By Dr. Dhai Barr
Skin cancer is the most common cancer in the United States, with one in five Americans developing some form in his or her lifetime. A large number of these occurrences are preventable.
Skin Cancer in Oregon
In 2009 Oregon ranked number 6 in the nation’s incidence of skin cancer. Many Oregonians believe that since it is cloudy and grey most of the time, they need not be concerned. This is far from the truth: the UV comes right through those clouds. In 2006 120 died in Oregon from melanoma, 17% higher than the national average.
According to the Centers for Disease Control and Prevention (CDC), women in Oregon have the highest death rate compared with woman suffering from melanoma in any other state.
There are several types of skin cancer, among which are the non-melanoma Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). These two will claim the lives of over 3000 Americans this year. Many cases of these two skin cancers arise from the precancerous lesion Actinic Keratosis (AK). AK’s affect more than 58 million Americans annually. 90 percent of these cancers arise from over-exposure to UV light, which is emitted by the sun and from tanning beds.
BCC, the most common skin cancer — with 2.8 million diagnosed annually in the US — is rarely fatal. The second most common skin cancer, SCC, affects 700,000 people each year.
Melanoma is the deadliest of the three types of skin cancer, with one person dying from it every four hours. Of the seven most common cancers in the US, Melanoma is the only one on the rise. While the mortality of melanoma has stabilized in recent years, the incidence continues to rise. With the ozone over time weakening the protection from above or strengthening the ill effects of UV light, the damage from earlier exposure is manifesting in the present. Increased awareness of the link with tanning, both outdoor and indoor, and an increase in self-exams and annual exams are leading to earlier detection, hence more cases being identified. Indoor tanning, with its concentration of UV exposure, is especially pernicious, greatly augmenting the risk. Other risk factors include being fair skinned, of Celtic origin, or a family history.
Among people under 30, Melanoma is the second most diagnosed cancer, and the most deadly. Evaluating your risk is done on a case-to-case basis. With daily exposure to sun while driving, the inevitable sunburns in everyone’s history, and the added atmospheric hazards, it is a wise and precautionary practice to come in for annual skin exams, something you might schedule every year around your birthday. Use of tanning beds in the past or present makes this an even more essential ritual.
The most effective tool for fighting Melanoma, and skin cancer in general, is prevention. Early detection and treatment will help keep the mortality rates down. Prevention includes using broad-spectrum sunscreen and staying out of tanning beds.
Diagnosing Skin Cancer
Annual skin exams play an important role in preventing skin cancer, and are key in preventing susceptible lesions from advancing to cancer. Self-exams at home between annual exams can reveal a suspicious lesion or mole that should be referred to your doctor.
Skin Mapping and Skin Exams
Here at the Center for Traditional Medicine we recommend annual skin exams. You will be gowned while your skin is examined from head to toe, with nothing left unnoticed or overlooked. All moles and skin lesions will be examined, and the mapping recorded for yearly comparisons.
During annual skin exams, while Dr. Barr observes and records all lesions and moles on your body, if she comes across anything she feels looks suspicious, she examines it further with a tool called a dermascope. If indicated, she will perform a small biopsy to rule out any concern. She will recommend treatment for any sun damage or AK’s that she finds you to have.
What you can do at home
Self-skin exams will help you pay more attention to changing moles or lesions on your skin between the visits for your annual skin mapping. If you notice changes in the appearance of a mole, it is a sign that you should see Dr. Barr before your next annual visit.
Learn the ABCDE of your self-exam. A is for asymmetry: one half of the mole may look different from the other half. B is for border; notice if the border is uneven, blurred or scalloped. C is for color; is the color in one mole uneven or multi-colored? D is for diameter; greater than 6 mm means that the mole needs regular monitoring. E is for elevation; if your mole is elevated or uneven, see the doctor.
Skin Cancer is preventable
Wear protective clothing, including a hat that protects your face, neck and ears. Wear sunglasses to protect your eyes from the UV light. Use a broad-spectrum sun block of SPF30 and apply generously before going outdoors for prolonged periods. Reapply sun block if you are swimming, sweating or towel drying. Always use SPF on your face in the morning before driving to work or play. Avoid tanning beds; there is no reason, EVER, to get in one. And be sure to schedule your skin exam.
Remember that melanoma is a highly preventable cancer and can be successfully treated if caught early.
For more facts on skin cancer please visit skincancer.org