Make time for skin cancer education in May
Make time for skin cancer education in May
Observance month, community outreach a natural
Education about skin cancer is still needed, says Linda K. Franks, MD, FAAD, director of Gramercy Park Dermatology in New York City, though it is common to see adults on vacation making little effort to avoid the known risks for skin cancer, which is exposure to ultraviolet radiation.
"The behavioral aspect of melanoma can be changed. It is like asking people not to smoke and decreasing the incidence of lung cancer; it is the same thing with the sun and melanoma," says Franks.
To raise awareness of prevention of skin cancer and importance of the early detection of melanoma the American Academy of Dermatology has designated May Melanoma/Skin Cancer Detection and Prevention Month.
Its purpose is to help people learn the warning signs of skin cancer and catch melanoma early as well as to teach about skin cancer prevention.
"It's important to remember that sun damage is cumulative," says Ronald S. Davis, MD, MS, FAAD, a dermatologist practicing in Tyler, TX, and a professor of dermatology at Tulane University Medical Center in New Orleans.
Davis says studies have shown that damage begins after only a few minutes of sun exposure and accumulates over the course of the day with five minutes here and there. It's not just extensive time in the sun while at the beach, pool or playing tennis or golf.
"Most skin cancers are directly related to lifetime sun exposure, so education needs to begin in childhood, both with parents and children," states Davis.
To help prevent skin cancer, people need to know how to protect themselves from ultraviolet rays. According to Davis, sunscreens are the primary means of protection and most dermatologists recommend a waterproof, broad-spectrum sunscreen that protects against both types of ultraviolet radiation: UVA and UVB.
The UVB rays cause sunburn and the UVA rays penetrate the skin more deeply, causing wrinkling. According to the Skin Cancer Foundation, "UVA rays also exacerbate the carcinogenic effects of UVB rays, and increasingly are being seen as a cause of skin cancer on their own."
Davis says the greatest stumbling block to the prevention of skin cancer is the persistent idea of a "healthy tan."
"There is nothing healthy about a tan. It is simply an indication of the skin's response to sun damage. This has been difficult to change in the public mind, especially among teenagers. The proliferation and use of tanning beds has made matters worse. I think early and continued education is the key," says Davis.
According to the Skin Cancer Foundation, determining which sun protection factor (SPF) to choose when selecting a sunscreen can be calculated by knowing how much protection the ratings offer. For example, if it takes 20 minutes for unprotected skin to start turning red, a sunscreen with an SPF of 15 would protect the skin 15 times longer, or about five hours.
Davis recommends an SPF of at least 20 to 30; however the degree of protection also depends on a person's skin color. The more fair-skinned a person is the greater their need for protection; people with darker skin, including African-Americans, can get skin cancer from sun exposure, too, he says.
Putting on sunscreen should be something that is done routinely such as brushing teeth, says Davis. Year-round use is especially important for people in sunny climates such as the southern states and California.
Other measures recommended
In addition to the proper use of sunscreen, people should know that clothing can protect their skin from the sun as well. However, the value of each piece of apparel depends on the weave and the fabric some are too thin to block sunrays. There also are products that can be added to the wash that increase the protection factor and several companies make clothing with a high SPF rating, explains Davis.
Hats are also important because they help protect the ears, which are very sensitive. Davis says a hat should have a four-inch brim. Sunglasses with UVA and UVB protection listed on the label should be worn as they help decrease sun damage to the eyelids where it is often difficult to apply sunscreen, adds Davis.
Spotting the warning signs
While people need to know what steps to take to prevent skin cancer, equally important is knowledge of the warning signs. Most important is to learn the warning signs of melanoma because if caught early it can be cured with simple surgery, but when diagnosed late it has a high mortality rate, says Franks.
Melanoma in situ is on the surface of the skin and is completely curable with surgery. The critical factor of a melanoma is its thickness measured in the skin at the time of diagnosis, says Franks. A very early, thin melanoma has a prognosis higher than 95%. The worse prognosis is a four-millimeter-thick melanoma, which means there is a high chance it has spread, says Franks.
To catch skin cancer, especially melanoma early, she tells her patients to stand in front of a full-length mirror naked and do a skin check every two months.
The ABCs of melanoma
The first five letters of the alphabet provide a guide:
- The A stands for asymmetry and during a body check people would look for moles where one half is different from the other. It may be higher, a different texture or different color.
- The B is for border irregularity. "Your mole should not look like the coast of Maine. It should have a smooth, round border. A tiny bit of notching is allowable but when there starts to be jagged edges or tails jutting out that is an irregular feature of a mole and could be a warning sign that it is evolving into melanoma," explains Franks.
- C is for color. If a mole has two or three colors or a variation that includes blue, black, or red, that is a warning sign.
- D is for diameter and moles larger than six millimeters, which is about the size of a pencil eraser, should be checked by a physician.
- E stands for evolving or changing and moles should be watched to determine if they have changed in any way.
While routine personal skin checks are important, people should also have their skin examined by a dermatologist. Franks says every adult should have a baseline skin exam completed. People who have any of the risk factors for skin cancer should have a yearly skin exam by a dermatologist.
These risk factors include having fair skin, which is typified by blond or red hair and blue or green eyes. Also a family history of melanoma puts people at greater risk, as well as having three or more blistering sunburns as a child. People who have spent a lot of time in the sun as a child or teenager working as a lifeguard or golf caddy or simply laying on a beach are more likely to develop melanoma as are those who have had other types of skin cancer or precancerous skin lesions.
People who have a lot of risk factors or a lot of moles should be checked by a dermatologist every six months, says Franks. Others should see a dermatologist if they notice a change in a mole or other warning signs when doing a skin check.
Melanoma/Skin Cancer Detection and Prevention Month is a good time to distribute information on skin cancer, hold seminars, and do free skin screenings, says Franks. Conduct a seminar at a community pool, a country club or the local middle and high schools, advises Franks. Offer a list of places where people can receive a free skin cancer screening.
SOURCES
For more information about skin cancer detection and prevention and ways to get the word out, contact:
- Ronald S. Davis, MD, MS, FAAD, 700 Olympic Plaza Circle, Suite 404, Tyler, TX 75703. Phone: (903) 595-2737. E-mail: [email protected].
- Linda K. Franks, MD, FAAD, director, Gramercy Park Dermatology, 60 Gramercy Park, New York, NY 10010. Phone: (212) 475-2312. E-mail: [email protected].
- American Academy of Dermatology, 930 E. Woodfield Road, Schaumburg, IL 60173. Phone: (847) 330-0230. Web site: www.aad.org.
- Skin Cancer Foundation, 149 Madison Ave., Suite 901, New York, NY 10016. Phone: (800) 754-6490. Web site: www.skincancer.org.
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