Skin Cancer Prevention and Detection
Brian Leav, PharmD
Candidate 2011
Skin Cancer
Background
Skin cancer is the most common form of cancer and
estimated to affect more than 2 million Americans annually.1,2 The 2
main types of skin cancer are melanoma and non-melanoma skin cancer. Melanoma
skin cancer can occur anywhere on the body but is more common on the chest and
back of males and the legs of females. Non-melanoma skin cancer mainly consists
of basal cell skin cancer and squamous cell skin cancer, with basal cell cancer
occurring most frequently. The non-melanoma skin cancers mainly appear on areas
of the body that have been exposed to the sun, such as the face and neck.
Are you at risk
for developing skin cancer?
The main risk factor for developing skin cancer is
exposure to ultraviolet (UV) radiation.1-4 Primary sources of UV
radiation are from sunlight and artificial sources, such as tanning beds and UV
lights. The overall lifetime exposure to UV radiation is a risk factor for skin
cancer. The amount of UV exposure is dependent on the length of time of
exposure, the intensity of the light, and whether or not the skin was protected
with sunscreen or clothing. People with light or fair skin have an increased
risk of developing skin cancer. Those with darker skin have an increased amount
of melanin that helps protect the skin from the damaging effects of UV
radiation. Even though people with dark skin have a lower risk of developing
skin cancer, this does not mean that these people cannot develop skin cancer.
Individuals at risk for developing skin cancer include:
•
A history of skin cancer
•
A 1st degree relative with skin
cancer
•
Freckles, light color eyes (blue, green, gray), or
light colored hair (red, blond, light brown)
•
Easily get sunburned
•
Those who live or vacation in tropical climates
or at higher altitudes
•
A weakened immune system
•
Those with many moles, irregular moles, or large
moles
•
Actinic keratosis, which is a skin condition
that can lead to squamous cell cancer. It is a flat, red or brown scaly patch
on the skin, usually on the hands or face, which is a result of excessive UV
exposure.
How do I know if I
have skin cancer?
The treatment of skin cancer has the best outcomes if the
disease is detected early.1,3 If you are at risk for skin cancer,
your physician can perform full-body skin exams during routine visits. Along
with this, you can perform self-exams periodically, ideally every month. The
purpose of the self-skin exam is to detect any abnormal growths on your body
but also so you can remember how any moles, or other skin growths, look.2
This will allow you to detect any changes in any current skin conditions.
To perform a
skin exam, you should be in a well-lit area and use a full-length mirror. The
process of checking your skin is listed below.1,2
•
Face the mirror and check your face, neck, ears,
and scalp. Use a blow dryer or comb to move hair away to examine your scalp.
•
Check both arms and underarms. Also check both
sides of your hands, fingers, and fingernail beds.
•
Next, check the front, back, and sides of your
legs. Using a hand-held mirror, check the back of your legs and buttocks. You
may also have a significant other help check for hard to see areas.
•
Lastly, check your calves and feet (top and
bottom).
While performing skin exams, you need to know what to
look for. A normal mole should be brown, tan, or black all over; flat or
raised; and less than ¼ inch across (about the size of a pea or a pencil
eraser).1 Make sure to look for any new growths that are raised;
red, pink, shiny, pale or waxy; and any scaly or rough patches.1-4
Also look for any growths that may bleed or ooze. Growths that do not heal after
a few months should also be further examined. If you have current skin growths
that have been already checked out by your doctor, make sure to look for any
changes in size, color, or texture. If you do find any growths on your skin,
follow the ABCDE rule.
•
“A” stands for asymmetry. Look for moles or
growths that do not look the same on both sides.
•
“B” stands for border. Look for moles or growths
that have irregular (ragged, notched, or blurred) outlines.
•
“C” stands for color. The color may not be the
same all over.
•
“D” stands for diameter. The diameter of the
growth is more than a ¼ inch (about the size of a pea or a pencil eraser).
•
“E” stands for evolving. The mole looks
different from before.
If you find any suspicious growths, make sure to have
your physician or dermatologist look at it and they will determine what to do
next.1-3
What can you do to
protect yourself from UV radiation?
It is unreasonable to think that you can completely avoid
exposure to UV radiation, but there are ways to protect yourself from the
damaging effects of the sun. To protect your skin, remember the saying “SLIP!
SLOP! SLAP! AND WRAP!”1 What this means is that if you are going to
be exposed to sun, you should:
•
SLIP on a shirt
•
SLOP on sunscreen
•
SLAP on a hat
•
WRAP on sunglasses
Clothing
Different types of clothing will provide different levels
of protection. Tightly woven clothing that is dark in color will provide more
protection than clothing that is loosely woven or of a lighter color.1
There is also special clothing available that has an ultraviolet protection
factor (UPF) to help reduce UV exposure.
Sunscreen
The use of sunscreen can also help reduce the damaging
effects of the sun.1,2 Sunscreen should be applied 30 minutes prior
to sun exposure and applied to areas of the skin that will be exposed to
sunlight. According to the American Academy of Dermatology, sunscreens with a
sun protection factor (SPF) of at least 30 should be used. There are 2 types of
UV radiation that are thought to lead to skin cancer, UVA and UVB. The SPF
number is based on how well the sunscreen protects against UVB rays; the higher
the SPF, the more protection against UVB rays. Sunscreens that are listed as “broad-spectrum”
protect against UVA and UVB rays, but there is no standardized way to measure
the amount of UVA protection. Although sunscreen provides some protection, it
will never completely protect you from UVB rays, no matter how high the SPF.
The level of protection against UVB rays with SPF 30 is about 97%. Using a
sunscreen with an SPF 30 in the sun for 30 minutes, you will receive the same
amount of exposure to UVB rays as someone without any sunscreen in the sun for
1 minute. One ounce, or about a palmful, should be enough sunscreen for an
average adult to apply to the arms, legs, neck, and face. You should also
remember to apply sunscreen even if it is not a sunny day because the UV
radiation can reach you on cloudy days. Ultraviolet radiation can also pass
through windows and can reflect off of sand, snow, and water, increasing the
amount of UV exposure. Sunscreen should be reapplied at least every 2 hours or
more frequently if you will be swimming or sweating. Waterproof sunscreen will
provide protection for 80 minutes while swimming or sweating whereas water
resistant sunscreen only provides 40 minutes of protection. Another way of
limiting your exposure to UV radiation is to avoid the sun between the hours of
10 am and 4 pm because this is the time the sun’s rays are strongest. Because a
risk factor of melanoma is being sunburned as a child, parents should also make
sure that they are taking the same precautions with their children.
Hat
Wearing hats with a 2 to 3 inch brim all around can also
protect your face, ears, and neck from UV radiation.1
Sunglasses
Sunglasses can also protect your eyes from the damaging
effects of the sun as well as the skin around your eyes.1 The
sunglasses should be labeled with “UV absorption up to 400 nm” or “meets
American National Standards Institute UV requirements” which means that it will
block at least 99% of UV rays.
For Further
Information:
American Academy of Dermatology: http://www.aad.org/
American Cancer Society:
National Cancer Institute: http://www.cancer.gov/cancertopics/types/skin
Skin Cancer Foundation: http://www.skincancer.org/
UIC Pharmcy - contact your UIC Pharmacist
References:
1.
American Cancer Society. Skin cancer prevention
and early detection. http://www.cancer.org/Cancer/SkinCancer-Melanoma/MoreInformation/SkinCancerPreventionandEarlyDetection/index.
Updated July 6, 2010. Accessed April 13, 2011.
2.
National Cancer Institute. What you need to know
about melanoma and other skin cancers. http://www.cancer.gov/cancertopics/wyntk/skin.
Updated June 2010. Accessed April 13, 2011.
3.
National Comprehensive Cancer Network. Melanoma:
NCCN guidelines for patients. http://www.nccn.com/images/patient-guidelines/pdf/melanoma.pdf.
Version 2010. Accessed April 13, 2011.
4.
National Cancer Institute. Skin cancer treatment
(PDQ): patient version. http://www.cancer.gov/cancertopics/pdq/treatment/skin/Patient.
Updated February 18, 2011. Accessed April 13, 2011.
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