Eva M. Balash, MD, of Boston Family Dermatology, is a board certified dermatologist at Faulkner Hospital and also serves as Clinical Assistant Professor of Dermatology at Boston University School of Medicine

Q: I enjoy going to the beach with my family and friends during the summer months and on winter vacation. Is there anything that I can do to prevent getting sunburn?

A: There are several steps that you can take to protect your skin from overexposure to the sun. First, it is important to note that any level of tanning is your skin's way of telling you that it has been damaged. It is also important to remember that overexposure to the sun is the primary cause in developing skin cancer. The sun is strongest during the hours of 10:00 a.m. to 4:00 p.m. While exposure to the sun during these hours should be avoided, there are several precautions you can take.

If you know that you will be in the sun during these hours, you should:

• Apply sunscreen that has a UVA/UVB blocker and Sun Protection Factor (SPF) of at least 15 (preferably 30) on all exposed areas of the skin. This should be done 30 minutes before you expect to be in the sun.
• Reapply sunscreen every two hours and after you have finished swimming or if you have experienced excessive perspiration while out in the sun.
• Whenever possible, wear protective clothing such as a hat when you are being exposed to the sun.

A: In theory, everyone is at risk. However, fair-skinned people, especially those with red or blond hair, who tend to burn rather than tan, are most likely to develop skin cancer. This is because their skin cells have less melanin, which is the pigment that helps prevent sunburn. In other words, the darker the skin, the more melanin there is present.

Another group that is at risk includes those individuals who suffered severe sunburns as children. Parents should note that they should protect their children by practicing sun safety, and they should also teach children good sun block habits for the future.

Lastly, those who have a family history of skin cancer are at greater risk themselves. Having a family history usually means a sibling, parent or another close relative had skin cancer such as melanoma. If you have any of these risk factors, please speak to your primary care physician or contact a dermatologist.

A: According to the American Cancer Society, any unusual, non-healing sore, lump or blemish may be a sign of skin cancer. A lesion or growth that is crusty, scaly, oozing or bleeding is also another possible symptom of skin cancer. While most skin problems do not turn out to be cancer, the only way to be sure is to be examined by a specialist.

Whether you are at risk or not, you should learn what your skin normally looks like. If you have this knowledge, you will know when something seems out of the ordinary. The best time to do this exercise is while standing in front of a full-length mirror or after taking a bath or a shower. A hand-held mirror can be used for those areas that are hard to see. You should also examine the palms of your hands, soles of your feet, spaces between your fingers and toes as well as your scalp (a hairdresser or family member can help with this).

Basal cell cancers are the most common skin cancer and often first appear as small, round or oval patches that are shiny and firm and are pale, but sometimes pink or red. Roughly 75 percent of all skin cancers are this type. Squamous cell cancers account for roughly 20 percent of all cancers and are usually small, round, slightly raised and are red and crusty. Often there is a sore in the center that does not heal, especially in the later stages.

Melanomas, which can appear on any area of the skin, often resemble moles. The easy-to-remember ABCD rule will help you in distinguishing a normal mole or other marking from one that could be a melanoma. If any of the following descriptions apply to any of your moles, please contact your physician immediately:

ASYMMETRY--One half does not match the other.
BORDER IRREGULARITY--The edges of the mole are ragged, notched or blurred.
COLOR--The color is not the same over the entire mole, but may be differing shades of tan, brown or black, sometimes with patches of red, white or blue.
DIAMETER--The mole is wider than 6 millimeters, (the size of a pencil eraser) or is growing larger.

Robert Eyre, MD, of the Faulkner Hospital Division of Urology, answers your questions on the topic of prostate cancer, a disease that affects one out of eleven men and takes 30,200 lives, annually.

Q: I have heard about a blood test for prostate cancer. What is it and how is it used?

A: Prostate specific antigen (PSA) is a protein made by the cells within the prostate, a walnut sized gland at the base of the bladder. All prostate cells, both benign and malignant, create PSA. Therefore, as the prostate gland enlarges with the normal male aging process (usually beginning in the mid-forties), it is normal for the PSA to slowly increase. We measure it by taking blood from a vein in the arm. Statistically, men who have a PSA value higher than the "normal" range are at higher risk for having prostate cancer. Since the test is very non-specific, it might detect elevated levels of PSA that are caused by other factors, among which are prostate gland infection, recent catheterization, or benign enlargement causing urinary difficulties. It is important for all men over age 50 to be tested every 12 months because the change in PSA value over the course of one year is a key determinant of cancer risk. Coupled with a digital rectal examination (DRE) of the prostate, the PSA test is very useful in revealing which men need further evaluation with a prostate ultrasound and biopsy.

A: Several years ago, concern was raised about a possible link between a vasectomy and prostate cancer. However, more recent studies have shown no association between the two. The most extensive of these studies was published in the October 1999 issue of Cancer Epidemiology, Biomarkers & Prevention.

To learn more about Prostate Cancer, please contact your primary care physician or Dr. Eyre at (617) 732-9806.

Norman Sadowsky, MD, Chief of Radiology and Medical Director of the Faulkner-Sagoff Centre and colleague Elsie Levin, MD, Associate Director of the Faulkner-Sagoff Centre answer your questions about mammography and breast cancer prevention. Breast cancer affects one in eight women and takes over 45,000 lives, annually.

Q: I am a woman who has never had a mammogram. At what age should I begin screenings?

A: Dr. Levin: You should begin scheduling annual mammograms starting at age 40. If, however, you have a first degree relative (mother or sister) who has been diagnosed with pre-menopausal breast cancer, you should start screenings 10 years prior to the age of that relative's diagnosis. For instance, if your mother was diagnosed with breast cancer at age 45, you should begin screenings at age 35. It is important to remember that mammography is only one part of breast cancer screening, which also includes regular physician check-ups and breast self-examinations.

Benjamin Smith, MD, director of the Gastrointestinal Endoscopy Unit and colleague, gastroenterologist Ewa Preneta, MD, answer your questions about colon cancer screening.

Q: When should I ask my doctor about colon cancer screening?

A: Dr. Preneta: Anytime and particularly if you have symptoms or are at high risk. Screening should begin at age 50 for men and for women with no risk factors. For those with a family history of colorectal cancer, screening should begin at age 40 or younger depending on the situation.