Skin Cancer

Introduction

Skin Cancer is the most common cancer now in the United States, with over one million new cases diagnosed each year. Unlike other illnesses you can develop while traveling, the choices you make which help skin cancer grow on your body will not affect you for many years and more probably, not for decades. Skin cancer is due to damage at the cellular level caused by UV radiation and whether the source is direct exposure to the sun or the use of sunlamps, tanning beds/booths, all sources emit UV rays. The use of tanning beds and/or booths should be given serious consideration, before climbing in, as they are rarely calibrated correctly - giving off much higher levels of UV radiation than regulations allow.^[1]

Any kind of tan or sunburn is cellular damage by UV radiation. Yes, your skin will heal afterwards but that damage is cumulative and lasts for the rest of your life. Imagine every tan, or much worse - sunburn, as being hit by a baseball bat lightly. At first it does very little damage but over time it can kill you. Though most skin cancers are shown to be slow growing and usually do not begin to appear until after the age of 50, this is quickly changing. Women under the age of 40 are now the fastest rising group to be diagnosed with basal cell and squamous cell carcinomas. (See descriptions below.)^[2][3]

Prevention

• Always use SPF 48 or higher sunscreen*, especially at the beach, on water, at high altitude and near the poles, such as Antarctica.
• Apply sunscreen at least 30 minutes prior to sun exposure for optimum absorption and protection.
• Reapply sunscreen every 2 hours and after each "dip in the pool, ocean, lake or stream".
• Wear protective clothing, sunscreen or a combination of both when outside between 10 am and 3 pm.
• Avoid activities like sunbathing.
• Never use tanning beds or booths because of the massive amount of UV radiation exposure.
• Prevent sun burn at all costs, especially for younger children.

*Currently, the minimum recommendation for a sunscreen factor is SPF 15 and is based on "general public average exposure". This does not take into account those with greater exposure times such as travelers and outdoor workers. Also, most sunscreens provide protection against both UV-A and UV-B rays though there are no international standards for labeling the degree of UV-A blocking ability. (All SPF labeling is based on UV-B blocking ability only.)^[4][5][6][7]

Pre-Exposure Vaccinations

There is no vaccination for skin cancer, although if the proper care is taken most people can avoid skin cancer.

Symptoms and Treatment

Symptoms

The main symptoms are scabs of unknown origin, unusual changes in skin texture, discoloration, ulcers of the skin that never heal and changes in preexisting moles. The three most common skin cancers are:

• Basal Cell Carcinoma - Most of the time this cancer will appear as a raised, smooth, pearly/waxy bump on a sun-exposed area of skin, such as the head, neck or shoulders. Sometimes blood vessels can be see inside the tumor due to it's transparency. Also a crusting over and/or bleeding inside the tumor is frequently observed. It is usually mistaken for a sore that does not heal. Less commonly, basal cell carcinomas can occur as flat, flesh-colored or brown scar-like lesions on your chest or back.
• Squamous Cell Carcinoma - This type of tumor is usually a red, scaly and thickened patch on a sun-exposed area of skin. Squamous cell carcinomas can also appear as firm red nodules which are commonly mistaken for boils or carbuncles in the early stages of development. Both the "flat scaly" and "raised nodular" forms of this cancer appear mainly on the face, neck, arms and hands. The "raised nodular" tumor is often seen on the lips. If this cancer is not treated it can grow into a large mass.
• Melanomas - Though melanomas are the least common of the three "most common" skin cancers, it is the one responsible for most skin cancer deaths. They appear as brown to black lesions with possible speckling. The key things to look for are a change in size, shape, color, elevation, pain, itching, ulceration or bleeding of a mole. The appearance of a new mole during adulthood is a strong indicator of a melanoma. Most melanomas will have an irregular border and some patients may develop red, white or blue to blue/black spots on their body or limbs. Dark areas developing on palms, soles, and/or mucous membranes should also be considered suspicious.^[8][9]

Treatment

Most treatment methods involve removing the tumor from your skin by various methods which include cryosurgery (freezing with liquid nitrogen), incised surgery, topical chemotherapy and focal radiation therapy. If found and removed quickly the risk for death is very low. Remember that UV radiation damage is cumulative so therefore it is very possible that another tumor can grow on or near the same spot of previous tumors and many skin cancer victims return for treatment every year in order to remove new tumors.^[10][11]