Okay summer is over-ish, let’s put away the sunscreen—or not?
So here is a topic that applies to EVERYONE. Your skin is the largest organ in your body. Many questions surround your skin: Can I be in the sun, how much, what sun screen, should I avoid water, wait is that a new mole? Shoot, that one looks kinda funny? How long have you been there, I don’t know, you are on my back—I cannot see you? A dark spot on my toe nail could be cancer?!
Skin cancer is the leading cause of cancer in the United States. Though, fortunately, VERY treatable. There are three types of skin cancer. Here is how I think of them: no big deal; don’t let that go for 20 years; and get this out yesterday. Or as medicine thinks of them: basal cell, squamous cell, melanoma.
Skin cancer risk increases as you age, likely due to the cumulative effect of the UV rays, though one of the biggest risk factors for melanoma is sunburns during childhood. The American Academy of Dermatology recommends at least SPF 30, the FDA recommends a minimum of SPF 15. Actually sometimes less is more—SPF 50 blocks 98% of UVB rays and SPF 100 blocks 99% of UVB rays. As the SPF increases, the protection from UVA rays decreases (more on this another day)
Okay, where was I? Oh yes…skin cancer
Let’s start with basal cell cancer—the no big deal guy. Your doctor takes this off, sometimes has to go back and get wider margins (meaning the cancer was a little bigger under the microscope than we could see on the skin), wham-bam. Done!
Next you have squamous cell cancer--this guy has more of a potential to become something bad. It can get into the lymph nodes and spread. But it is VERY SLOW—like 20 years slow. So if you haven’t been watching the thing grow longer than your 5 year old is alive—likely the same basal cell. Take it off, with clean margins, wham-bam done!
And then there was one—Melanoma. Melanoma accounts for about 1% of skin cancer. Melanoma can, and does grow fast. It can metastasize quickly to other locations, such as the brain (for all my Grey’s Anatomy fans, this would be what Izzy had). These definitely require a pretty sizable skin removal--your doctor may send you to a Mohs surgeon for this, and sometimes require chemo and radiation. And it will FOR SURE lead to very frequent skin checks with a dermatology team.
Now, this is not to scare you, nor is it to make light of a real issue that does need to be taken seriously. But it is to tell you to check your moles. Here are some things that put you at higher risk for skin cancer. The USPSTF gives the designation of I for routine skin checks. This means there is no recommendation for or against, so talk to your doctor about your risk and recommendations for screening.
…until next time, #IrishDoc07