Cancer is more than skin deep

Cancer is more than skin deep

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All up and down the Eastern seaboard, at beaches from Provincetown to Poodle Beach, Rehoboth and beyond, a silent killer is stalking its prey. [Cue music.] Dunh ... dunh, dunh ... dunh, dunh, dunh, dunh, dunh, dunh ... Wait, wait, hold on a minute! We’re not talking a remake of “Jaws” here. But the killer I’m talking about is just as insidious as the mythical Great White shark that terrified those fictitious ocean bathers — and real-life theatergoers — in that ’70s summer movie classic.

We’re talking about cancer here — specifically, skin cancer — and every year this killer takes a bigger “bite” out of the population. Incidence of melanoma, the most dangerous form of skin cancer, was up nearly 8 percent in 2005 (the last year for which statistics are available) over 2003 among men and 3 percent among women for the same period. While deaths from this type of cancer have remained level over the past two decades, the fact that we continue to see spikes in the incidence of this preventable disease means we aren’t doing enough to protect ourselves.

First, a few facts: The three most common forms of skin cancer are basal-cell and squamous-cell carcinomas and melanoma, which is the most deadly of the three.

Basal-cell carcinomas are the most easily treated, usually by surgical excision or “freezing” them off. While they are the least likely to spread, they have a high rate of recurrence.

Squamous-cell carcinomas are the second-most common type of skin cancer. They tend to be slow-growing and difficult to distinguish from rough, scaly skin, especially in the early stages of growth. Both basal- and squamous-cell carcinomas are primarily caused by exposure to the sun’s damaging rays.

However, exposure to chemical toxins, radiation or immunosuppresant drugs can also be factors.

Both basal- and squamous-cell carcinomas are highly curable, but left untreated, can cause damage to nearby tissue, nerves and even bone. Untreated squamous cell carcinomas can destroy healthy tissue and even spread to the lymph nodes and other organs. Rarely, it can even be fatal.

Melanoma, the most serious type of skin cancer, usually develops in the cells that produce melanin — the pigment that gives your skin its color.

The exact cause of all melanomas isn’t clear, but exposure to ultraviolet radiation from sunlight or tanning lamps and beds greatly increases your risk of developing it. About 65-90 percent of melanomas are directly due to exposure to ultraviolet light or sunlight.

Who’s at risk?

As you can probably surmise, anyone who is regularly exposed to sunlight or UV rays and does not take precautions is at risk for skin cancer. Folks with light or fair skin, which has a propensity to freckle or redden easily, have an increased risk for the disease. Likewise, those with light eye and hair color are more likely to get skin cancer. Possessing a certain type or large number of moles is also an indicator for these types of carcinomas and melanoma. Those with a personal or family history of skin cancer are more likely to get it as well.

Also, persons with HIV (or for other reasons) are at higher risk for a particularly aggressive form of squamous-cell carcinoma.

What to look for

There are some general things that one can be on the lookout for in the early detection of skin cancers, but there are many variations of these symptoms, and they may — or may not — indicate a carcinoma or melanoma. Generally speaking, however, if you notice a change in the appearance of a mole or other mark on the skin, particularly in areas that are exposed to sun and UV light, it’s a good idea to have a doctor check it out.

Can we prevent it?

Most definitely. The sun’s UV rays can damage your skin in as little as 15 minutes. In Rehoboth, it might take you that long just to find a spot to park your towel! Put on sunscreen before you go outside, even on cool or cloudy days. Remember what your mother always said? She was right! And don’t waste your time with anything lower than 15 SPF. The higher the number, the greater the protection.

Shaved heads may be sexy, but not when they’re covered with scars from surgical excisions. Wear a hat, preferably one that covers the ears. If baseball caps are your preference, however, don’t forget about your ears and nose when applying sunscreen.

Long-sleeved, loose-fitting clothing may not create quite the fashion statement you were hoping for, but it’s a good idea all the same. Just to put things in perspective, a typical T-shirt actually has an SPF rating of 15 or less. A T-shirt without additional sun protection is not a great solution.

Sunglasses protect your eyes from harmful UV rays and reduce the risk of cataracts. They also protect that tender skin around your eyes from sun exposure, and if you’ve ever gotten bad sunburn on your face, you know what I’m talking about.

Speaking of shades, why not spend some time in the shade? Use the shade of an umbrella or tree to prevent getting too much sun, not as relief from too much sun. Protect yourself now, so when you’re older, you can have it made in the shade!

Robert Winn, is the medical director at Mazzoni Center, Philadelphia’s only LGBT health center.

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