11:21 PM PST on Tuesday, January 24, 2006
By SHARON McNARY and PAT O'BRIEN / The Press-Enterprise
Rising rates of the potentially deadly skin cancer, especially among Latinos, has many people rethinking how they protect themselves from the sun, because pigment just isn't enough.
Carlos Castillo learned that the hard way. After years at construction sites, sitting on an excavator in a short-sleeved shirt, his sun-exposed arms developed precancerous nonmelanoma sores that a doctor burned off.
"I didn't know any better," said Castillo, 41, of Riverside. He said he ignored his Mexican-born father's tradition of wearing wide-brimmed hats and long-sleeved shirts while working outdoors.
"I'm the second generation. I was never taught to wear anything until I got the cancer on my arms," Castillo said.
Wearing a long-sleeved T-shirt while running errands, he said he makes sure his son, Cody, 6, wears sunscreen on his face and on forearms, which are left uncovered by his school-uniform T-shirt.
"I don't want him to take a chance with the sun," Castillo said.
Melanoma is becoming more frequent among people of all races and ethnicities, experts say. One in every 250 people was diagnosed with the disease in 1981, but by 2000 that rate increased to one in every 150, said Riverside oncologist Fawaz Gailani.
People with light skin, or freckles, or red or blond hair are still at highest risk for the invasive skin cancer. What was unknown until a study, which was released Monday in the medical journal "Cancer," was that the rate of melanoma is rising among Latinos.
The study by epidemiologist Myles G. Cockburn, of USC's Keck School of Medicine, said the rate of skin cancer among Latino males had been growing at double the rate for whites.
Cockburn and colleagues analyzed 14 years of data from the California Cancer Registry (a state-run service that collects information about all cancers diagnosed in the state) and identified differences by race and ethnicity.
They found that melanoma in Latino-surnamed male Californians increased 7 percent per year from 1996-2001, the most recent data available.
Cockburn said by phone that people have a misconception that only light-skinned people had risk of skin cancer. "We need to get people out of that mind-set," he said.
Light skin and sunburns, especially in childhood, are risk factors. Someone with three or more moles larger than a pencil eraser has a seven or eight times higher risk of developing melanoma than someone without moles.
But much is unknown about how and why some people get melanoma. He suggests it may be a combination of genetics, sunburns, which damage cells, and other factors.
Since melanoma can be deadly unless removed early, the most important thing people can do is check their skin regularly for any changes in moles and see a dermatologist yearly for a skin check, he said.
Unfortunately, Cockburn said Latinos, because of the assumption that they have less risk of getting skin cancers, are less likely to take those steps. He hopes the study will change that.
John Morgan, a doctor of public health and cancer epidemiologist for the California Cancer Registry in the Inland area, said melanoma is increasing across the board, and people with darker complexions shouldn't be complacent.
"It is not a zero risk, and it is increasing," he said. "The real message here is people need to protect themselves from UV exposure regardless of race or ethnicity."
"We assumed people with darker skin had more protection," said Gailani, an oncologist at Kaiser Permanente Riverside Medical Center. He directs a center that treats all Kaiser patients in California and Hawaii who have advanced cases of melanoma. He is seeing more Latino patients.
"Those people who were led to think they have protection, who went out without sunblock, now we're paying the price 20 to 30 years later." The damage of the past cannot be reversed, so, Gailani said, "We have to go and protect the next generation."
Wendy E. Roberts, a dermatologist in Rancho Mirage, who trained at King/Drew Medical Center in Los Angeles in the midst of a community that is mostly Latino and black, said the USC study reflects what she sees in practice.
"Skin cancer is not just for white people," she said. "No one is immune. All people of color are at risk." Not only are Latinos and blacks not likely to think they have skin cancer, they may have limited access to health care and therefore put off getting checked early, Roberts said.
"The earlier the diagnosis, the higher the survival rate," she said. People should suspect any growth that has warning signs, such as itching, redness, swelling, tenderness or pain.
"If you have a spot on your body that's bothering you, that is an important indicator of skin cancer," she said. "It's very subtle."
Shaon McNary
Pat O'Bien
Specializing in Cosmetic, Geriatric & Ethnic Dermatology and Generational Dermatology
