Growing Pains: Coming of Age with Skin Cancer

Young People at High Risk of Developing Skin Cancer

When young people start to spread their wings, their quest for independent adventure can put them at high risk. One carefree, unprotected day in the sun, for example, can multiply their odds of developing skin cancer.

Dermatologist Linda Franks, MD, vividly remembers when her 12-year-old daughter, Katie, came home from a day with friends at the community pool. She had a bright red blistering sunburn. "Since it was cloudy, she hadn't thought she needed sunscreen," Franks recalls.

Six years later, when Katie returned home from college at age 18, she showed her mother a mole where the back of her thigh and buttocks met—in the exact spot of the sunburn from the day at the pool. "It didn't have any of the ABCD warning signs of melanoma (asymmetry, irregular borders, color differentiation, and diameter larger than 2 mm), "but it did have the E, for Evolution or Change. It was new, and Katie just didn't like it," says Dr. Franks.

The next day, Katie had the mole biopsied. It proved to be a very thin (.39 mm) early-stage melanoma. "Hearing that number was a huge relief," says Dr. Franks. "Had it been over 1 mm, I would have had to sit down." As Dr. Franks explains, about 98 percent of early-stage melanomas are completely curable, but a melanoma over 1 mm may be considered stage II, calling for a lymph node biopsy to see if it has spread.

"Kids at her age feel invincible, but after an unfortunate lesson early in life, she's on the bandwagon now about sun safety,"
says Dr. Franks.

Two years since the melanoma was removed, Katie remains cancer-free. "Kids at her age feel invincible, but after an unfortunate lesson early in life, she's on the bandwagon now about sun safety," says Dr. Franks. "In fact, none of my four daughters will go out of the house without sun protection. They also warn classmates who visit tanning salons that they are increasing their risk of skin cancer."

Franks shares her daughter's experience with other young patients, stressing that UV rays from the sun and tanning machines can cause premature aging as well as skin cancer. "You have to make young people aware, because skin cancer is becoming a younger phenomenon. I hit all parts of their psyche where they might relate," she says. "I tell them how happy they will be 20 years from now if they don't have to worry about wrinkles and sun damage."

The single most important message, she says, is do not burn. "If you ask somebody to give up all outdoor exposures, especially a teen, you've already lost them. Instead, we tell them, 'We know you're going to be out in the sun—so cover up, seek the shade, use high-SPF sunscreen, and be very careful on overcast days, because the sun can go right through clouds and fog.'"