Kansas rate surpasses US average by 9 percent.

By Amy Bickel The Hutchinson News
Growing up on a farm in the 1950s and 1960s, the first days of spring fieldwork always left Bill Heer with the first burn of the season.
It was an era where most tractors didn't have cabs and plowing fields meant little relief from sun exposure. Like most farm kids, after a few burns he began to tan and never gave it a second thought.

"A lot of us grew up with an umbrella or buggy top on the tractor, but no protection for the ultraviolet rays," the Hutchinson resident said. "A lot of us out there who were farm kids, we had never heard of suntan lotion."

After a heat stroke while in the fields during graduate school, Heer, largely put on sunscreen or wore long sleeves while working as the head agronomist at Kansas State's South-Central Kansas Research Field, a job he had for nearly 30 years.

His precautions, however, came too late in life. The early years of sun exposure and burns already had caused harm to Heer's skin.

Heer's doctor began noticing the spots on his arms, and removed several of the suspicious ones, including a few that ended up being pre-melanoma skin cancer.

"My forearms are affected the worst," he said. "When you operate a piece of equipment, those parts of your arms are always out there and really catching the sun."

And, across a state reliant on the agriculture economy, he's not alone.

A 2009 study by the Center for Disease Control shows that more than a million people in the United States have been diagnosed with skin cancer, making it the most common of all cancers. Moreover, Kansas is 9 percent higher than the national average and ranked 18th in the U.S. for new melanoma cases - with 610 residents diagnosed. About 80 Kansans die from skin cancer every year.

"Due to the large number of outdoor workers in Kansas, there is a very high skin cancer incidence," said Dr. Stephen Marshall, a dermatologist at Hutchinson Clinic. "I personally see five or six nonmelanoma skin cancer (patients) each clinic day and one or two melanoma skin cancer (patients) each month."

Marshall said there are two types of skin cancer - melanoma and nonmelanoma. Nonmelanoma rarely metastasizes to other body organs but can cause local destruction - resulting in removal of areas, such as parts of an ear or nose. Melanoma, however, is the most serious and is potentially lethal.

Genetics, including a person's ability to tan, are set a birth, Marshall said. Thus, sun exposure is really the only factor people can control.

"A tan is your body's attempt to protect itself from further ultraviolet injury and a 'healthy tan' is no tan," he said.

For instance, he said, while some smokers might not get lung cancer, the odds increase by smoking. The same is true when people don't protect themselves from the sun.

But for those like Heer who didn't apply lotion at an early age - the damage has been done. One of the big risk factors of skin cancer is suffering from burns at an early age, according to the CDC.

Another factor is tanning booths.

Women age 15 to 35 have the highest increase in melanoma skin cancer - the exact target for the tanning industry, said Marshall.

The World Health Organization recently issued a statement recognizing ultraviolet exposure as a significant risk factor, and several countries have legislated against tanning, including Brazil, where all artificial tanning salons are illegal.

Melanoma is curable if the diligent catch it in the early stages. And Marshall said that recently a couple of chemotherapy agents have been developed that prolong survival for metastasis melanoma, "which is a big start in the right direction."

Heer had several of his questionable spots removed. However, having so many of them, his doctor prescribed a cream instead of freezing each one off. In June, Heer's forearms were a deep red and purple as the cream worked to kill the rapidly growing cells, he said.

"I was surprised to see how bad it got,' he said.

"Fortunately, my primary care physician, when I had my physical, caught on to the fact I had these spots on my hands and arms and took a proactive course to take care of it," he said. "People should watch their skin and make note of any discolorations. They should tell their physicians about every spot and make sure everything is OK."


? Since 1975, the melanoma death rate has risen about 2 percent per year among state residents over the age of 50.

? For people born in 2006, 1 in 53 will be diagnosed with melanoma, nearly 30 times the rate for people born in 1930.

? One American dies from melanoma almost every hour.

? More people were diagnosed with skin cancer in 2009 than with breast, prostate, lung and colon cancer combined. About 1 in 5 Americans will develop skin cancer during their lifetime.

? Women age 15-25 have the highest increase in melanoma skin cancer - the exact target for the tanning industry.

? Those with a higher risk of skin cancer include those with a family history, lighter skinned people, exposure to the sun through work and play, history of sunburns in early life, history of indoor tanning, have blonde or red hair or have blue or green eyes.

? "The question about whether UV radiation in the world is increasing is a matter of debate, but that the incidence of skin cancer increasing is fact," Stephen Marshall, of The Hutchinson Clinic said. UV rays are strongest and most harmful during midday - typically from 10 a.m. to 4 p.m.

? Use sunscreen with at least SPF 15 and UVA and UVB protection when going outside.

Sources: Dr. Stephen Marshall, Centers for Disease Control, Environmental Protection Agency.

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