Out of the bronzed age

Out of the Bronzed Age

The great American migration seekingfun in the sun is now under way. The stirrings began with the vernal equinox as the winter sun crossed the equator, heading north and increasing the hours of daylight. Over the next three months, from June through Labor Day, that migration will take people to lake shore and ocean front beaches and up into the thin, clear mountain air.

For many of these people, an importantpart of the fun will be "getting a healthy tan.' But in recent years, more and more Americans have been getting the message that there's really nothing healthy about a "healthy tan.' For the first time, there may be a generation growing up that understands the risks of tanning and burning and cancer and cataracts that can result from too much sun.

"Too much' can mean a severe sunburnand the temporary punishment of pain and peeling that goes with it. But to physicians, especially dermatologists, it also means a lifetime of exposure to the sun that puts the skin through a repeated cycle of injury, repair and, ultimately, permanent damage.

Skin damage from sunlight is cumulative;the harmful effects build up with each exposure, whether sunburn occurs or not. Effects can include wrinkling and premature aging of the skin and, in time, the almost leathery appearance of long-time desert dwellers and fishermen and others who have spent their lives in the great outdoors.

It is the ultraviolet radiation in sunlightthat injures skin cells in exposed and unprotected areas of the body. Although the skin's own repair mechanism will immediately go to work, this does not mean it can undo all the damage. If the cycle is repeated day after day and year after year, the damage can become irreversible.

The most dreaded consequence of excessiveexposure to the sun is skin cancer, usually associated with aging, although dermatologists report seeing it in a surprising number of adolescents and young adults. The most prevalent skin cancers are basal cell and squamous cell carcinomas.

Basal cell carcinomas appear on thehead, neck, hands and trunk and are the type most often seen among Caucasians. They are slightly raised, slightly translucent nodules that, if untreated, may crust and bleed. They grow slowly and do not spread (metastasize) through the blood-stream to other parts of the body. In time, however, they can penetrate to underlying tissue and form swelling tumorous growths that crowd against and damage organs and tissue. Some 500,000 cases of basal cell carcinoma are expected in the United States this year.

It was a basal cell carcinoma that wasremoved last year from President Reagan's nose; from the First Lady's upper lip; from Vice President Bush's cheek; and from newsman Ted Koppel's eyelid.

Squamous cell carcinomas are reddishor pink raised nodules or warty growths, most often found on the lips, face, mouth, hands, ears and other areas exposed to the sun. They may bleed and form small ulcers, and they can eventually grow downward within the skin and metastasize to other organs and tissue, causing serious damage, even death. Some 100,000 cases of squamous cell carcinoma are reported each year in the United States.

Both basal cell and squamous cell carcinomasare almost always curable if detected early and removed by simple surgery or freezing with liquid nitrogen.

A more sinister kind of skin cancer ismalignant melanoma. Although very rare, it is often fatal, but is more treatable with drugs and surgery than it once was. Some 20,000 cases will likely be reported this year.

Although the relationship betweenmelanoma and the sun is not as clear as for basal cell and squamous cell carcinoma, some experts believe it can be traced to intense, short-term exposure-- often before age 20--accompanied by blistering and painful sunburn. There is evidence that heredity may also be a strong determinant.

Back in 1930, about one person in1,500 in the United States could expect to develop melanoma in his or her lifetime, according to the American Cancer Society. By 1980, that had risen to one person in 250, and by the year 2000, it could rise still further to one in 100. Tanning was not as fashionable in the thirties as it is today and, if the sun does trigger melanoma, one reason for the increase could be Americans' fascination with tan bodies.

The upper back, torso, head, neck andlower legs are the most common locations for melanomas, which often arise from an existing mole. The average person's body will have about two dozen moles, and these should be checked from time to time to be certain they are not changing in shape or color. If any are, see a doctor right away.

Compared to a harmless mole, amelanoma will develop spreading and uneven edges and show colors of black, brown and even red and blue. If not treated with drugs or surgery, a malignant melanoma lead to death as it spreads through the body. With early diagnosis, survival rates for treated cases are considered good.