Ken Landau thought he was doing a decent job protecting his skin. The voice of Colorado College men’s hockey spent most workdays in a world where sun’s a kind of Kryptonite, and when he played outside, he did as advised, avoiding peak hours and wearing sunscreen.

It wasn’t enough for the 56-year-old Aurora resident, whose mother died from melanoma, the rarest and most fatal form of skin cancer.

“It’s very close to me in a family-history sense. I’m fair-skinned, burn easily, and when I had hair on my head, I was a redhead,” said Landau, the Tigers’ play-by-play announcer for more than a decade. “I would use sunblock when I knew I was going to be outside for a long period of time, which is not the right approach.”

Ultraviolet radiation from the sun or man-made sources ravages skin cells and causes close to 90 percent of all nonmelanomas, including basal and squamous cell carcinomas, the two most common forms of skin cancer. Sun and UV radiation also play a major role in the development of most malignant melanomas, which account for less than 1 percent of skin cancer cases but almost all skin cancer deaths.

Suffer more than five sunburns in your life, your risk of developing melanoma is said to double.

Live in Colorado Springs, your odds of getting a burn are greater than at lower elevations, said Dr. Elizabeth Piantanida, a dermatologist with Skin MD Dermatology and Skin Enhancement Center and a member of the medical staff at Penrose-St. Francis Health Services. It’s a warning that comes for every month of the year and is usually emphatically restated around May, which is designated as skin cancer awareness month.

“We’re definitely at higher risk here. When you get a sunburn or any ultraviolet rays on the skin, some of that energy is absorbed by the DNA and can cause mutations. That’s how sun causes skin cancers,” she said. “Because we’re getting higher doses of ultraviolet radiation, in a shorter time, you burn more quickly and are at a greater risk of long-term damage.”

Skin cancer on the rise

Despite the fact that it’s widely known to be one of the more preventable cancers, skin cancer has been on the rise for both genders since the 1970s. Recent decades, though, have seen a dramatic increase in the number of young adult women and adult men who are diagnosed and ultimately succumb to melanoma, which, untreated, quickly can metastasize to other parts of the body.

“In the last 35 years, new cases of melanoma have tripled from 8 cases per 100,000 (Americans) to almost 24,” said Dr. Vishal Rana, an oncologist with the University of Colorado Health Memorial Cancer Center. “The average age of a patient dying due to melanoma is 69, and the reason for that is the longer you’re exposed to sun, the higher the risk, and people are living longer . but more and more we are seeing younger patients.”

Doctors and researchers agree that the rising rates among women in their 20s and 30s are due, in large part, to the modern use of tanning beds; Rana has some ideas, but no firm answers, about the spike in melanoma among men.

“Men and women are equally susceptible, but out of a population of 100,000 people in America, about 28 men will get melanoma, compared to only about 17 women,” Rana said. “We don’t know what all the reasons are, but one of the suspicions is that men are more exposed to the sun, for longer periods of time, and might not be using as much sunscreen compared to women.”

That was the case for Landau, who also has a few of his own theories about the increase in melanoma for men.

“I fully realized I did not do all the things I should have done. I did not go in for regular skin checks, and that’s my bad. I am a typical male, and I think most guys will stay away from the doctor until there’s something major wrong or we’re really sick,” he said.

Visible damage

Sun’s damage, even when superficial, isn’t pretty.

Piantanida routinely sees patients with signs of photoaging, including premature wrinkling and pigmentation issues such as freckles and “liver spots,” due to cumulative, lifelong UV exposure.

“Those usually are found in areas of the skin that are exposed to sun over the years, such as the face, back of hands and forearms . and they look different from pre-cancerous changes,” she said.

More immediately worrisome are moles, rough patches and lesions that display certain precancerous hallmarks.

Warning signs include growths that are asymmetrical or have an irregular border.

“If you put a line down the middle of the mole or lesion and the two sides don’t match, or if the border is scalloped or jagged, those are features that may be suspicious for melanoma,” she said.

Growths that vary in shade, pattern or color also are cause for concern.

“Many have some kind of brown or black pigmentation to them, but they’re not always brown or black. They also may have multiple colors – black, pink, white, red or tan – in the same mole,” Piantanida said.

If the growth is larger than a pencil eraser – about six millimeters – or is evolving in shape, size, color or texture, have it checked.

“A benign mole that’s slowly changing or that’s started to bleed or itch or have crusting on it, that could indicate the point where it’s changing into melanoma,” Dr. Rana said.

Prevention and treatment

Given his family history with the disease, Landau thought he knew what to look for. To him, the spot under his right eye appeared to be “just another freckle, albeit a bigger one,” he said.

“I knew there was something there, I just didn’t think it was cancerous,” said Landau, who began to take things more seriously when his primary care physician noted the spot as an area of “concern” during his annual physical.

A biopsy confirmed cancer, and Landau was referred to University of Colorado Hospital in Aurora for Mohs surgery, a technique that removes successive layers of skin until all cancer cells are eradicated. Four surgeries later, Landau was cancer-free, but not nearly out of the woods.

“By the time they were done with those, the size of the area that had been excised basically encompassed a good portion of my right lower eyelid,” said Landau, who then had to undergo rounds of reconstructive and plastic surgery. “I had no idea that I was going to have to go through all the things I went through, but even if it would have taken eight tries, it wouldn’t have mattered. The whole point of this was to get the cancer out of my body, and I consider myself fortunate that we got to it when we did.”

Since the diagnosis, Landau conducts routine self-exams, is a regular at the dermatologist and has embraced a new and in-your-face approach to skin protection.

“I have a sticky note on my door, that’s the last thing I see when I walk out of the house. It’s got one word on it, and that’s ‘sunscreen,’ ” he said.