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SALT LAKE CITY — Retired pilot Ray MacKowan flew 30 years with a major commercial airliner. He now has regular checkups to make sure he stays cancer free after doctors successfully removed a basal cell carcinoma from his face.
"It was on the side of my cheek," MacKowan explained. "It was about 10 years ago in a dermatology appointment. My doctor saw something."
MacKowan said he hears similar stories from many of his fellow pilots.
"One had a chunk of cancer removed from the side of his nose, while another gentlemen also had a cancer on the cheek," he said.
Dr. Glen Bowen with the Huntsman Cancer Institute explained that "in a Nordic study of over 10,000 pilots, their risk of skin skin cancer compared to a control population — namely, people who are not pilots — is double, more than double."
- Ultraviolet (UV) radiation: A person's risk of skin cancer is related to lifetime exposure to UV radiation, which comes from the sun, sunlamps and tanning beds.
- Personal or family history of skin cancer: A person who has a close family member (parent, sibling, or child) with skin cancer may have an increased risk of the disease.
- Actinic keratosis: This is a type of flat, scaly growth on the skin. It is most often found on areas exposed to the sun, especially the face and the backs of the hands. Without treatment, a small number of these scaly growths may turn into squamous cell cancer.
- Bowen's disease: This is a type of scaly or thickened patch on the skin. It may turn into squamous cell skin cancer.
We already know altitude plays a major role in skin cancer. If you live in Utah and play a lot outdoors, your risk is higher than if you romp around in a state at a lower elevation.
So if pilots fly hundreds of hours at a higher altitude where UV rays from the sun are even higher in concentration, are they more vulnerable? Is the riskier UV ray known as UVA, which doubles at 50,000 feet, making its way into the planes?
That's what Bowen and his colleagues thought they would find. But in preliminary data, little dosimeters worn by the pilots and another device specifically measuring UVA from various locations in the plane did not support the theory.
The windscreen on the planes apparently blocks out all UVC and UVB rays, and 50 to 70 percent of the UVA rays. In fact, overall exposure was substantially less than what bicycle racers absorb on the ground.
So what else? What about cosmic rays at that altitude?
"It's been calculated that the amount of radiation in an airplane going from Los Angles to New York in a cross-country trip is the same radiation that is equivalent to a chest X-ray," Bowen said.
That's not a lot, but as Bowen suggests, the secret might be found in studying long-term effects. Pilots simply may be in a unique situation where the risk is cumulative from several sources.
Thirty to 50 percent UVA and low-level cosmic rays in the plane and easy access to tropical destinations, or other places where it's warm and sunny, may all be contributing factors. Whatever is going on, something is happening to more than double their risk for skin cancer.
More research needed
"I think it would be a good idea to let us all find out what could be done, if anything," pilot Bill Banner said.
Dave Haymond, president of the Utah General Aviation Association agreed. "I would think that if there is in fact a risk, we would want to know about it for sure," he said.
Dave Chapman, who's also a pilot, said he's known many men and women in the profession who have had bouts of skin cancer over his 23-year career.
"The interest in skin cancer is in the back of people's minds, so I think it would be welcome to hear what they have to say," said Pat Morely, director of the Utah Division of Aeronautics.
And Bowen and his team will have more to say. Since pilots fly free to those warmer sunny climates, do they spend more vacation time basking in the sun, again adding to that so-called cumulative effect?
Medical professionals don't know, but Huntsman researchers hope to find some answers as they continue the next phase of their study.