Skin cancer or not is kinda up to you


Skin cancer is the most prevalent form of all cancers in the U.S., and the number of cases continues to rise. There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. The first two are less serious and make up 98 percent of all skin cancers. Melanoma is the most serious form of skin cancer, and it causes a majority of all skin cancer deaths. The American Cancer Society predicts about 78,870 new melanomas and 9,940 melanoma deaths for 2017.  

Although anyone can get skin cancer, the risk is greatest for folks who have fair or freckled skin that burns easily, light eyes, and blond or red hair. Other risk factors include having a family history or personal history of skin cancer, having an outdoor job, and living in a sunny climate.   

The most common warning sign of skin cancer is a change on the skin, typically a new mole or skin lesion, or a change in an existing mole. Basal cell carcinoma may appear as a small, smooth, pearly or waxy bump, or as a flat, pink/red or brown-colored lesion. Squamous cell carcinoma can appear as a firm, red nodule, or as a rough, scaly flat lesion that may itch, bleed, and become crusty. Both basal cell and squamous cell cancers occur mainly on areas of the skin frequently exposed to the sun. Unlike basal cell carcinomas, squamous cell cancers metastasize (spread) when they are not detected and removed at an early stage. Melanoma usually appears as a pigmented patch or bump.  When looking for melanoma, think of the ABCD rule:

Asymmetry – the shape of one half doesn’t match the other

Border – edges are ragged or blurred

Color – uneven shades of brown, black, tan, red, white or blue

Diameter – a significant change in size (greater than 6mm)

Remember, like children, skin cancers don’t always follow the rules. Don’t dismiss an odd-looking or changing mole because it doesn’t resemble the above.

Ultraviolet (UV) radiation from the sun is the number one cause of skin cancer, but UV light from tanning beds and sun lamps is just as harmful. UV radiation from the sun comes in two basic forms: UVA (95 percent) and UVB (five percent). Dermatologists often refer to UVA as “aging” rays and UVB as “burning” rays. However both can lead to skin cancer.  UVB rays are blocked by window glass, UVA rays are not. Tanning beds and sun lamps mainly emit UVA radiation. The UV radiation intensity from tanning beds can be 10-15 times stronger than sitting in the sun in the middle of the day. An estimated 30 million Americans visit tanning salons each year (in data from 116 American cities, the average number of tanning salons exceeds the average number of Starbucks or McDonalds). 

Sun protective factor (SPF) applies to UVB wave lengths. SPF compares the amount of time needed to produce sunburn on protected compared to unprotected skin (higher SPF means greater protection). Consumers should look for labels that tout “broad spectrum” protection. Certain ingredients like zinc oxide and titanium dioxide provide protection against both UVA and UVB rays. The American Academy of Dermatology recommends a SPF of at least 30. Regular use of sunscreen prevents actinic keratoses (a squamous cell cancer precursor) and it’s suggested that melanoma may indeed be prevented by regular use of sunscreen.


So what can you do to help lessen your chances of acquiring skin cancer:

• Avoid sun exposure during the peak hours of the sun’s rays (between 10 a.m. - 3 p.m.).

• Apply sunscreen with an SPF of 30 or greater, labeled as “broad spectrum.” Make sure to cover face, nose, ears (and scalp, especially if yours resembles mine). Apply 30 minutes before exposure to the sun so as to allow penetration.  There’s no such thing as “waterproof,” for they all wash, rub, or sweat off, so re-apply often in those situations. No matter the weather, use your sunscreen – if it’s cloudy, snowing, or sunny, UV rays are still present. Most folks don’t use enough – you should use about a shot glass size amount (for those of you who “pour,” this would be about one quarter of a four-ounce bottle).

• Wear a wide-brimmed hat.

• Wear sunglasses with UV protection.

• Use a lip balm with an SPF.

• Examine your entire skin surface thoroughly every month or two, checking for such changes as mentioned above. For hard-to-see areas, use a mirror or seek help from your “significant other.”

• For those who have had a previous skin cancer or have multiple actinic keratoses, have your skin checked by your dermatologist annually.

• Do not use sunscreens on infants under six months of age – they should be kept out of the sun.

Remember, sunscreen is no substitute for common sense, hats, sunglasses, sleeves, and shade.

The reasons for my emphasis on the potential harm from tanning beds are (1) I want to make sure you know that there is no such thing as a healthy tan, and (2) to urge you to save your UV exposure for something important, such as fishing.

Dr. William McKell is a Northsider.

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