Connecticut’s Dr. Dan Davis discusses injury prevention and treatment, as well as general health and fitness, to help keep you on the court or field.
A look at skin cancer and what to do about it
Q: How common is skin cancer?
A: It is the most common cancer of all. According to the American Cancer Society, skin cancer accounts for nearly half of all cancers in the U.S. The good news is, it’s usually the most treatable.
Q: Are there different kinds of skin cancer?
A: Yes, and they are typically named for the cell layer of the skin in which they appear –such as basal cell skin cancer, squamous cell skin cancer and melanoma which begins in the melanocytes, or pigment cells. Although melanoma accounts for just a small percentage of skin cancer, it is by far the most serious and dangerous and results in more than 9,000 of the 12,000 skin cancer deaths that occur each year.
Q: What causes skin cancer?
A: Exposure to the sun -- in particular ultraviolet light from the sun -- is the biggest cause. Ultraviolet light passes through clouds, so even on an overcast day, you can get sunburned and damage your skin without realizing it. I’m not saying you should never go out in the sun. In fact, sunlight is good for you. It helps you produce Vitamin D, which is important for bone health. I also recommend avoiding tanning salons. Their tanning beds expose you to ultraviolet light and increase your chance of developing skin cancer. In addition, overexposing your skin to ultraviolet light causes your skin to age more rapidly. Who wants that?
Q: There are suntan lotions and sunblock lotions. What’s the difference?
A: Sunless spray-on tanning products are a somewhat safer manner to get an "instant tan." These products contain DHA, (a sugar cane derivative) which is an FDA approved substance that causes an interaction with the dead layer of cells on the outermost layer of the skin. This reaction stains the dead skin cells darker and this buys you an "instant tan" that lasts until your body sloughs the dead cells on your own or until you wash them off as you would in a shower every day.
Sunblock products offer different levels of protection against the sun’s ultraviolet light, and those differences are reflected in the SPF (Sun Protection Factor) number that you see on the package. The SPF number indicates how much sun they can block, relatively speaking. For example, if you use a product with a SPF of 4, that means it would take four hours in the sun to get the same impact from exposure to the sun that you would get in 1 hour if you didn’t apply the product. With an SPF 15 sunblock, it would take 15 hours in the sun to get the same impact as spending 1 hour in the sun without the sunblock on. However, be aware that if you are out in the sun for long periods of time, you could sweat the lotion off, or if you’re in the water, it could wash off. The sunblock could also rub off on your clothes. SPF products provide great protection to overexposure to UV rays. The technology is improving to the point that some sunblock products are more moisture and exercise resistant. Read the labels carefully to make sure you are properly protected.
Q: What can we do to protect ourselves against skin cancer?
A: Contrary to public opinion, a tan is NOT a good protection against UV damage. It gives an SPF equivalent of anywhere between 2 and 2.7. Hence, even with a good tan base, damage can still be done. Plain and simple, over exposure to UV light causes skin damage (via DNA damage to skin cells). Moderation with regard to exposure to the sun is key to remaining healthy. If you’re going to be out in the sun for any appreciable length of time, you should use some form of UV blocker.
Q: How is skin cancer detected?
A: You should see a dermatologist for a full body exam once a year, especially if you are 30 or older. Dermatologists are experts at detecting various forms of skin cancer as well as precancerous lesions. Any suspicious lesions can be biopsied or removed in their office in a painless fashion.
Q: What should we look for even before we see a dermatologist?
A: Basically, if you see something on your skin that doesn’t look “normal”-- for example – a recently developed discoloration or a flaky, crusty area of skin -- you should have it checked by a dermatologist. Also, be sure to have someone, such as your spouse, look at your back and check for abnormalities. If caught early, the vast majority of skin cancers can be easily treated by removing the abnormality.
Q: What if the skin cancer isn’t caught early or is simply ignored for a period of time?
A: Left undetected or untreated, skin cancer can spread, and that can lead to serious issues and more intense treatment – like chemotherapy. And there can be complications from the cancer which could be fatal.
Q: You mentioned earlier how serious melanoma is. What do you look for with regard to melanoma and figuring out what to do about it?
A: I use what we call the “ABCDs” as markers on a patient for devising a treatment plan. “A” stands for Asymmetrical. If a lesion is asymmetrical, that is not a good sign. By
contrast, a harmless freckle typically has a symmetrical shape. “B” stands for Border. If a lesion has an irregular border (uneven surface that you can see or feel- or an outer border that is irregular ), that is another red flag. “C” stands for Color. A normal freckle has the same coloration throughout. A lesion which is dark brown on one side and light brown on the other is a problem area. “D” is for Diameter. If the questionable area of skin is larger than a pencil eraser, you likely need to have a biopsy done. If the lesion has more than one of the ABCDs, then the proper treatment needs to be implemented as soon as possible.
Q: What are your overall recommendations with regard to skin cancer?
Most people take their skin for granted, and that’s a mistake. The skin is the largest organ of the body. It is a barrier that protects your internal organs from bacteria and other germs and from ultraviolet light which would otherwise destroy those organs. The skin helps prevent water loss. It helps control your internal body temperature by producing sweat to keep you cool when you’re in a hot gym, for example, and running up and down the basketball court. So, it’s critical that you take care of your skin and do whatever you can to avoid or reduce the probability of skin cancer. As officials hit the fields this fall, limit exposure to the sun and use sufficient sunblock. And apply sunblock not just to the obvious parts of the body – face arms, legs, chest and back – but also to your ears, to the backs of your knees and to your feet, including the backs of your ankles. I’ve seen a number of patients who developed skin cancer on their feet because they didn’t think to apply sunblock. The bottom line is this: When it comes to skin cancer, an ounce of prevention is worth a ton of cure.