Burned To A Crisp

I play most of my golf in Arizona. Am I at a greater risk in areas where the sun is more intense?
Surprisingly, Arizona didn't crack the top 10 among states with the highest number of melanoma cases. According to the American Cancer Society, 62,480 cases are projected this year. Three Sunbelt states topped the chart: California (7,620 cases), Florida (4,430) and Texas (3,940). But because the next seven spots were occupied by Northern states, experts struggle to reach a consensus about geography's role in skin cancer. "It's a tricky question," says Dr. Perry Robins, president of the Skin Cancer Foundation. "Obviously you're at greater risk in the Sunbelt states and at higher altitudes. But, then again, people who live in states that don't get a lot of sun might tend to overdo it when the sun is out."

Does the color of your skin make a difference?
Though skin cancer is less common in people with darker skin, it's often more deadly because it's harder to detect. "And melanoma can sometimes occur in non-sun-exposed areas, including the soles of the feet," says Dr. Bruce Brod, a dermatologist who also teaches at the University of Pennsylvania and is a weekend golfer. "Dark-skinned people still have to be concerned with skin cancer."

My skin is loaded with freckles and sunspots from too many years on the range. How can I check myself for skin cancer?
Every expert we spoke with said you should see a dermatologist once a year. In the meantime, you should inventory the moles, freckles and blemishes on your body -- make mental notes or take pictures. Then check monthly for changes. Don't forget those hard-to-see places like your scalp and backs of the legs and neck. Changes in color, size and texture are what you're looking for. Watch for spots or sores that continue to itch, bleed or don't heal. For more on melanomas, visit skincancer.org and click on "melanoma" and then "warning signs."

How is skin cancer removed?
For melanoma, the malignant skin cells and a wide margin of healthy tissue surrounding them are removed with a scalpel and sent to a lab for testing. This is typically an outpatient procedure. "If it's not melanoma, then it's crucial that your doctor is trained in Mohs micrographic surgery," says Dr. Kates, of Worcester (Mass.) Dermatology Associates. "Mohs is the gold standard. Essentially we remove a tiny piece of skin, test it for cancer, and then remove another tiny piece until we've removed all the cancer, while doing minimal, if any, damage to the healthy skin."

Are there any removal procedures that don't involve surgery?
Yes, removal is sometimes done with creams and scraping, but most nonsurgical procedures are used only on precancerous blemishes and only the smallest and shallowest basal- and squamous-cell carcinomas. Liquid nitrogen is often used to burn off spots. Other techniques, says Dr. Kaminer, are laser-based.