My husband Barry loves being out in the sun. Unfortunately, skin cancer runs in his family. Over the years, he has had several lesions removed, frozen or burned off. He’s lucky because, so far, all have been either precancerous areas called actinic keratoses or basal cell carcinomas, which are easily treated. He has all the risk factors:
• Light-colored skin, hair, and eyes – that’s my Barry.
• Family history – yes.
• Age – non-melanoma skin cancers are more common after age 40, and he passed that milestone a while ago.
• Sun exposure – he loves the sun
Barry slathers on the sunscreen, so, when the FDA updated its guidelines for rating and labeling sunscreen a few years ago, it caught the family’s attention. The sunscreen industry supposedly brings in sales approaching $1 billion a year, yet, according to the Centers for Disease Control, the rates of malignant melanoma, the most dangerous form of skin cancer, increased by 1.6 percent among men and 1.4 percent among women between 2001 and 2010. (2010 is the latest year data are available.)
Sunscreen is not the only defense against the harmful effects of the sun. It’s hard to imagine sunshine when you’re in the midst of a snowstorm, which is happening as I write this, but when the sun is out, it’s best to limit your time in it, especially at midday, and to wear a shirt or some kind of cover-up and a hat. You also want to avoid tanning beds or booths and sun lamps, which expose the skin to concentrated amounts of ultraviolet radiation. There is mounting evidence that they all increase the risk of melanoma and other skin cancers.
When you put on the sunscreen, you not only need one with a skin protective factor or SPF of 15 or higher, it should also be broad-spectrum. Broad-spectrum means that it protects against two types of ultraviolet radiation UVB rays, which burn your skin, and UVA rays, which cause skin cancer and premature aging of the skin.
Updated FDA sunscreen guidelines are:
In order to claim that a sunscreen protects against skin cancer, it must be at least SPF-15 and must protect against UVB and UVA. If the claim can’t be made, a warning must be added to the label: “This product has not been shown to prevent skin cancer or premature skin aging.”
No sunscreen is really waterproof, so only the term water-resistant can be used and only if studies prove that the product retains its value after being exposed to water.
The term sun block can no longer be used, because no sunscreen can completely block the sun.
Barry sees the dermatologist regularly, and we are always on the lookout for signs of skin cancer. Usually, it will be a “little place that has become red or a tiny sore that won’t heal.” Those are typical signs of basal cell carcinoma, the most common form of skin cancer. The other major types are squamous cell and melanoma, melanoma being the most serious form of skin cancer.
Basal cell signs
• Persistent open sore that won’t heal
• Reddish patch or irritated area that may be crusty
• Shiny bump
• Pink growth with elevated border and crusted indentation in the center
• Scar-like area
Squamous cell signs
• Persistent red scaly patch
• Elevated growth with depression in the center
• Sore that bleeds and crusts and doesn’t heal
• Wart-like growth
• Mole with asymmetrical shape
• Uneven borders
• Variety of colors
• Larger than pencil eraser
About five years ago, instead of removing a suspicious area, our dermatologist prescribed a cream with the brand name Aldara (imiquimod), which Barry has used many times since. It works by triggering the immune system, which in turn activates the molecule interferon-alpha to fight the pre-cancerous or cancerous cells. Treatment lasts four to six weeks and as it progresses, the area can look pretty angry. It also often expands beyond the original site. We see the latter as a good thing, because it means his immune system is attacking pre-cancerous cells we didn’t even know were there. He doesn’t like how it looks during the treatment, but told me, “I have peace of mind because I get a sense that I’ve prevented something from becoming worse.”
If anything is to be learned from Barry’s willingness to share his story, it is that early detection is key. If you have something suspicious looking on your skin, don’t hesitate to get it checked out. Your best defense against skin cancer is to prevent it in the first place.
One final word: Summer will be here before we know it.
Diane Atwood writes the blog Catching Health with Diane Atwood, which received a Gold Lamplighter Award from the New England Society for Healthcare Communications and a Golden Arrow Award from the Maine Public Relations Council. Find it at catchinghealth.com.