A few weeks ago I was invited to a Cubs game at Wrigley Field. Baseball in April and May in Chicago, whether you’re on the north- or south-side, can be hit-or-miss weather-wise. So while most of the country is enjoying warmer spring weather, Chicago is often late to the party. That day was no exception. With a cool breeze from the east there was a chill in the air, but the sun was strong. Being so early in the season I was not yet in the habit of putting on sunblock, so when I got home from the game I realized I had gotten too much sun. I know better—not only because I’m a doctor —but because my loving spouse is always reminding me to lather up.
Skin cancer should be front-and-center for me not only because it’s Skin Cancer Awareness Month, but because I’m also currently caring for a patient who might be dealing with it. He’s recently been diagnosed with squamous cell carcinoma in his lung and we’re wondering where the cancer came from; skin cancer is one possibility.
You may have heard of the different types of skin cancer. The most common is basal cell carcinoma, or BCC. BCC typically occurs on areas of the skin that have had intense exposure to the sun and can appear as sores, shiny bumps, or scars. Squamous cell carcinoma, SCC, is the second most common form of skin cancer, and is a result of years of exposure to UV radiation of any type, including the sun as well as tanning booths. SCC can appear as warty growths or open sores, and often starts as a scaly patch that feels a little like sandpaper. Both BCC and SCC, if caught early, are often treated with a Mohs procedure, where thin, progressively deeper, layers of skin are removed by the surgeon until an onsite pathologist confirms that no further cancer remains. With this technique, SCC and BCC can be cured in over 90% of cases.
The same is not true for melanoma. Melanoma is the most dangerous form of skin cancer, and is also triggered by sun exposure. I. Melanoma presents a little differently than BCC and SCC. Melanomas often resemble moles, which are small brown patches that appear on almost everyone’s skin. A change in one of your moles is often the first sign of melanoma.
Seek the shade, especially between 10 AM and 4 PM.
If you can’t stay in the shade, cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day, even when it’s cloudy. For extended outdoor activity or when spending time in the water, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
Apply 1 ounce (2 tablespoons or about a shot glass worth) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or immediately after swimming or excessive sweating.
Avoid tanning and UV tanning beds.
Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
Examine your skin head-to-toe every month.
See your physician every year for a professional skin exam.
That last recommendation is a challenge for a number of reasons. For one, getting an appointment with a professional is easier said than done. Secondly, is your health care professional – primary care physician or allied health professional (APN, FNP, PA) – able to distinguish a normal skin lesion from an atypical one? Does your insurance cover a visit to a dermatologist for a screening skin exam? The more questions there are, the less likely you are to do it.
At Harper Health we recently partnered with SkinIO to help screen our patients for skin cancer. At each patient’s annual physical exam we take photographs of their skin; SkinIO’s software allows the pictures to be digitized, encrypted, and sent to a licensed dermatologist. The SkinIO team evaluates any skin changes and returns a report, including any concerns, to me within one to two business days. If there are any areas that need follow-up, we can then facilitate an appointment with a trusted dermatologist for further evaluation. This partnership is highly valued by us and our patients.
If SkinIO were around years ago, would it have prevented my patient’s SCC in his lung? I don’t know the answer to that, but I do know that if he had known more about skin cancer prevention when he was young, he could have better protected his skin against sun damage. As Skin Cancer Awareness Month enters its final week, I encourage all readers to wear sunblock and get a quality skin assessment. Nothing is better than prevention and early detection.