Basal Cell Carcinoma Skin Cancer

captioning provided by caption associates, llc www.captionassociates.com . >> coming up on kcpt we take a closer look at an under-estimated killer: skin cancer. good evening everyone, i'm nick haines. stay with us for this local show special "more than skin deep" next. >> there will be as many cases of skin cancer in the united states next year as all cancers combined. >> melanoma is the most rapidly increasing cancer in the united states, and we're in a desperate search for new ways to treat it but once it spreads, it kills. >> in the first few days, i was positive, it's just skin cancer, it's not going to hurt you. and he told me going through

this treatment is going to be like getting run over with a truck. having that truck back up over you, and having that truck run over you again. but then look what i've also been through. i've also had melanoma, i almost had my life taken away from me because i wanted a tan. well, if the sun is fading the paint on car, just think of what it's doing to your skin. so why aren't we covering our kids up? over the last 3-5 years, i have to say there's really been a dramatic drop in the average age of the patient that we treat here. >> i walk the beach quite a bit and i will see these people and there's half a dozen people burnt to a crisp

and you just wonder how unlucky or lucky they will be. it's a front page news story, veteran kansas city royals broadcaster fred white dies after battling melanoma, good evening, everyone, i'm nick haines. every eight minutes, someone in the united states will be given a melanoma diagnosis and every hour someone will die from the disease. and if you live in kansas city, you may have more to worry about. did you know that cans and missouri rank among the ten states with the highest death rates from melanoma? on this special edition of the local show, kcpt partners with the producers of the national public television documentary, "more than skin deep" to tell the story of

skin cancer. during this one-hour special you'll also have a chance to speak to area dermatologists at the kcpt phonebank to address your own medical concerns. and we'll take your calls with a panel of medical experts live on the air. tonight we expose skin cancer. but to do that, you have to understand it. here's skin cancer 101. >> how does sunlight cause skin cancer? the answer lies in those often hurt initials, uva and uvb. >> uv rays are light rays that contain energy that come from the sun. uv rays don't penetrate very deeply into the body. the uvb rays don't get very far past the top layer of skin, or the epidermis, which is about a millimeter thick,

about the thickness of a fingernail. the uva ray can penetrate a little farther, maybe 2-millimeter, but they don't penetrate any deeper than the top layer of the skin. ultraviolet rays contain energy so in the case of uvb rays which cause most of the damage that's related to skin cancer, these rays collide with proteins in the newcally us -- nucleus of the cell and interact with the dna and cause mutation. ultraviolet rays are hitting all dividing cells in the skin. if they're hitting the cells in a mole, which contain normal anticytes, the mole is at greater risk for developing melanoma. >> so moles are the strongest risk factor for the deadliest skin cancer, so the more

moles you have, the more likely you are to get melanoma, the funnier looking moles, the more likely you have to get skin cancer and many of the melanomas arise in a preexisting moles. being able to keep track of your moles for any changes -- for any changes is important for melanoma detection. melanoma can happen a, anywhere on the body, b, don't have to arrive in preexisting mole, and c, happen on anyone, when they will molely or have recognized risk factors. >> you can certainly have a mole changing, and that is a melanoma, and yet not have any pain whatsoever. in general, actually, most melanomas do not cause pain. >> and many times after all these years of seeing patients i will say i feel

something here, and they will say well, i don't think it's there, then i take a biopsy of it, well, it's really not bothering me do i -- so i don't need to have it done, but you do, because it will get bigger, it can cause ulcers in the skin, it will begin to bleed. i've actually seen entire cheeks have to be removed because the skin cancer grew so large, and still really wasn't hurting or bothering the patient. >> the abcd and sometimes es that were developed to help patients and doctors be aware of the warning signs of melanoma. a means asymmetry, it means that one half of a dark spot or pig mented spot doesn't match the other half. if you look at one side, it doesn't match the other side.

b refers to the border. and if the border is irregular or hazy, there's not a sharp demarcation, that's a warning sign of melanoma. color refers to any color that's not an even light brown, such as black, blue, red, or white, and especially combinations of two or more colors are very worrisome. d is the diameter of the lesion. and usually greater than six or 7-millimeters, which is commonly referred to as the size of a pimple eraser. it's more of a risk for being melanoma. e refers to evolving, or evolution, and basically, that's anything that has changed in any way, becomes elevated, enlarged, bleeding, any type of unusual symptoms. >> while the abcdes are a

common he will accepted guide they don't forecast all melanomas. >> so i went online and followed the abcde rules, and it really wasn't anything like the pictures that you see. i think sometimes they put the worst case scenario online and this is definitely the best case scenario. even the doctor, even the dermatologist, wasn't too concerned about it. he scratched it and looked at it and he said well, we'll get it off for you, but i don't think it's anything to be concerned about. sure enough it came back melanoma. >> ultraviolet light exposure and damage is cumulative, it builds up on your skin. from the time we're small children and playing outside.

now, you may not see the effects of that ultraviolet damage until later in life, but it's very important to understand that it's not just the sun composure we get as adults but it's cumulative from the time we're little children playing. that's why we need to protect our children. >> while most of your sun exposure, two-thirds to 3/4, occurs before 18 years of life so you never get that back, your body never forgets that ultraviolet exposure and you may pay the price later in life, even if you change your habits. you can't completely erase that. >> sun exposure is dangerous to children, but it in particular, sunburns. there's dad dat -- data to show five childhood sunburns

doubles your chance of developing skin cancer later in life. >> our youngest daughter, colette, had a mole removed, something that she noticed was changing. it was a mole from birth. and the diagnosis at the time was congenital, a 1 percent chance of melanoma. i recall her saying i'm lucky, it wasn't melanoma. quite honestly, i didn't know what melanoma was. i did not know how deadly it was. >> colette, the youngest of our five, was not a sun worshiper, but she had been exposed to the sun when she was young. she had -- i recall her having a sunburn when we took her to disneyworld, florida, and i recall she had another sunburn as a teenager, and

the doctor said that's all it took to trigger her melanoma. obviously, my other children may have had sunburn, but given their genetic makeup for them, it was not as deadly. we will not know until time passes. you have a 1 in 50 chance of developing melanoma in your lifetime according to the american cancer society and the statistics are ballooning. in the last three decades, the incidence of melanoma increased by 800 percent among young women and 400 percent among young men. stay with us on kcpt, as we continue with "more than skin deep" in just a moment but i want to introduce you to a number of experts in our studio. dr. gary doolittle who

specializes in melanoma and second opinions in cancer at the university of kansas cancer center. dermatologist glenn goldstein, director of the dermatology and skin cancer center in leawood. and kelly klover is founder and president of the outpacing melanoma foundation. >> are you more likely to get skin cancer than in the 1950s in america or 1970s in america? >> absolutely. we're an outdoor society, people work outside, they play outside and now they have sunscreen, have some protection, they are staying outdoors for many more hours than they ever have before. >> so the conditions are different today than they were then, dr. doolittle?

>> i don't know that the conditions are different but our lifestyle has changed. we are sun worshipers. if were born in the 1930s, you might have a 1-500 chance of developing melanoma but in 2013, a one out of 50 chance of developing this staoes. >> one of the issues for many people is nobody thinks it's ever going to happen to them. kelly, it happened to your husband, richard. he died of melanoma in 2010, at the age of 46. >> that's correct. yeah, just three years ago. you know, we were caught off guard, just blindsided, stunned that he was diagnosed at stage four, and we had just celebrated the holidays with family and friends, and had no idea that his life was about to be cut short.

it was just seven weeks later that we lost him. five years prior, he had a mole on his back that tested positive for melanoma, and the mole was removed by a procedure called mose surgery, and we were told that they got it all, it was a small lesion, less than 1 millimeter, and that we should never have to worry. we were told no further treatment was necessary. it was recommended that he go and to his dermatologist, every 4-6 months, for checkup, and he did that, and he did have other suspicious moles removed as well. so we felt like we did what we were told to do. and i considered us lucky. i never once knew that his life could be in jeopardy. >> so you thought you were doing all the right things

and it still happened. how common a story is that dr. tkpwao*ld stein? >> it -- goldstein? >> it happens, if you don't catch it early enough, there are people that will succumb to that disease, so we ask people if you see something that looks unusual in your skin, to get in as early as possible and have it looked at, because the faster you have it diagnosed, the better chance you are going to have later on. >> i have to acknowledge, right here on this program, i'm a 44-year-old man with deep dark skin. i've never been to a dermatologist office. one of our producers was saying we have more chance of taking our pets in than going to the dermatologist. very few of us actually go.

>> the american academy of dermatologists suggest that people over the age of 40, if they've never been in should get in, have a baseline exam and make sure the spots look okay. >> what does it mean to go to the dermatologist's office? >> when you go to the dermatologist's office they'll examine not only the sun-exposed areas but the nonsun-exposed areas as well and look for moles, look for spots that don't look normal. >> you talk about moles. obviously, in my own research for this program, dr. doolittle, it says you can get melanoma -- you can get it in the eye, under the fingernail, toenail, so it doesn't have to be a mole. >> the majority of melanomas start in the skin, better than 80 percent do but some

start internally, some start in the back of the eye, there can be other areas of origin for the disease. >> we see that the young women are the main demographic coming in with this issue right now, it is the fastest growing group for skin cancer. why is that? >> i think there's been a lot of sunburns in young women, they hear in the literature about what's going on with skin cancer and they want to make sure that they are not a statistic later on. >> so are those the people that are coming in to your determineta logical office, the young women who come in. >> it really is. >> in melanoma, you have to remember that the peak incidence is between the age of 20-and 45.

that's where we see the biggest number of melanoma patients. so i would say the bulk of patients coming in are young women, and also, probably men over the age of 45 or 50, who are starting to notice new lesions on their skin. >> is there a genetic connection to skin cancer, dr. doolittle? >> there are some families that have a genetic link, that it's passed from one generation to the next, but the majority are sporadic, they occur spontaneously in an individual. the genetic piece may have to do with the coloring you inheret. blond hair, blue eyed people are higher risk, red-headed people at higher risk, those that have multiple mole, a family in which multiple

moles are passed from one generation to the next, you're at greater risk. >> this hour, you can get your questions answered by a dermatologist at the kcpt phone bank. they are there to help you. call the top number on your screen. if you have a broader question about skin cancer that you think others would like to know the answer to, we welcome you calling the bottom number on the screen, that will connect you with me, kelly and our two doctors. before we're heading to the switchboard, where he told skin cancer is highly preventable, yes, but how do you get folks, particularly sun worshiping young people, to pay attention to that message?

>> in the skin cancer community, melanoma is known as the beast, a formidable and deadly foe. but in the general public, melanoma is often tragically underestimated, or misunderstood. experts are trying to spread knowledge of the disease where we are most vulnerable, at play. today, we are doing our annual mole patrol. we do a skin cancer screening for the people who are here at the beach and trying to raise awareness about skin cancers in general, and the harmful effects that a day in the sun can bring. >> but i think that's pretty suspicious. >> yes. >> basal sell carcinoma. >> yes. >> i recommend this one, that

this one be biopsied. >> if i had not gotten checked out today, it probably would have been a while before i noticed anything because it's on my lower back and it's not a spot that's visible to my eye. it might have gotten worse. so i'm glad that i came in and got it checked out. >> well, one of the things we don't see very much in an event like this, are older men, and we know that that is a big problem. when we get -- when we are in the hospital, seeing our melanoma patients, older males tend to show up with bigger melanomas, more advanced, higher risk, and they are more likely to die from their melanomas than the younger people that we see. >> we actually saw a

clearwater policeman, after a lifetime of being in the sun on patrol had obviously taken its toll on his skin. >> i'm deputy david littlejohn and i spend on average probably six, seven hours daily in the sun. as a kid, i grew up in florida, and pretty much during the summer, you got out of school, you put your shorts on, and that was it. off you went. you got a couple of sunburns and figured you were good for the summer and everything we did was outdoors. my attitude towards sun protection, 180 degrees from what it used to be. i enjoy a lot of outdoor sports. i used to go in my boat, i'm just going fishing for a couple of hours, won't bother with a hat, sunscreen,

anything at all, and i would peel, my nose would peel, i didn't think anything of it, but after the diagnosis of melanoma, sunscreen is going on, got my wide brim hat on, yard work is done by 9:30, 10:00, during the day. what i'm paying with now is what happened to me as a child. i was always getting sunburned, never giving any thought to it. it's kind of hard now, it's like closing the barn door after the horse is out. by the time the kids develop the same cancers i had, it's too late. >> i don't o'clock of -- don't think of damage later on in life. i do think of how i will look. my honest opinion? i worry about how i look when

i'm older, the skin damage itself, what it would do to any body, i don't o'clock of -- i don't think of that. the only thing enforced in school was drug and alcohol, smoking and i have to tell you, i'm 21 years old, i don't drink, i don't smoke, because i know the harmful effects it can have on my body but i don't really remember learning about sun damage or taking care of my skin. >> we need to do a much better job of teaching our kids about sun protection, sun awareness, and sun avoidance. it's when you're kids that you get your sun exposure, it's when you're a kid, you feel nothing can hurt you. we have to teach our kids. i look forward to the day when kids say mom, dad,

you're going out without your sunscreen. we learned in school that is bad. that's what we need to get to. >> people have been trying to get shades on the playground for 15 years. it took a while to explain that it's the accumulation of sun, you can get five minutes here, five minutes there, 10 minutes here. it doesn't wipe the slate clean. once you get that exposure, that's permanent. it's in there. the school board was on board, the timing was right, they had money in their budget, and they budgeted $2.1 million to cover all 22 elementary schools in collier county, because since the year 2000, we've known that

uv radiation is on the known carcinogen, like asbestos and tobacco. we don't let kids smoke in school, they ripped asbestos out in the '80s. we're still sitting with uv pounding our kids. i want to get the covers up yesterday. >> no, we never do enough when it comes to our kids and public health and safety. we do as much as we k. but we're all fighting for air time in the schools. >> we can't even get music and arts curriculum, how can we get a message about a disease that you have to prevent now when you're a child and you won't even see the effects until maybe 20, 30 years later? >> now for a special report, go to our health reporter, olivia.

>> thanks jen. we asked what is melanoma? >> melanoma. >> that's what you get from touching bad chicken! >> mag-no! >> melanoma? a nightclub singer. >> wrong, baby! >> melanoma is the worst kind of skin cancer. if not treated early it can be deadly. it comes from too much sun exposure. do you don't -- so you don't have to do this or this. but seek shade between the hours of 10:00 and 4:00, and wear your shades! >> wear a hat! >> use sunscreen, at least 15 spf. this way, we can all have fun in the sun. >> even children are getting the

message. back with our documentary "more than skin deep" in just a moment. i'm back with dr. glenn goldstein director of the dermatotology and skin cancer center in leawood, dr. gary doolittle from the university of kansas cancer center, and kelly klover with the outpacing melanoma foundation. >> kelly, do you get a chance to spread the message about the dangers of sun? >> nick, we have not had that opportunity yet. i have approached one school district, and we were allowed to have a student give a presentation into the health classes. -- for a class project, but that is something that is definitely something we'd like to do. >> is that a challenge,

dr. goldstein? >> i've spoken once before to the kansas city, missouri school district where they had all the newspaper writers come in and get informed about skin cancer and they went back to their schools and wrote articles on it, but it is a challenge for them. >> okay. we're going to go to the phone now to hear what you have to say and your questions for our panel. we go first to christine in independence. welcome christine, your question please. >> hi. >> hello there. >> where can i go to get it checked out? >> i don't have any insurance, and the guy i went to at the swope place on 50 highway and cleveland didn't

want to take it out. >> okay. if you don't have insurance, and you have an issue, where would you go? >> there are several free health clinics that are available, and even some of our dermatologists from our practice do that. one is in johnson county free clinic. also, metro med also has dermatologists that are available as well, after they check you out to make sure you don't have insurance. >> there's also the jackson county free health clinic. >> absolutely. >> if this lady is in independence. so you can go to see a dermatologist at a free health clinic? >> yes. >> madam, you've got your

question answered there, you can still, even without insurance. okay? we go now to a gentleman from gladstone, with your question next, sir? >> yes? >> hello there? madam? >> we're ready for you. >> oh. yes. >> katie, hello? >> i'm calling about mercel cell sars nomea. -- carcinoma. >> what would you like to know? >> i'd like to know more about it. my brother-in-law passed away two years ago with it. i would like to know. >> this is an interesting question because we focused a lot on melanoma so far, but

only 5 percent of skin cancers are melanoma. isn't that the case? >> yes. >> tell us about, so what are the other 95 percent of those skin cancers that people are dealing with? >> well, basal carcinomas represent about 80 percent of all of the skin cancers that are out there. 20 percent are represented by squamos cell carcinomas and 1-5 are melanomas, then there's a mercel cell tumor that that comprise less than 1 percent of all skin cancers out there. >> do you deal with that at the university of kansas cancer center, dr. doolittle? >> we deal with mercel cell. often times the patients present to determinenologists first and the diagnosis is made.

sometimes there's surgery that is necessary, and if the mercel cell spreads beyond the primary site, sometimes chemotherapy. >> when we talk about melanoma, it's like -- first of all, is this an automatic death sentence if somebody is told at a dermatologist's office they have melanoma? >> absolutely not. the prognosis is based on the thickness of the melanoma at the time of the diagnosis, so the earlier it's caught, the thinner the melanoma is, and therefore, the greater the prognosis later on. and that's why we tell people, when they see a mole changing, or something looks unusual, get in early, because the earlier you detect it, the better your chances are going to be. >> but that being said, i

think many times, often times significant symptoms do not present themselves, and it's too late. like in our case. i mean, you know, how do you go that stage zero or one to four, almost overnight? >> right. >> you know, it just -- it's so hard to process. >> if you present with a melanoma, does that automatically then leave the hands of a dermatologist and go into the hands of someone like dr. doolittle at the university of kansas medical center? >> i would tell you, we practice together, the dermatologist, medical oncologists work as a team. even when patients come to me with higher stage disease i work with a dermatologist like dr. goldstein and others

for that followup. once you've had one melanoma, you're at risk for developing a second and it's critical to work in that team manner with your dermatology colleagues. >> we go next now to the phones, and dale in leavenworth, your question for the panel, dale? >> thanks, nick. thank you for the show, and thank you for the subject. i wanted to -- and i'm in liberty, but that's okay. >> no, you deserve all of the attention and recognition for being in liberty. >> [laughter] >> i have had a melanoma removed. i've been followed by the group that's on your panel for the last three years. they are very diligent. >> okay, he's dropped off the line for a moment.

i should point out, by the way, this is melanoma awareness month, and that's appropriate as the month of may is when people start heading into the sun. a couple of weekends ago, though, on may 5th, on a more chilly sunday morning at corporate woods in overland park, hundreds of runners took part in the second annual outpacing melanoma 5k run. some just walked, but all were there to honor those who have been lost and those who are surviving melanoma. kcpt's todd feeback was there. >> and they're off! outpacing melanoma. step by step. >> we're out here today to raise awareness and to fund research for melanoma. >> outpacing melanoma is really about getting

awareness out so people understand the impact of melanoma. it really is about getting checked, you know. our slogan, don't delay, get checked now, is so critical. >> i have had melanoma three times since the age of 25. >> i'm a 2-time melanoma survivor. i was diagnosed in august of '97. >> i was diagnosed when i was 21. >> melanoma is the most common type of cancer among 25-29-year-olds. and the second most common for young people 15-29 years old. but most of us think it only happens to other people. have you ever considered that everyone else in the world, you are that other person? >> when you get diagnosed and

-- you're terrified. i mean, i was -- i didn't know if i was going to live to be 22, and you're 21. >> i had an older daughter that had just graduated, a son that was getting ready to graduate, and a two-year-old, and i thought that i was done i wasn't going to see my kids grow up. >> i did tan when i was younger like all my friends did, and we wererer all just, you know, never thought it was going to happen to me. but now it's very real, i don't go out in the sun very much. if i do, i have sunscreen all over, and i reapply at least every hour, if not more. i'm very self-conscious and aware. i try to spread the awareness to everyone that i see or know.

>> your chances of getting melanoma are a lot less if you just go to the doctor and get checked. >> stay out of the sun. stay out of tanning booths. that's our message. >> i just -- i don't want anybody to go through what i went through. just the thought of you're not going to see your kids grow up, you know, the thought of it's never going to happen to me, that's wrong it's a wrong concept. it can happen to anybody. adam stanislauv, you ran the race. now you're helping us at the phonebank. what kinds of questions are we getting in at the phonebank? >> nick, we're hearing a lot about tanning beds, sunscreen, when should i get checked, i have moles, what should i look fork the

abcdes, all those factors that really come down to making sure that you do get checked, and that you understand, you look at your body. because it's really important. that's the message that's getting called in on the phones and trying to understand that. >> we should point out these are all medical doctors we have, these are trained dermatologists. >> they are and they are also calling in about sunscreen, the different types thaw might want to apply and how to apply it and when to apply it. >> i'm going to answer those questions in our expert panel in a moment. this hour you can confidentially get your own

medical concerns answered by a dermatologist at the kcpt phonebank. they're here to help you tonight. call the top number on your screen. if you have a broader question about skin cancer that you think others would like to know the answer we welcome you calling the bottom number to speak with our experts here in the studio. we'll get to your calls right after hearing from another skin cancer survivor who kcpt tracked down at the outpacing melanoma 5k a few weekends ago at corporate woods. >> my name is rachel hagen, i'm 37 years old and almost four years ago i was diagnosed with stage two melanoma, i found the mole by chance, my two-year-old son had a viral skin disorder, so i happened to be going into

the dermatologist office to get him treated, and it was in the summer, and i walked out, and the dermatologist said there's something on your leg, and she said you're coming back tomorrow morning at 8:00 a.m. to get this thing taken off, so i went back, got it taken off, go back 10 days later, the doctor comes in, the hand is on the arm and comes back that i have a stage two melanoma. followup surgery was scheduled, they got all of it out. i have a lovely scar to remember my saving grace by that doctor who was treating my son, and the wart that is my son had are what ended up saving my life and i'm four years out of having melanoma and i would like to just definitely tell people that

as you can tell, i've never been tan, and i'm never going to be tan and it's okay. i have three kids that are 11, almost 10, and six, and they all are skin aware, and they wear their sunscreen, their hats, they're not out during the hottest times of the day and if they are, they are covered up, and they are telling their friends that the way we were born and the way we look is the way we're supposed to look and take care of our skin so we can have long, healthy lives. >> we were just hearing from adam at the phone bank and a lot of the questions at the phone bank were about the sunscreens and what you should use. tell us what sunscreens you use yourselves. tell us what you use, kelly. >> you know, to be honest, i

have not always been very good with the suntan lotion. that's something that in recent years, since i've lost my husband, i am now starting to pay attention to. >> but i did read the statistic, and this is from the american association for cancer research, more than one out of three americans, first of all, don't use any sunscreen, but 27 percent of people who were actually diagnosed with skin cancer don't use sunscreen, dr. goldstein. >> they should know better. >> they should know better. what we usually tell our patients, they should use an spf of at least 30 and look on the label to see if it says broad spectrum because broad spectrum covers both uva and uvb rays and that's very important.

>> what do you personally use? >> i personally use an sbf of 85 or even 100 on some occasions on my face, because my feeling is if you're making the attempt to put sunscreen on because you don't want any sun exposure, why not use the highest spf you can? >> how about you dr. doolittle. >> i use an spf of 50 or higher. it's not hard for me to stay out of the sun because i burn so easily. i think the other message that might be conveyed is staying out of the sun from 10:00 to 4:00, if that's an option for you, you should try to avoid sun exposure. >> i use an spf200, you squirt the bottle and a sweater comes out!

a little bit of humor. >> wear protective clothing. >> tell us about the protective clothing. you key a -- you see a lot about spf clothing in catalogs and other places. are these just marketers trying to get money out of us or do those clothing items work dr. doolittle? >> they are very effective and i encourage patients with an spf, sun block, sun-protective clothing, caps and try to stay out of the sun as best you can. >> there has been a dispute also that if you have a sunscreen above 45, you're wasting your money and it has no effectiveness. >> certainly any sunscreen that gets sweated off or washed off in the water isn't going to be effective, so you need to remember to reapply

it, every two hours or so, after you have put it on the first time. >> okay. now, many people blame the tanning beds. , particularly among young people for this explosive rise in skin cancer diagnoses. we track that issue next as we return to the documentary "more than skin deep". but as you're about to see, using artificial sunning devices to darken the skin is nothing new. >> this man is giving his face a six minute exposure to sun craft ultraviolet rays. next morning, he seems rather pleased with the healthy outdoor appearance created by the swelling of the capillaries under the skin. this sunburn or arythema is the first prerequisite of

ultraviolet therapy, ultraviolet rays improve the sun and the healthy skin is a beautiful skin, the reflector of the flexible sun craft lamp may be readily attached so as to follow the motions of a wiggling infant, more and more people are stepping out of the shadow, bringing vital rays into their homes for a happier and more healthful living. >> i started going to tanning beds my sophomore year in high school, i went for about three years, and i would go at least twice a week. >> yeah, i usually would tan the most in the spring when the summer is going because i wanted to go to the beach and be already tan, not go to the beach and be pail -- and be pale, especially prom season, i'd go like three, four times a week.

>> the use of tanning facilities among young people is a disaster, because of the ability of these uv rays to increase the incidence of melanoma in young people. >> at first, i discovered i had melanoma when i was 15. it was on my foot, and it was just like a small mole at the time. it was really scary. i really didn't know what to think. i was like the youngest patient that my doctor said he's ever seen and people think it doesn't happen until you get older but you never know. it's ageless, really. when i was in the waiting room for my checkup and even before surgery, it was a special designated room for skin cancer patients and most are older people and they

have like huge, like, bangs -- badges on their faces and heads and it's like half their faces are gone or on their legs and i'm lucky mine was on my foot so it's not, like, noticeable. it might seem fun now, you want a tan, you think you look prettier but when you get older it's going to be a completely different story and you're going to look back on it and say why did i do that, like it was so stupid, but it will come back and haunt you. >> laura kelly! >> you might say i was the envy of a lot of young women, when i was crowned miss maryland. at the age of 20, i was diagnosed with stage two melanoma. looking back, i now know how i got melanoma.

i didn't have to tan. i chose to. and i nearly paid with my life. since then, i have had 24 additional surgeries to remove suspicious lesions. i am left with an 8-inch scar across my back and the constant reminder of why i must teach people about this disease and how to prevent it. >> how many go every day? that was me. >> a lot of teenagers and even adults look to hollywood, movie stars and models and fashion icons for how they want to look, how beautiful they want to be and it's funny to me how we're going tanning, going into the tanning salons to achieve that tan that's going to make us look beautiful and the people we are admiring,

looking up to be, are doing the complete opposite. >> is it more damaging to your health to use an in door tanning bed than to actually sun bathe at the pool? >> absolutely, because you're getting such a high concentration of ultraviolet light in such a short period of time. >> dr. doolittle, i mean, there are some states that are now regulating the use of tanning beds. what about in kansas and missouri? >> in kansas right now, the regulation for tanning beds falls with the board of cosmetology, there has been legislation in the last couple of years looking at restricting tanning for teens, 17 and younger, but it hasn't -- that law has not been passed.

missouri now has a law, the house passed, for parental consent for 17-year-old children or younger, but it hasn't gone through the senate yet. so there's a level of awareness that exists now that hasn't in past years, and that's encouraging. >> some people though would say well, there are -- if you use a spray tan, there are chemicals in spray tans that also could be damaging to your health. dr. goldstein? >> i don't think so, because the spray tans are pretty much a colored sugar and basically when they spray it on your skin it stains your skin and that's why it sloughs off as the skin sloughs over the next several days afterwards. but it can look very natural

and certainly so much healthier than getting into an indoor tanning salon or booth. >> okay. we're now going to go back to the phones and go to nancy? oath. nancy, thank you for being so patient on our phone lines. your question for our panel, please? >> all right, we're not going to go to nancy. how about margaret in overland park, are you with us, mark receipt? -- margaret? we're not going to worry about those right at this moment in time. what about race and skin cancer? is there a -- do you see patients who are hispanics and african-americans who also have skin cancer?

and how does that play out. >> we do see some who are hispanic and african-americans, but the truth is that we see more of it in patients who have fairer skin and burn easier. those people who freckle very quickly, who burn very easily, are the ones most susceptible in getting skin cancer. on darker people it will be on the lighter areas of the skin. >> i agree with dr. goldstein, we do see melanoma in the african-american and hispanic population. the incidence is less but the challenge is they are often diagnosed at higher stages and the treatment is more challenging because of that. >> okay. well, next on our documentary

"more than skin deep"we track the issue of race and skin cancer. and you may be surprised how melanoma cuts across ethnic groups. >> while children and the fair-skinned may be most at risk melanoma can target any ethnic group. >> in terms of asian americans, african-americans and latino americans, melanoma is much less likely, however it can be more deadly because it's able to be developed in many cases undetected. many times, those are further along because they've been misdiagnosed. let's take bob marley, for example, who graced the world with his music. he is an avid soccer player in jamaica, up in the states, and he was actually misdiagnosed by some of the

west indian doctors, they thought it was a soccer bruise. he had a dark streak underneath his toenail and african-americans and asian americans in particular will get melanomas, where you see them more underneath the finger nails, the toenails. unfortunately, bob marley, by the time they diagnosed it under his toenail spread to his brain and liver and he died from metastasis. >> my name is jacqueline smith. i was diagnosed with melanoma at the age of 28. i had a lump in my bikini line on the right side. i went so my primary care physician and i saw his physician assistant initially and she told me that it was probably from some sort of infection and gave me

antibiotics. i also saw the nurse practitioner there and she gave me more antibiotic, and then when i went to school, i saw a doctor, a physician, and she gave me more antibiotic, and she's the one who told me if it doesn't bother me, don't bother it. so i didn't really believe that there was nothing wrong, but since i had had so many medical professionals tell me that it was nothing, i began to believe that. >> ⶠ>> ⶠi was almost instantly devastated, but i was also in shock, because i didn't have a mole, and in school, we learned that you get melanomas from a mole, and atypical borders, and it bleeds, so i was confused because this was something that was internal.

the first surgeon wanted to do an operation, where he wanted to take out all of my jorgans, and -- or begans and he wanted to -- organs and i was nervous because he said where he cut me wasn't where this lump was, so i didn't understand how he was going to help me. out of the 16 months, i had melanoma in five, so following that, i was told i would need to have interfuron therapy, as well as radiation it's been a year and two months since i was diagnosed with stage three melanoma. i had my pet scan and it came back completely clear. so that means that it did not detect any cancer cells, anywhere within my body. my number one piece of advice for everyone is if there's something that you think is wrong and even the doctors

don't think it's an abnormality, to just be diligent, harass them if you must. that has become one of the things that -- that's one of my traits that i'm now proud of, that i have no shame, i will keep sending e-mails, i will keep making appointments, because if i didn't do that, then i might not be here, and that's only because i followed my own heart. >> ⶠ>> ⶠ>> kelly klover, you have to be empowered about your own health care. >> yes. we need to be our own best advocates. we need to get in and be seen and, you know, if -- i just felt like if this can happen to us, i mean, it can happen

to anyone. and that's why, you know, in the fall of 2011, we created the outpacing melanoma foundation, and to honor my husband's memory and to bring awareness to this cancer that is both misunderstood and underestimated. >> absolutely. we have a lot of people still on the line. margaret from prairie village, thank you for your patience, what's your question for the panel margaret? >> great show. >> thank you. >> my question is if you develop a skin melanoma in an odd place like the toe or something, it's not a high sun area, does that mean that you were exposed to the sun at that location, or could you have been exposed

anywhere on your body and it showed up at that location? >> do you have an answer to that? >> that's a very good question, margaret. what i would tell you is that not all melanomas occur in sun-exposed areas, that they can occur on any location in the body, so we all need to be vigilant for any type of pig mented lesion that tops up that looks atypical. >> how can that be, dr. doolittle? you would expect, if this is a sun-related condition, that it would show up there. >> and nick, the only thing i can tell you is we don't have a full understanding of that piece. we do know that most melanomas are from the skin, 85 percent of the time, 15 percent of the time, they

are internal, and we don't have a full understanding. >> yeah, and we just heard from the patient a few moments ago, the girl saying they were probing in parts of her body that had nothing to do, no part of the body that she felt was affected. >> david in south kansas city is on the line. david, thank you for your patience. what's your question? >> well, i'm 79 years old, and i grew up in platte county, and i did farm labor as a young kid, and i have been in the hospital with sunburn, and i've had a basal cell carcinoma taken off of my cheek about three years ago and i go to the v.a. and they checkny two, three times -- check me two, three times a year, pretty well from head to toe.

i was wondering, i haven't had a carcinoma, if i am still subject to maybe the possibility or the possibility has diminished through the years. >> good question. and the answer to that is what? >> well, i would say you can develop skin cancer at any age, but once you've had one skin cancer, you're at a higher risk of developing another. usually 30 percent of patients who develop one skin cancer get another one within a year and because it's all cumulative sun exposure. >> watching this program, i've not been to a dermatologist, and i'm going to go to the dermatologist office and i can get checked, and then i can pat myself on the back for a job well done,

but i have to come back, right? how often are you supposed to get checked? >> kelly? >> well, i think at least every one or two years. but i think if you have more moles on your body or if you have a history, like, you know, where my husband had melanoma, my children could be at higher risk. >> yes, okay. >> and so you want to take those precautions and maybe get in every six months. >> if i came to your office right now and i -- and how often would you expect me to come back and see you, dr. goldstein? >> depending upon what we would find, if we didn't see anything suspicious, we may tell you to come back in one or two years.

if we found a number of lesions that we thought were concerning we'd probably have you come back at least twice a year or more often depending upon what we find. >> we go to bill in lenexa, thank you for being on the line, your question, please. >> i've had mole surgery but i was told also that even though you may be at the beach and under an umbrella, that you still can receive damage from rays that are reflected by the sand. is that true? is that serious? i'll hang up and listen for your answer. >> is that true, dr. doolittle? >> that is true and also reflection from the water, if you are out boating. and that's why it's just so important, again, the

message, sun block, sun protective clothing, try to avoid the sun during peak hours. >> okay. we go next to blaze in kansas city, blaze, your question please. >> yes. i have dealt with this disorder for a number of years and i was wondering, if i use a light in my home that's the same as a sunlight, does that also give me some risk for exposure and developing carcinomas or melanoma? >> good question. >> would it be the same as sunlight? >> the question was whether or not indoor lights are similar to the sun. they can be, depending upon the type of bulbs you are using.

>> okay. well, that is all we have time for there. any final comments, and final reminders for our viewers, dr. doolittle? >> don't delay, get checked today. >> dr. goldstein. >> examine your birthday suit on your birthday. get in every year and have your skin looked at. >> i don't know where to look! okay, kelly klover? >> i just want people to know that melanoma needs to be taken seriously. too many people think that oh, it can be cured. they take that risk. they go to, you know, get that tan, and it's just -- there's no guarantee. >> this 44-year-old paled skin man from britain

promises to go to the dermatologist for the very first time. for our thanks to our guests, dr. gary doolittle who specializes in melanoma and second opinions in cancer at the university of kansas cancer center, dermatologist glenn goldstein, director of the dermatology and skin cancer center in leawood, and kelly klover, co-founder and president of the outpacing melanoma foundation. you can continue to call our dermatologists at the kcpt phonebank. they will stay here for a while longer so they can make sure your question is answered. our thanks to z- film producers of "more than skin deep." learn more at morethanskindeep.org. we've pulled together a lot of resources on how to

prevent and diagnose skin cancer along with our resources mentioned in this program. check them out for yourself at the local show.org. i'm nick haines, from all of us here at kcpt, goodnight. captioning provided by caption associates, llc www.captionassociates.com