Darker side of the sun

The bad news
-A world average of one in 75 people will develop melanoma, the often-fatal form of skin cancer, and if the current increasing trends hold true, the percentage will keep getting higher still.
-The incidence of melanoma has increased by 1 200 percent since the 1930s.
-In teenagers it has increased by 100 percent in the past 10 years alone. 
– It is the most common cancer in women under 30 years of age.
– Deaths from melanoma continue to rise despite newer treatment modalities.
The good news
The good news is that you can actively change the above statistics for yourself or your children through relatively easy steps: firstly prevention, and secondly, early recognition and treatment.
For the purpose of this discussion, we will focus on melanoma rather than the other two skin cancers, basal cell and squamous cell carcinomas, because melanoma does routinely kill people, while the other two do so only rarely.
Causes
In some parts of the world, melanoma rates are increasing exponentially and faster than those of any other cancer. Here in Zimbabwe, and elsewhere in the tropics, we have the climate many other nations only dream of. However, it is this very love of the warmth and sun that puts us at higher risk because of our greater exposure to the sun, however unintentional, throughout the entire year. The cause of increasing melanoma rates are still somewhat of a puzzle, but appears to be directly linked to:
-Increasing sun exposure: It is widely accepted that tanned skin makes a person look healthy, younger and slimmer.  Many blame the designer Coco Chanel for first introducing tanned models and making tanned skin fashionable. 
– The rest of the fashion industry has further contributed by doing away with clothing as a form of sun protection; hem lines have gone up, swimwear has shrunk, and parasols and gloves have gone out of style.
-Henry Ford and the automobile are also at fault. As more and more people drove, the wearing of hats was abandoned, and the current popularity of motorised transportation has led to ozone depletion and global warming. 
– Holes in the ozone layer allow more cancer-causing rays to reach the earth’s surface, and global warming has led to sunnier days.
-Our country’s increasing leisure time spent in the sun has also played a role, as well as the fact that more light-skinned people are living in tropical climates. 
– Lastly, the possibility has been raised that perhaps the increasing length of sun exposure enabled by sunscreen use has allowed more tumours to form.
Other risk factors that may contribute to melanoma development 
– Skin colour, is indirectly related to sun exposure, i.e., because lighter skin has less intrinsic protection against the sun, it allows more sun to penetrate the skin surface. Interestingly, very dark-skinned people often develop melanoma in less pigmented locations, such as the palms or soles of the feet.
-Family history of melanoma; it is unclear whether this is simply due to similar skin colour and similar sun exposure, or rather due to some inherent genetic tendency.
-People with more than a hundred moles are at an increased risk as well; especially if many of these moles appear atypical.
Prevention
So, in light of the above grim statistics, what can you do to avoid getting melanoma?
The most critical tactic is prevention. Since more than 80 percent of all sun damage occurs before the age of 18, the most effective time for this is during childhood. Unfortunately, children are not sovereign and cannot do this on their own. Unless the parent takes serious responsibility for sun safety, the child will enter adulthood with irreversible damage already done.
In America the Environmental Protection Agency is concerned enough about the lack of sun safety during childhood that it has developed a program to use in elementary schools. Over the next few years, children will begin learning about sun safety as part of their required curriculum, but until then, nothing is being taught.
This is in contrast to Australia, a country with similar melanoma rates to the USA, where skin safety instruction begins at the kindergarten level and national policy requires children to put on hats and sunscreen prior to going outside. Moreover, lunch and breaktimes have been moved to avoid noontime sun when the ultraviolet rays are particularly damaging.
Similar strategies will undoubtedly become mandated policy in other countries, but since bureaucracy moves slowly, this will inevitably come too late for this generation of children. If you are already an adult, all is not lost and you can still reduce your chances of skin cancer somewhat by starting with safe sun practices now. If you’re an adult who fried their skin during childhood and have done irreversible damage already, you need to perform routine self-exams and learn to recognise melanoma early, so that it can be treated before it has a chance to develop further.
Signs of melanoma
Since melanoma is now common in our population and can develop in young people, even teenagers, we all need to learn to recognise its warning signs. Melanoma can look like a mole, however, it differs from ordinary moles in five ways, which can be remembered using an ABCDE algorithm:
A stands for asymmetry; melanoma can be asymmetric, whereas ordinary moles are usually round and fairly symmetric.
B stands for border irregularity; melanomas can have irregular or jagged borders, whereas benign lesions tend to have smooth borders.
C stands for colour, which is usually black or has variations of different colours, including brown, black, or red; harmless moles are usually all one colour.
D stands for diameter, which is usually larger than six millimetres, or the size of a pencil eraser; harmless moles are usually smaller.
E is for expansion; even if melanoma starts out small, it usually enlarges.
More on this next week.
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