Skin protection, monitoring is key to preventing cancer

The month of May is Skin Cancer Detection and Prevention Month. Although Hawaii produces impressive sun intensity year around, as we approach summer in the islands, it is important to be reminded of the risks of skin cancer and implement strategies for prevention to optimize the wealth of health.

Skin cancer is an abnormal growth of skin cells. It most often develops on areas of the skin exposed to the sun’s rays. Although those with light skin who sunburn easily are at a higher risk, skin cancer affects people of all colors and races.

Actinic keratosis is a precancerous growth that shows up as dry, scaly patches or spots that can eventually progress to squamous cell carcinoma, the second most common type of cancer. It often looks like a red, firm bump, scaly patch or a sore that heals and then reopens.

Basal cell carcinoma is the most common type of skin cancer; it looks like a flesh-colored, pearl-like bump or a pinkish patch of skin.

SCC and BCC tend to form on skin that gets frequent sun exposure such as on the face, neck, rim of the ear, arms, chest and back. Early diagnosis and treatment can prevent both types from spreading to other areas of the body.

Melanoma is the deadliest form of skin cancer. It frequently develops in a mole or suddenly appears as a new dark spot on the skin. Early diagnosis and treatment are crucial and will ultimately determine one’s prognosis.

More than 3.5 million skin cancers are diagnosed in more than 2 million people in the United States annually with an estimated 1 in 5 Americans developing skin cancer in their lifetime.

In 2012, there were 131,810 new cases of melanoma recorded in the U.S. It is estimated that one in 50 Americans will develop melanoma in their lifetime.

The last reported projection in the U.S. of total direct cost in the past decade associated with the treatment for non-melanoma skin cancer was $1.5 billion, while melanoma costs were estimated at $2.36 billion.

BCC and SCC are easily treated if detected early and have cure rates approaching 95 percent. The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 98 percent. When melanoma metastasizes locally and distantly, the five-year survival rates drop to 62 percent and 15 percent, respectively. More than 65,000 people a year worldwide die from melanoma, with 9,180 deaths nationally reported in 2012.

The key component to skin cancer survival, like all cancers, is early detection which saves lives and dictates outcome probabilities. Knowing the ABCDE warning signs can help you find an early melanoma: asymmetry, an irregular or poorly defined border, color that varies from one area to another, diameter that is greater than 6 mm (the size of a pencil eraser), and evolving characteristics in size, shape or color. Identifying the appearance of a new growth on the skin also can help with an early diagnosis.

Since exposure to ultraviolet light is the most preventable risk factor for all skin cancers, the American Academy of Dermatology encourages everyone to protect their skin by applying sunscreen, seeking shade and wearing protective clothing.

One ounce of sunscreen — enough to fill a shot glass — is considered the amount needed to cover exposed areas of the body for proper sun protection. Sunscreen selections should include a broad-spectrum, water-resistant sunscreen with a sun protection factor of 30 or more. “Broad-spectrum” provides protection from both ultraviolet A and ultraviolet B rays.

Sunscreen should be applied roughly 20 minutes before going outside so it has time to take effect before direct sun exposure. It is important to reapply approximately every two hours, even on cloudy days, and after swimming or sweating because heavy perspiration, water and towel drying removes the sunscreen’s protective layer.

Not all sunscreens are created equally as many products do not provide enough UV protection or contain hazardous chemicals such as oxybenzone and avobenzone. For safe sunscreen op-tions, the Environmental Working Group provides a quality rating of more than 1,000 sunscreens in a mobile bar code scanning app called Skin Deep that helps guide consumers on the best choices for sunscreen options.

Sun safety awareness should be incorporated into the outdoor routine of every isle resident and visitor. Sun exposure has a snowball effect, so suntans and sunburns year after year have a cumulative impact to your skin, which may result in the consequence of wrinkles or, even worse, skin cancer.

To be the safe in the sun this summer, consider scheduling weekend activities to avoid peak sun intensity hours between 10 a.m. and 2 p.m. while remembering to apply and reapply a high quality sunscreen ever few hours. Finally, be sure to see your health provider for a comprehensive annual skin check.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.