If ever there was ever another reason for your mother to tell you to get married, it’s cancer prevention. May is officially Skin Cancer Awareness month, and the American Academy of Dermatology (AAD) has started their new campaign for skin cancer and melanoma prevention this spring, called Who’s Got Your Back. With spring in full gear, and the reappearance of warmth and sun, it is the ideal time to remind people about safe sun practices and how to detect skin cancers early. The incidence of both non-melanoma skin cancers, namely, basal cell (BCC) and squamous cell skin cancers (SCC) and melanoma is rising worldwide, and particularly in younger people.
According to the Journal of the American Medical Association, one in five Americans will develop skin cancer in the course of his/her lifetime, and, specifically, 40-50 percent of Americans who live to age 65 will have either BCC or SCC at least once. The American Cancer Society projects that the annual incidence of non-melanoma skin cancers will exceed 3.5 million in 2015 for white, non-Hispanic persons, alone. About 90 percent of non-melanoma skin cancers are attributed to sun (UV) exposure.
One person dies of melanoma every hour. Between 2000 and 2009, the incidence of melanoma has increased 1.9 percent annually. Statistics published by the Skin Cancer Foundation indicate that approximately 73,870 new cases of invasive melanoma will be diagnosed in the US in 2015, and 9,940 will die. While most people assume that melanoma does not develop until middle age and beyond, after a lifetime of sun exposure, in fact, melanoma is the most common cancer diagnosed in young adults 25-29 years old and is the second most common cancer diagnosed in young people 15-29 years old.
About 86 percent of melanomas can be attributed to exposure to ultraviolet (UV) radiation from the sun, which includes the use of tanning beds. It is estimated that a person’s risk for melanoma doubles if he or she has had more than five sunburns. Experiencing 5 or more severe sunburns before the age of 15, increases one’s lifetime melanoma risk by 80 percent. Regular daily use of a broad-spectrum sunscreen with an SPF 30 or higher sunscreen can reduce the risk of developing squamous cell carcinoma by 40 percent and can reduce the risk of developing melanoma by 50 percent.
With the back being the most common site to develop melanoma, a potentially lethal cancer that is treatable when caught early, the AAD’s campaign is focused on reminding you to make sure that you apply sun protection all over, but to be especially mindful not to miss your back. If this means having someone else remind you to cover up or even to, literally, apply sunscreen to your back, if you can’t reach it, then make sure that you have that person.
Sunscreen is not just meant for beach days. Sun protection needs to be part of everyone’s daily routine. Brush teeth, wash face, apply sunscreen, get dressed. It’s important to apply sunscreen to all sun exposed areas including face, ears, chest, back of the neck, arms and hands every day. Even when it’s cloudy. Brimmed hats, larger sunglasses with UV protection and longer sleeves are easy ways to cover up and prevent sunburns, future sun spots, wrinkles, cataracts, and, of course, skin cancer. Gone are the days of sticky, messy, white, goopy sunscreens that are unappealing and difficult to wear with regular clothing. Today there are fast-drying light lotions, sprays, powders, gel and sport- formulations that are cosmetically appealing to all skin types and activities.
The key things about wearing sunscreen are:
- The bottle should say Broad-spectrum (UVA and UVB) with an SPF of at least 30.
- You must use enough product to get adequate protection. A shot glass (1 ounce = 2 tablespoons) is needed to cover the entire body, with 1 teaspoon allocated for the face/ears/neck.
- Reapply every 2-4 hours, especially after sweating and swimming, even if the bottle says water-resistant.
- Remember that it’s just cream! It’s not a 100% protective sun barrier. Keep covered during peak sun hours, when practical. Find shade, wear sunglasses, throw on a hat and keep sensitive areas covered up.
Getting an annual mole check by your dermatologist takes only a few minutes of your time, but can save your life, if skin cancer or melanoma is detected. However, it is important for everyone to know their own skin, and to perform self skin examinations every month. The ABCDE pneumonic was developed to help people recognize potentially pre-cancerous moles and melanomas.
A – Moles should appear round or oval and symmetric. One half should look the same as the other half. ASYMMETRY is concerning and needs further examination.
B – The BORDERS of the lesion should be smooth. Any lesions with jagged or notched edges should be examined.
C – Moles can safely be any COLOR, including light, medium or dark brown. But, if you notice a mix of colors or change of color, or a mole that is a different color than all of your other moles, then those moles need to be examined further.
D – The DIAMETER (size) of a mole should be no larger than the back of a pencil eraser. Melanoma can appear in all sizes, but it is important to have larger lesions examined more closely.
E – Be aware of EVOLVING or changing moles. Moles in kids are supposed to get bigger and change as the child grows. Adults should not have changing, growing moles. If any of your moles have changed color, size, shape, texture, or are bleeding or itching or hurting, they need to be examined by a dermatologist.
Summer is meant to be enjoyed outdoors. Remember to play safe in the sun, keep covered and make sure that someone has your back.
Tsippora Shainhouse, MD is a board-certified dermatologist. She is a clinical instructor at USC – Keck School of Medicine and works in private practice in Beverly Hills. She is an advocate for safe sun practices and skin cancer prevention.