Steamboat Springs Pale is the new tan.
As skin cancer rates continue to increase, that's the message three Steamboat Springs residents would like everyone to embrace.
Andy Caress has metastatic melanoma, the most serious type of skin cancer. He doesn't like to remember all the time he spent in the sun playing tennis and competing in triathlons.
Dermatologist Sandy Eivins, M.D., is alarmed by the skin cancer incidence and mortality rate in Northwest Colorado, which she says is one of the highest in the nation.
Oncology nurse Jan Fritz, R.N., director of Yampa Valley Medical Center's Cancer Services, sees more cases of melanoma showing up in younger people.
At age 23, Caress thought he was too young to worry about skin cancer. When a small, rubbery, pink growth appeared on the back of his neck last fall, he was annoyed but not anxious.
"It was just bothering me," he said. "So I cut it off with a nail clipper, which was a big mistake. Eventually it stopped bleeding and healed, but about a month later, it reappeared and grew back bigger. It looked like a pencil eraser when I went to see Dr. Eivins."
The dermatologist diagnosed the growth as melanoma, and Caress's medical odyssey began. He has since endured six surgeries and two rounds of intensive chemotherapy. Currently receiving radiation therapy in Texas, he is passionate about sharing what he has learned about melanoma - especially with young people.
Eivins, too, is concerned about those who are in their 20s. She points to three potential reasons for a growing rate of skin cancer in this age group: a misguided commitment to tanning, incidents of sunburn during childhood and lack of awareness that skin cancer can strike at any age.
Melanoma often appears as a dark, irregularly shaped and colored mole. But not all melanoma looks the same.
"Some growths pop up quickly, and people think they're pimples because they don't look like moles," Eivins said. "Melanoma can be underneath a toenail, showing up as a brown streak in the nail."
Fritz emphasizes that melanoma can appear anywhere on the body - even on the bottom of the feet and in the scalp. Any skin change should be reported to a physician immediately.
"The most important part of recognizing melanoma is doing our own skin checks regularly," Fritz advises. "Most people don't know what skin cancer looks like, so just look for skin changes. And see a doctor for an annual professional skin check."
Preventing melanoma is, of course, preferable to detecting it in its early stages. The most effective strategy is to limit sun exposure and wear sunscreen and protective clothing when out in the sun.
For a total sunblock, Eivins recommends micronized zinc oxide. The sun bounces off this substance. Her favorite chemical sunscreen is Mexoryl, which has the highest blocking factor for ultraviolet A and B (UVA and UVB) rays.
"Wear sunscreen with a sunblock factor (SPF) of at least 30," she says. "The higher SPFs give a better buffer zone, but it's important to reapply every two hours because it does wear off."
Another important preventive measure is to avoid tanning beds, which Eivins says carry the same danger as the sun.
"In fact, tanning beds emit much higher doses of UVA - the tanning rays - than the sun does," she said. "Both UVA and UVB rays cause melanoma."
Can the efforts of Caress, Eivins, Fritz and many other health advocates really convince people to shun the sun and tanning beds? Eivins hopes we will learn some lessons from "down under."
With the highest incidence of skin cancer on the planet, Australia launched an educational program to change the way its citizens view the sun and tanning salons.
"A tan is not a sign of good health. A tan is a sign that the skin is getting UV radiation damage," reads one message.
Caress endorses this point. That is why, when he ran the Steamboat Marathon 10K on Sunday, he was slathered in sunscreen and wearing protective clothing. It was his first time in the sun since November 2008.
Christine McKelvie is public relations director at Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.