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Doctor: Farmers should be aware of skin cancer
By CINDY LADAGE
Illinois Correspondent

SPRINGFIELD, Ill. — Farmers are at an increased risk for developing skin cancer.

In 2000, the odds for Americans of developing melanoma were 1 in 100. Dr. Stephen Stone, a professor of dermatology at the Southern Illinois University (SIU) School of Medicine in Springfield, Ill., said the rate is expected to increase to 1 in 50 by 2010.

“The theory for the increase is increased sun exposure and increased tanning, and there may be other factors we just don’t know,” Stone said. “There are also genetic factors of familial melanoma.”

Farmers and those who work or spend time in the sun are particularly at risk, he said. Stone even had a term for the crisscross pattern that farmers often get on the back of their neck.

“Farmer’s neck, is that wrinkled neck from constant exposure to the area between the hat and the collar,” he said.

Stone explained that people can protect themselves from Farmer’s neck by wearing a wide-brimmed hat that offers more protection than a typical farm, baseball-style cap. “A wide-brimmed hat also protects the ears,” he said. “For farmers, the back of the hands, neck and arms are at the greatest risk for skin cancer. Melanoma appears to be related to burns, while non-melanoma skin cancer is related to cumulative sun exposure.”

To reduce the risk of skin cancer, farmers can “use sunscreen and wear sun-protective clothing, especially a hat.”

Wearing sunglasses is also suggested. Use sunscreen with at least 15 SPF. Sunscreen should be applied 20 minutes prior to going outdoors, and water-resistant sunscreen should be reapplied every two hours after strenuous activities.

For those who have had skin cancer, buy clothing especially made to be protective from the sun.

Spring planting
Spring planting brings long hours and farmers in contact with the sun during the danger hours from 10 a.m. until 4 p.m. Working in direct sunlight exposes farmers to detrimental ultraviolet light. Prolonged exposure to ultraviolet light can cause skin cancer.

Skin cancer is defined as a malignant growth of cells in the skin. Along with the sunshine itself, damage can be increased by wind, reflection from the water, sand and snow. Farmers should be concerned about the long-term effects of skin cancer. The immediacy of the problem depends on the type of skin cancer.

“There are two types of skin cancer, melanoma and everything else, lumped together as non-melanoma skin cancer (NMSC),” Stone explained.

“Melanomas are on the increase. Melanoma tends to be more worrisome because it is the type of skin cancer that has the most significant potential to cause death. Fortunately in recent years, the five-year survival (for those diagnosed with melanoma) is between 90-95 percent.”

Not all skin cancer is a melanoma, in fact, 80 percent fall under the non-melanoma category.

There are two basic types of non-melanoma skin cancers.

“The most common is basal cell carcinoma,” Stone said. “These tend to be raised, flesh color toned. They are treated by scraping, cutting, freezing with liquid nitrogen, or by putting medicine on the skin. These are cancers and can be destructive although they rarely spread to other organs. Squamous cell carcinoma is the second common kind of non-melanoma skin cancer.”

Squamous cell carcinoma is identified by red raised areas with scaling that often occur on surfaces like lips, genitalia, and also in scars like burn scars.

“These should be treated by a dermatologist. Left untreated, they can metastasize,” Stone said.

Cancer prevention
Preventing the spread of the cancer is important. Stone advises his patients to follow the ABCDE method. A is for asymmetry. Moles are round and symmetrical, skin cancer is not. B is for border. The border of skin cancer is irregular. He said that even when moles are scalloped, that the scallop appears at regular intervals.

C is for color. Look for irregularities in the color. Moles are even colored, or if they have flecks, they are evenly dispersed. Skin cancer color may be irregularly dispersed. D is for diameter. The area is usually at least one-quarter inch in size. Look for moles that are more than 6 millimeters in diameter. E is for evolution, change - the spot evolves more. Moles you may notice don’t change much.

Melanoma has noticeable changes.

If in following the ABCDE of inspection, a farmer thinks he may have a suspect area, go to a dermatologist. “The dermatologist can recognize it,” Stone said. “If he or she is concerned, they can do a biopsy. If still concerned, they can remove it.”

For the more complicated skin cancers, Stone said removal of the cancer by Mohs surgery, is the best method. The cancer is removed one layer at a time. That is the most economical way at present. Mohs surgery is so important because the cancer can grow continuously in different ways, Stone said.

For information about skin cancer, call SIU at 217-545-3821, or the American Academy of Dermatology at 1-888-462-DERM or log onto www.aad.org

This farm news was published in the April 5, 2006 issue of Farm World.

4/5/2006