Tag: skin cancer

This column is about skin cancer – about prevention and about early detection.

I am bold (and bald) enough to tell you that I have not picked this subject because my shiny scalp is devoid of bicolored locks, hence increased risk of exposure to the sun’s damaging ultraviolet rays, but I think skin cancer is an important subject as we get into hot weather.

For my head shave, we were able to raise over $2200 for the Canadian Cancer Society – a big thank you to generous contributors who made the event satisfying and worthwhile.

Now, for $10,000 to the cancer society, I may be (I repeat, may be) tempted to get an ear ring, a nose ring and a tattoo on my scalp! A little advisory here – statement like this is not to be taken seriously and there is no need to call a psychiatrist. My head is bald but it is not out of place!

Anyway, we won’t discuss this any further. Let’s get back to our discussion on skin cancer.

There are two important things to remember about prevention of skin cancer: cover up and stay out of the sun, says an editorial in the British Medical Journal (BMJ).

Skin cancers can be divided into two types: melanoma and non-melanoma. Non-melanoma skin cancers are: basal cell cancer and squamous cell cancer.

Experts believe that 90 per cent of non-melanoma skin cancers and two thirds of melanomas may be attributed to excessive exposure to the sun, says the BMJ.

According to Alberta Cancer Board publication (Cancer in Alberta, A Regional Picture – January 2003) non-melanoma skin cancers account for approximately 30 per cent of malignant cancer cases diagnosed each year among Albertans. It says that although these tumors are malignant, they are not typically life threatening and are usually successfully treated in doctors’ offices.

Melanoma accounted for four percent of new invasive cancers in Alberta in year 2000. In 1993, Alberta Cancer Registry adopted a new coding system to monitor incidence of melanoma. Since 1995, melanoma rates in Alberta have remained pretty much stable. In 1999, 194 new melanoma cases were diagnosed in Alberta.

In the Palliser Health Region, on an average 13 cases of melanoma are diagnosed each year.

For Canadian males, the incidence rate for melanoma has tripled since the late 1960s. For Canadian females, the rates have varied over the years but still shows a gradual increase.

In the United Kingdom and the United States the incidence of melanoma has doubled in past 20 years.

Melanoma is by far the most serious form of skin cancer, the survival rate is very high when detected and treated early, says the Alberta Cancer Board document.

To prevent deaths from skin cancer, particularly melanoma, the public has to be educated on two strategies: advice on early recognition and advice on prevention. Australia has done well in this regard. The incidence of melanoma has been falling in that country.

Can we achieve the same results in Canada?

By way of prevention: we need to keep reminding ourselves that skin tanned by ultraviolet radiation is damaged skin which predisposes to cancer. There is a potential risk of using sunbeds. We need to avoid sunburn and generally reduce exposure to ultraviolet radiation by staying out of the midday sun, wearing protective clothing, seeking shade, and applying sunscreen.

By way of early recognition: we should have moles or sun burnt skin surgically removed if they show signs of change or non-healing. Bleeding, chronic irritation, change in color or size should warn us to have these moles removed.

The BMJ article says that despite having a good understanding of the relation between overexposure to the sun and skin cancer, 81per cent of Americans still think they look good after being in the sun. Do you feel the same way? A good tan may shorten your life.

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“Melanoma rates are now rising faster than for any other cancer in men and second only to lung cancer in women,” says Dr. Darrell Rigel, Associate Professor in the Department of Dermatology at the New York University School of Medicine.

There are three types of skin cancers: Basal Cell Cancer, Squamous Cell Cancer and Melanoma. First two are very common and can invade local tissues but are not fatal. Melanoma is not that common but can be fatal if not detected early and excised.

The death rate from melanoma continues to rise about two percent annually. Most skin cancers are due to exposure to sunlight and ultraviolet rays. So, this is a good time of the year to remind ourselves of the dangers of sunrays and ultraviolet radiation.

Skin is not only the largest organ of our body but has many important functions to protect us from environment Skin is constantly exposed to sun, wind, industrial elements and other causes of external and internal injury.

There are more than 25 human disorders that are either caused by or aggravated by exposure of the skin to sunlight.

Melanoma arises from cells called melanocytes. These cells contain melanin (melas = black) – a principal pigment responsible for the color of human skin, hair, and eyes. Melanin also acts as a filter to decrease the harmful effects of ultraviolet rays to the dermis.

When the skin is exposed to ultraviolet radiation, there is immediate increase in the number of melanocytes and production of melanin pigment. This results in tanning. The amount of melanin produced is genetically determined. That is why some people burn easily without tanning.

The risk of skin cancer is increased in individuals who spend too much time outdoors, children who have had episodic sunburn, and if there is a family or personal history of skin cancer (especially melanoma). Males are affected more than females.

Can we prevent skin cancer?

Yes! The Canadian Cancer Society recommends the following preventive measures:

1. Avoid prolonged exposure to the sun especially between 11:00 am and 4:00pm.

2. Wear protective clothing, such as long-sleeved shirts, and wide-brimmed hats.

3. Use a sunscreen with a SPF of 15 or higher to absorb ultraviolet rays.

4. For the nose or lips, use a sun block preparation containing zinc oxide or titanium dioxide that will deflect ultraviolet rays.

5. Seek prompt treatment of any skin abnormality.

Skin cancer can be cured if detected early and appropriately treated. If a mole bleeds or is in a place where it gets irritated constantly; if there is a change in size, shape, and colour of a mole then it should be removed.

Prognosis for melanoma depends on the depth of the mole (deeper the mole worse the prognosis). Therefore, full thickness biopsy is important.

Konrad Adenauer, former Chancellor of the then West Germany once said, “A thick skin is a gift of God”. Let us put it this way: “A healthy skin is a gift of God; to be treated with respect and care”.

So have fun but be sun smart!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!