Because skin cancer can often be cured with early detection and treatment, it may not seem as worrisome as malignancies like breast and colon cancer that take more lives. But that doesn’t mean skin cancer doesn’t pose a health risk.
Every year, over 3.5 million Americans are diagnosed with non-melanoma skin cancer, according to the American Cancer Society. The most common forms, basal and squamous cell cancers, start on the outer layer of the skin on sun-exposed areas. While both tend to grow slowly and can usually be removed surgically, they can spread to other parts of the body.
Another 73,000 cases of the potentially life-threatening form of the disease, melanoma, are expected to be diagnosed this year, too. The most dangerous skin cancer, melanoma is the most likely to metastasize to other parts of the body, including the brain, if not caught early. Over 9,000 people in the U.S. die from melanomas annually, according to the Centers for Disease Control and Prevention (CDC).
Bottom line: While early skin cancer detection and treatment is important, preventing it in the first place makes the most sense.
Wear sunscreen every day. Excessive exposure to ultraviolet (UV) radiation (from sunlight or tanning beds and lamps) is an important risk factor for basal and squamous cell cancers and many melanomas, according to the American Cancer Society. Use a broad-spectrum sunscreen which filters both kinds of UF radiation — UVB (the shorter wavelength of light that penetrates the surface of the skin and causes sunburn) and UVA (the long wavelength of light that penetrates to the deep layers of skin).
Never use tanning beds. In addition to aging your skin prematurely, they are not safer than tanning in the sun. Studies have shown consistently that indoor tanning increases your risk for skin cancer.
Wearing sunscreen with a sun protection factor (SPF) of 15 or higher daily is one of the best ways to prevent skin cancer. Unfortunately, the majority Americans aren’t taking this advice seriously, a CDC study revealed.
Women were more likely than men to use sunscreen on their faces. “However, it’s important to protect your whole body from the sun, not just your face,” said Dawn Holman, MPH, a behavioral scientist at the CDC who headed the study.
Apply sunscreen liberally and use it anytime you’re outside, even if the sun isn’t shining. UV light penetrates through the clouds, and reflects off water. Although sunscreens can be water resistant, none are truly waterproof, according to Mayo Clinic dermatologist Dawn Davis, MD. So reapply your sun protection at least every two hours, or more often if you’ve been perspiring a lot or swimming.
Don’t bake in the sun — cover up! Instead of taking skin-damaging sunbaths, seek out shady areas and beach umbrellas this summer. Wear hats and sunglasses that filter out UV radiation to protect your eyes and the delicate skin in the eye area. Don T-shirts and other cover-ups when at the pool or beach, too.
In fact, consider wearing sun protective clothing with an ultraviolet protection factor (UPF) on the label for outdoor activities. The higher the UPF, the higher the protection. UPF clothing protects with a tight weave but is often lightweight. You can find a variety of UPF long sleeve shirts made specifically to be worn while swimming to help protect from too much sun.
Face facts: Your skin color won’t protect you from skin cancer. It’s true that fair skinned people have an elevated risk for sunburn and many skin cancers. But no matter what your skin tone, ability to tan, or race is, you are in danger of skin cancer if you don’t protect yourself from excess sun and use sunscreen with a SPF of 15 or higher.
Squamous cell carcinoma is the most common skin cancer among African Americans and Asian Indians, and the second most common skin cancer in Hispanics, according to the Skin Cancer Foundation. Minorities are typically diagnosed at a more advanced stage of skin cancer and have lower chances of survival than caucasians.
"Our minority populations have this perception that they are at low risk and little can be done to prevent it. The reality is that skin cancer is a significant health concern for minorities,” said Henry Ford Hospital dermatologist Diane Jackson-Richards, MD.
Pay attention to changes in your skin. If you have a history of excessive sun exposure, very fair skin, or a family or personal history of skin cancer, check your skin over once a month for any changes. If you are in a lower risk category, check your body for possible signs of skin cancer every three months. Enlist the help of a partner or friend to check areas that you can’t readily see, such as your back.
Acral melanoma — a rare type of skin cancer that caused reggae musician Bob Marley's death — is not caused by UV sun damage and most often develops on hairless parts of the skin. So include the palms of your hands, soles of your feet, and nail-beds when you do a self-check.
Be on the lookout for a new mole or other growth on your skin. Also check for changes in the appearance of scars (especially those caused by burns). Watch for a patch of skin that becomes darker or changes color and for any sores that don’t heal. If any changes in your skin, including moles that have changed size or color, don’t go away within one month, make an appointment with your doctor for an evaluation, advises the National Cancer Institute (NCI).
See your doctor regularly. When you have a regular check-up, make sure your doctor looks you over for any signs of skin cancer you might have missed.
If you’re taking prescription medications, ask about side effects, including those that could impact your skin. Certain medications, including antibiotics and hormones, can make your skin more sensitive to damage from the sun and may require extra protection. In addition, drugs that suppress the immune system to treat some diseases may up the risk for skin cancer, requiring extra vigilance about changes in your skin.
You may be concerned about having a low level of vitamin D from reducing your sun exposure, but getting only 5 to 30 minutes of sunshine twice a week is enough to maintain normal levels of vitamin D. Many foods are good sources, as well, including fatty fish, mushrooms, and milk. The NCI advises talking with your doctor if you are interested in taking vitamin D supplements.
The NCI also offers a free brochure about skin cancer, and how to avoid it.
June 29, 2015
Christopher Nystuen, MD, MBA