McFarland Clinic

Skin Cancer: Detection and Prevention

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May 13, 2011

May 1 marks the beginning of Melanoma/Skin Cancer Awareness Month across the nation. Each year the number of people diagnosed with melanoma increases – with an estimated 114,900 new cases in 2010 alone, says McFarland Clinic Dermatologist Daniel MacAlpine, MD. In recognition of this month and in preparation for summer, it is important to protect your skin from the sun year round and be aware of any skin changes you experience.

Skin cancer is the uncontrolled growth of skin cells – basal, squamous and melanoma are the three most common kinds of skin cancer. Basal and squamous skin cancers are the two most common types. Both occur in sun exposed areas like the nose, ears, face, bottom lip and backs of hands. Basal skin cancer grows slower and is less likely to metastasize (spread) while squamous may grow rapidly and has an increased risk of spreading. Surgery is the most effective treatment for basal and squamous skin cancer and if detected early there is up to a 99 percent cure rate, says Dr. MacAlpine.

Melanoma is the most serious type of skin cancer. The risk for developing melanoma is doubled if you have had one blistering sunburn before age 18 or five plus burns in a lifetime, says Dr. MacAlpine. Sixty-five percent of melanoma diagnoses are blamed on sun exposure.  Melanoma is characterized by different colored moles or rough patches. Melanoma initially grows superficially, and then grows roots. If it has roots it is much more dangerous.

“Catching melanoma before it spreads to the lymph system makes surgery more effective. It’s a matter of a millimeter, about 15 sheets of paper, before it becomes a big problem,” says Dr. MacAlpine.

If caught while on the surface it is almost 100 percent curable, adds Dr. MacAlpine. Once it has spread to the lymph system the five-year survival is only 30 percent and less than 10 percent if it has spread to the brain or liver.

There are many effects – short and long – of prolonged sun exposure, some more harmful than others. Sun damage is cumulative, says Dr. MacAlpine. Long-term effects from sun damage include wrinkles, sun spots, freckles, atrophy (thinning of the skin) and, in some cases, skin cancer. Risk factors that contribute to skin cancer include age, lighter complexion, history of extensive sun exposure/tanning, living in close proximity to the equator or at higher altitudes, family history and a personal history of skin cancer.

Protecting skin from the sun greatly reduces the likelihood of developing skin cancer. Using a combination of avoidance, sunscreen and clothing can help you protect your skin. The sun’s rays are most damaging from 10 a.m. to 4 p.m., says Dr. MacAlpine. If possible, avoid exposure to the sun during this peak time, when the highest levels of ultraviolet A and B (UVA and UVB) are present.

Sunscreen should be used every day, year round and is especially important during the summer. Knowing how to read the bottle will help in purchasing the most effective sunscreen for you and your family. SPF (sun protection factor) signifies how much you are protected from UVB rays. For example, SPF 15 blocks 93 percent of UVB rays, says Dr. MacAlpine.

Another key phrase to look for is “broad spectrum.” Broad spectrum sunscreen protects from UVA and UVB rays and probably contains one of the following ingredients: titanium dioxide, zinc oxide or avobenzone (Parsol 1789), which are potent UVA blockers, says Dr. MacAlpine.

“Purchasing a sunscreen with SPF 60 offers no great advantage. After SPF 30 (which blocks 97 percent of UVB rays) the protection doesn’t get significantly higher. I recommend using broad spectrum sunscreen with an SPF 30 and reapplying every two hours,” says Dr. MacAlpine.

Properly applying sunscreen is equally important. Most people only apply ¼ to ½ of what they should. One ounce should cover all exposed areas, says Dr. MacAlpine. Apply sunscreen to all surfaces – including an SPF lip balm or lip stick for the lips – 15 to 30 minutes before going out. It takes time for the chemicals to interact with the skin. Be sure to allow dry time and reapply after exposure to water, adds Dr. MacAlpine.

If you choose to wear clothing to protect your skin from the sun, wear loose fitting clothes that cover the greatest area, including broad brimmed hats. Garments that have been washed offer more protection, as do synthetic fabrics, says Dr. MacAlpine. Garment color is not a predictor of sun protection.

“It is important to get in the habit of examining yourself every six to 12 months and to know your ABCDEs (asymmetry, border, color, diameter and evolution),” says Dr. MacAlpine. If you detect any changes, consult with a dermatologist.

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