Take Eva Ljungwe (pronounced Young-va), a 29-year-old chemist from Laguna Hills. A dedicated runner and bicyclist, Ljungwe is the sort of woman Outside magazine might put on its cover to illustrate the vitality of California's healthy way of life.

Started as a Small Bump

Her eyes are the color of the sky on mornings when the Santa Anas have been blowing. Her personality might be described as sunny.

Three years ago, however, a small, colorless bump appeared on Ljungwe's neck. It was diagnosed as malignant melanoma. Cancer spread into Ljungwe's body through her bloodstream. Now the disease is steadily changing her life, and may claim it completely. "I still have a lot of denial. I still can't believe it's happening to me. . . . But I think my chances for living another five years are really remote," she said.

Most Common Cancer

Each year, about 500,000 people in the United States walk out of doctors' offices pondering the news that they have non-melanoma skin cancer, according to the Skin Cancer Foundation in New York, a nonprofit organization that compiles data on skin cancer. This represents a 15% to 20% increase in the past 15 years. According to the American Cancer Society, the disease is the most common form of cancer in humans. But "it's also one of the most curable--and preventable--forms of (cancer)," society literature points out.

If diagnosed promptly, most types of skin cancer are easily arrested, dermatologists say. However, the American Cancer Society predicts about 23,000 new cases of malignant melanoma--and 5,600 deaths from the disease--this year.

The Skin Cancer Foundation calls the rate at which malignant melanoma is increasing in the United States "alarming." In 1930, an individual's lifetime risk for getting melanoma was one in 1,500; in 1950 it was one in 600, and the foundation predicts that if the trend continues, by the year 2000 nearly one in 100 Americans will develop the disease, which usually announces itself in the form of small, brown-black or multicolored patches or nodules with irregular outlines, and often develops in pre-existing moles.

Studies have shown that incidence of melanoma is twice as high in Sun Belt areas as in the country at large. UCLA Medical Center's John Wayne surgical oncology clinic--one of the few clinics in the country with melanoma treatment and research as a specialty--takes a multi-discipline approach to melanoma, generally after patients have been diagnosed and referred by a dermatologist; and USC specializes in melanoma research at it's Norris Cancer Center. The center opening today at UCIMC will offer "state of the art diagnosis, treatment and research," according to Dr. Ronald Barr, an associate professor of dermatology and one of seven doctors in the center's "core group."

Graphic Evidence

At the same time, Barr and others will continue seeing the patients who pass through UCIMC's twice-weekly dermatology clinic to be treated for other forms of skin cancer.

One patient undergoing treatment at the UCI clinic recently offered graphic evidence of the different forms the disease takes. The man, who asked that his name not be used, had arrived in California when he was 5. But his fair complexion was clearly not designed for this Golden State. Now, at age 72, his skin shows the effects of a lifelong battle with sunlight.

Turning the patient's hands, Barr pointed out the results of "chronic skin damage"--scaly red and white patches of pre-cancerous skin called solar keratoses and areas of solar elastosis, where the skin had yellowed and wrinkled.

The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma, and the patient has had bouts with both, Barr said.

Squamous cell cancer, such as the man had on his hands, usually starts as red patches or nodules, tends to grow slowly, and may ulcerate like a persistent sore as it spreads, Barr explained. Prognosis is usually very good, he added.

Basal cell cancer usually starts out as a small pearly bump or nodule on the head, neck or hand, and may display a fine network of small blood vessels, Barr said. Basal cell cancer also spreads slowly, and if diagnosed early, is usually fairly easy to control.

Waited Too Long

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