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Skin
Cancer 101
Advice from Gino Bottino, M.D.
It is interesting to see how things have changed! At the turn of the
century people endeavored never to be sun exposed (especially women) and
doctors recommended sun bathing for good health. After World War II, sun
bathing and deep tanning became a rage, and remains so today. Social
perception has also changed as a suntan used to be a sign of poverty,
whereas these days it is perceived by many as a sign of wealth.
Medically speaking, some sun exposure is required for good health, but
getting a sun tan is not. Anyone who spends time on or near the water
gets plenty of sun without sunbathing at all. As a doctor, I have to
recommend to you that sunbathing is almost as bad for you as smoking and
should be totally avoided.
SUNBURN AND ITS AFTER-EFFECTS
Sunburn is a form of radiation burn not heat burn. It is the acute
(rapid) damage caused by the sun striking the skin. Sunburn is not the
most dangerous aspect of the suns energy, or the one that most concerns
doctors, but it can be serious and precautions are most certainly in
order.
The long term effects of the suns radiation are:
1. Rapid aging of the skin with loss of elasticity and wrinkle formation
2. Sun-induced skin diseases (non-tumorous) such as multiple nevi
(moles), Keratotic lesions (sun spots) and rashes
3. Cataract development in the eyes
4. Non-malignant skin cancers
5. Malignant skin cancers
The short term effects of sun exposure are:
1. Overheating syndrome
2. Eye strain
3. Headaches
4. Sun burn
WHAT IS THE RISK, WHOS TAKING IT?
In 2006, over 1.5 million Americans will be diagnosed with some form of
skin cancer and over 30,000 will die from skin cancer. In our lifetime,
one in five Americans will be diagnosed with skin cancer. This is double
the number of cases reported 10 years ago. We must also be aware of the
progressively increasing risk due to the depletion of our ozone layer.
As sailors, we contribute to the destruction of the ozone by using our
engines and using on board items as freon (hopefully no longer)
propellants, air conditioners and refrigerators. Consider switching to
newer non-ozone depleting systems currently available.
If you want to avoid being one of the 1.5 million afflicted by skin
cancer, ACT NOW. By reducing the earths exposure to ozone depleting
materials and by simply using good sun screening technique, including
use of sunscreen every day and by wearing protective clothing when
prolonged exposure to the sun is likely, you can reduce or even
eliminate your risk of skin cancer.
Once the skin damage has occurred, there are treatments available to
help you. Retin-A cream will minimize wrinkles, age spot and keratotic
lesions. It can also treat and help prevent recurrent skin cancers. Oral
retonic acids, Accutane, may also be effective. The standard treatment
for limited skin cancers and lesions is removal, either by surgery or
freezing. There is also a chemotherapy cream called 5-flurouracil (5-fu)
which your doctor may use. All of these treatments require a doctors
prescription and supervision.
As for the over the counter aids available, there are new skin
treatments with fruit acids and the like that may be beneficial for
decreasing the damage to skin. And products like Solarcaine will help
with the sting of the burn, as will the old folk remedy of a vinegar and
salt solution applied to the burn. If the burn blisters or the skin is
broken do not use either of these as they will greatly irritate the
burned skin. Burns that blister should be considered a medical problem
and you should treat them as such. More on this next time.
A little color is certainly not worth all of the medical risks involved.
Remember sun exposure is cumulative. Should you develop a skin cancer or
sun damaged skin, the risks of ANY further sun exposure could be deadly
and that would really put a damper on your recreational pursuits.
So Play It Safe, PUT ON PROTECTION!
The long term effects of the suns radiation are:
Rapid aging of the skin with loss of elasticity and wrinkle formation.
Sun-induced skin diseases (non-tumorous) such as multiple nevi
(moles), Keratotic lesions (sun spots) and rashes.
Non-Malignant Skin cancers
Malignant skin cancers
SKIN CANCER FACTS
In 2006, over 1.5 million Americans will be diagnosed with some form
of skin cancer
This has doubled the number of cases reported 10 years ago.
Over 20,000 will die from the disease
One in 5 Americans and one in 3 Caucasians will develop skin cancer in
the course of a lifetime.
Nationally, there are more new cases of skin cancer each year than the
combined incidence of cancers of the breast, prostate, lung, and colon
Cancer is a condition where one type of cell grows without limit in a
disorganized fashion, disrupting and replacing normal tissues and their
functions, much like weeds overgrowing a garden.
There are three main forms of skin cancer -- Basal Cell Carcinoma,
Squamous Cell Carcinoma and Melanoma.
Basal Cell and Squamous Cell cancers are usually curable.
Melanoma is also completely curable when detected early, but can be
fatal if allowed to progress and spread.
One person dies every hour from skin cancer, primarily melanoma.
By 2010, melanoma is projected to rise to one in 50 Americans.
While melanoma is uncommon in African-Americans, Latinos, and Asians,
it is most deadly for these populations
More than 90 percent of all skin cancers are caused by sun exposure,
yet fewer than 33 percent of adults, adolescents, and children routinely
use sun protection.
In the past 20 years, there has been more than a 100% increase in the
cases of pediatric Skin Cancer.
Less than one third of all teenagers use sunscreen.
The effects of photoaging (skin aging caused by the sun or tanning
machines) can be seen as early as in ones 20s.
The Incidence of all skin cancers is 7 times higher in Colorado than
in New York
The Incidence of all skin cancers is 3 times higher in Australia than
in the USA
Melanoma: Epidemiology 2005
Malignant melanoma represents
3% of all cancers
1% of all cancer deaths
12-fold increase in incidence since 1935
9th most common malignancy in the US, but 2nd in terms of years of
potential life lost
Melanoma Incidence and Mortality
American Cancer Society 2005
Incidence (US)
- 59,580 new cases
- 33,580 new male cases
- 26,000 new female cases
- 12 per 100,000 population
Mortality (US)
7,770 total
4,910 males
2,860 females
Risk Factors for Development of Malignant
Melanoma
Acute sun exposure, especially at young age
Blistering sunburns
Immunosuppression
Family history of melanoma
Hereditary syndromes: atypical mole/dysplastic nevus syndrome
Features: blue/green eyes, blond/red hair,
light complexion, freckles
Regular sun protection throughout childhood can reduce the risk of
skin cancer by 80%.
One blistering sunburn in childhood more than doubles a persons
chances of developing melanoma later in life.
Scope of the Problem-Summary
Skin Cancer is a leading cause of Morbidity and Mortality in the US
effecting one in three to one in five of all Americans
Skin Cancer is caused by Sun Exposure
Exposure during childhood and adolescence accounts for 50 to 80% of
the Problem
Where the exposure takes place is an important factor (altitude and
closeness to the Equator)
Sun Safety 101
Generously apply sunscreen to all exposed skin using a Sun Protection
Factor (SPF) of at least 15 that provides broad-spectrum protection from
both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply every
two hours, even on cloudy days, and after swimming or sweating.
Wear protective clothing, such as a long-sleeved shirt, pants, a
wide-brimmed hat and sunglasses, where possible.
Seek shade when appropriate, remembering that the suns rays are
strongest between 10 a.m. and 4 p.m.
Use extra caution near or on the water, snow and sand as they reflect
the damaging rays of the sun which can increase your chance of sunburn.
Protect children from sun exposure by applying sunscreen.
Get vitamin D safely through a healthy diet that includes vitamin
supplements. Dont seek the sun.
Sun Safety 101
Avoid Sun Bathing and tanning. Ultraviolet light from the sun and
tanning beds causes skin cancer and wrinkling. If you want to look like
youve been in the sun, consider using a sunless self-tanning product,
but continue to use sunscreen with it.
Check your birthday suit on your birthday. If you notice anything
changing, growing, or bleeding on your skin, see a dermatologist. Skin
cancer is very treatable when caught early.
Sun Safety 101-Using Sun Screen
Use sunscreens every day if you are going to be in the sun for more
than 20 minutes.
Apply sunscreens to dry skin 15 to 30 minutes before going outdoors.
When applying sunscreen, pay particular attention to the face, ears,
hands and arms, and generously coat the skin that is not covered by
clothing.
One ounce of sunscreen, enough to fill a shot glass, is considered the
amount needed to cover the exposed areas of the body completely.
Reapply sunscreens every two hours or immediately after swimming or
strenuous activities.
ABCDs of Skin Cancer Detection-self examination
Do regular self examinations or go for screenings
Look for the Danger Signs in Pigmented and other Lesions of the Skin
Consult your dermatologist immediately if any of your moles or
pigmented spots exhibit a change. Use the ABCD system
ABCDs of Melanoma Detection
A
Asymmetry -- one half unlike the other half.
B
Border -- irregular, scalloped or poorly circumscribed border.
C
Color -- varied from one area to another; shades of tan and brown,
black; sometimes white, red or blue.
D
Diameter -- while melanomas are usually greater than 6mm in diameter
(the size of a pencil eraser) when diagnosed, they can be smaller. If
you notice a mole different from others, or which changes size or color,
itches, or bleeds (even if it is small) you should see a dermatologist.
By Gino Bottino, M.D. |