Skin cancer is more common than you may know. An estimated one in five Americans will develop skin cancer in their lifetime, according to the American Academy of Dermatology (AAD). And young people are not immune. Melanoma, the most serious type of skin cancer, is one of the most common cancers to strike people under the age of 30. The AAD has designated May as National Skin Cancer Detection and Prevention Month to spread the word about skin cancer.
“The best strategy to defeat skin cancer is to prevent it entirely, or to detect it as early as possible,” says Hubert Greenway, Jr., MD, chairman of Bighorn Mohs Surgery and Dermatology Center at Scripps Clinic, Torrey Pines.
Especially in Southern California, where the sun’s rays burn stronger than in milder climates, it is important to understand the risks, protect your skin, and be aware of the early signs and symptoms of skin cancer.
There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma, which is the most serious.
“Cumulative sun exposure is a major skin cancer risk factor for developing the first two types,” Dr. Greenway explains, “but episodes of acute sunburn are often linked to melanoma.” And while a severe sunburn will heal on the surface in a few days, the real damage may not emerge until decades later.
Everyone needs to protect their skin from sun damage. In Southern California, using 30 Sun Protection Factor (SPF) sunscreen — or higher — should be a daily ritual. Some clothing also offers SPF protection. In addition, wearing a wide-brimmed hat will keep sunlight off the head and neck, and sunglasses can protect the eyes and surrounding skin.
When it comes to tanning beds, Dr. Greenway is firm: “Exposure to damaging rays should be avoided, whether they are natural or artificial. Tanning beds raise the risk of melanoma and also dry the skin, causing wrinkles and premature aging.”
Direct exposure to sunlight isn’t the only skin cancer risk factor. Reflected rays from water, sand or snow, which intensifies them, magnifies their effect — and the risk of a burn. Dr. Greenway recommends staying out of the sun during the most intense hours, between 10 a.m. and 2 p.m. So plan your tennis match, tee time or surfing session early in the morning or late in the afternoon.
Anyone who has ever had a sunburn is at risk for melanoma, but genetics also play a part. People who are fair skinned or have a family history of the disease should be more vigilant about sun protection.
“Regardless of their family history or personal risk, San Diegans should watch for atypical moles, which tend to be multicolored and asymmetrical,” Dr. Greenway advises. Precancerous moles tend to form on the head, neck, upper back, torso or lower legs, but can be found anywhere on the skin.
Moles should be self-checked monthly. Mirrors and digital photographs can be useful to observe and track them. If a mole becomes darker, develops ragged borders or appears to be changing, see a dermatologist. An itchy mole can also indicate problems. Finally, if a mole just seems more obvious, even if there’s no apparent reason, it’s a good idea to get it checked. And be sure to see a dermatologist at least once a year for a thorough full-body exam.
The earlier melanoma is found, the easier it is to treat. Once the disease has spread, it becomes a serious problem. In its earliest stages, melanoma can be removed surgically. Mohs surgery is a precise surgical technique used for treating melanoma and other forms of skin cancer. During Mohs surgery, layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.
If melanoma has spread to the lymph nodes, other therapies may be required. Advanced melanoma treatment options are limited in terms of their long-term success. There are several approved chemotherapy agents, as well as interferon, interleukin and other biologic modifiers that prime the body’s immune system to fight cancer, including some newly approved agents.
Pharmaceutical and biotech companies continue to look for better treatments, such as a recent trial that tested attaching a virus to the melanoma for identification and treatment.
Melanoma accounts for less than 2 percent of all skin cancer cases, but it causes a large majority of skin cancer deaths. According to the American Cancer Society, approximately 10,000 people are expected to die of melanoma in the United States in 2015.
So it bears repeating: the most effective way to beat melanoma is to prevent it entirely. Otherwise, early detection is the best bet. Monthly self-exams and annual dermatologic checkups can be life-savers.