Archive for November, 2006
Skin cancers. How to avoid it.
Pauline Alton of Toronto loved being in the sun – too much.
In her teens and twenties, she frequently got sunburned in the summer and would take trips south in winter where she also got sunburned.
When Pauline was 48, she noticed a freckle on her left arm that grew and changed colour. She mentioned it to her doctor during an annual exam. After seeing a dermatologist and surgeon, the growth was removed. A month after that, she was asked to come in to see the surgeon the next day. She knew something was seriously wrong.
Her surgeon said she had malignant melanoma, the most serious type of skin cancer and would need another surgery to go deeper on her arm.
Like all cancer patients, she was faced with the question: “Am I going to survive?”
The good news is that Pauline remains cancer free almost three years after her diagnosis and two day-surgeries on her arm. But she watches for any change to her skin, as the cancer can return and if it spreads, it can be deadly.
Our skin acts like armour – protecting us from dehydration, infections, pollution and the sun. And just as armour can get rusty and corroded, our skin can develop cancer.
The main skin cancer risk is something we cannot even see – ultraviolet (UV) rays, which are produced by the sun and certain lamps, including tanning lamps. Most often, skin cancer is the result of overexposure to the sun. It is estimated that UV rays are responsible for 90 per cent of all skin cancers.
UV rays can damage skin cells, some of which die and some repair themselves. A few may become defective. Our bodies may not be able to destroy them as UV rays can also lower the body’s immune system. A cancer tumour can begin to develop, with skin cells becoming abnormal and raging out of control, growing and increasing in number.
Of the three types of skin cancer, the most dangerous is malignant melanoma, which represents a small percentage of all skin cancers. Each year, an estimated 1,600 Ontarians develop malignant melanoma and 370 are expected to die from it.
All skin cancers, including malignant melanoma, can usually be cured if detected early. Malignant melanomas occur earlier in life and progress more rapidly than other skin cancers, developing on almost any part of the body. Dark-skinned people can also develop melanoma on the palms of their hands and soles of the feet.
Some factors that may increase your risk of developing malignant melanoma are:
- Fair or freckled complexion, blue eyes and light coloured or reddish hair
- Sunburn during childhood
- Lots of moles
- Family history of melanoma
The other skin cancers are basal and squamous cell carcinoma. They tend to develop primarily among Caucasians later in life on skin that has been exposed repeatedly to the sun, such as the face, neck or hands. They progress slowly and rarely cause death because they do not spread to other parts of the body. They are easily removed by surgery.
Even though the risk of sun exposure is widely known, over 50% of Canadians do not use any sun protection. We can certainly enjoy outdoor activities, but simply need to take reasonable precautions.
As a result of her cancer, Pauline learned about sun protection and now acts as the conscience for her family and friends, reminding them to put on sunscreen whenever they are outside and to sit in the shade.
She says: “I love the outdoors – golf, tennis and our backyard pool. I was afraid I would have to give it up. But it hasn’t changed my lifestyle. I just put on a hat, sunscreen, long pants and long-sleeved top and continue to do what I did before.”
To protect yourself, use a sun block or sunscreen lotion with an SPF of 15 or higher. SPF stands for Sun Protection Factor, which refers to a product’s ability to stop your skin from burning. Levels vary from 2 to 50, and therefore vary in their ability to protect skin from sun damage. The higher the SPF rating, the more it will protect your skin and the longer you will be able to stay in the sun before burning. Be sure to choose a broad-spectrum sunscreen that protects against UVA and UVB radiation. Also look for products approved by the Canadian Dermatology Association.
If you are fair-haired and fair-skinned, you are more likely to burn and should therefore use a higher SPF sunscreen. Also, the more time you spend in the sun, the more skin damage is done and the greater your risk for developing skin cancer later in life.
When you use a sunscreen, follow these rules:
- Apply it 15-30 minutes before going outside to give it a chance to start working
- Apply it generously. Ensure your skin is dry when applying it or it will roll off and not be effective. Do not be afraid to apply too much, many people make the mistake of not using enough! For instance, if you are using a white cream, it should appear white on your skin. Do NOT rub it in, let it soak in
- Cover all exposed skin including ears, nose and neck. Apply an SPF 15 lip screen as well
- Reapply sunscreen every two hours, or more often if you are sweating or swimming
Follow the following rules to avoid overexposure to the sun:
- Try to select shaded areas for outdoor activities, or create your own shade
- If you have to spend long periods in the sun, wear a broad-brimmed hat that shades your ears and neck, a long-sleeved shirt, long pants and gloves
- Avoid the sun when it is highest in the sky between 11:00 a.m. and 4:00 p.m. from May until August. Be careful all year long. You can get sunburned skiing in winter just as easily as you can while biking in the summer
- Wear UV-protective sunglasses
- Many websites, newspapers as well as radio and television newscasts mention the daily UV index. When it is seven or higher, take extra precautions
These suggestions are especially important for infants and children. They are at greater risk because of their thinner skin. Even one serious sunburn before the age of 18 may increase the possibility of skin cancer.
As skin cancer can affect anyone, so it is important to check your skin regularly. You should ask someone to help you check hard-to-get-at places such as your back, back of your neck, ears and backs of your legs.
You should check your skin monthly and look for any:
- Birthmarks or moles that appear or existing ones that change shape, colour, size, edge pattern or surface
- New growth on your skin – pale, pearly modules that may grow larger and crust, or red, scaly, sharply defined patches
- Sores that do not heal
- Patches of skin that bleed, ooze, swell, itch or become red and bumpy
Ask your doctor for help if you notice changes to your skin or are confused about what you should be looking for. If skin cancer should develop, early detection and treatment are the best defense.
Nearly all skin cancer can be successfully treated if detected early, but as Pauline Alton knows now, it is much better to prevent it in the first place.