It was three months before her wedding when Julie Dugdale, a Denver-based writer, noticed an irritation near her nose that wouldn’t seem to go away. She thought it might be a pimple and ignored it. When a little voice inside nagged her to see a dermatologist, she brushed it off. “I didn’t want to hear news I didn’t want to hear before the wedding,” she says. “I figured I’d deal with it later.”
Dugdale saw a dermatologist soon after her nuptials, and a biopsy showed that the little, inconspicuous-looking spot was skin cancer. “Even though it was a basal cell carcinoma, which is ‘the good kind’ to get, it was terrifying,” Dugdale says. “Nobody wants to hear the ‘C word’ in a medical diagnosis.”
Luckily, Dugdale had outpatient surgery to remove the skin cancer and is left with just a small scar. She’s proof that while skin cancer is scary, it is often treatable if caught early, and most skin cancers are preventable.
Here’s what you need to know to learn about your risk, plus the best ways to arm yourself with information and sun protection strategies that’ll help keep you safe.
Geographic Risk Factors for Coloradans
Here in Colorado, we love spending time outside — and the longer you’re in the sun, the more damage it can do, says Dr. Chandler Rundle, a research fellow at the University of Colorado School of Medicine.
“Just minutes of sun exposure can do a significant amount of damage to skin,” Rundle says.
Living at elevation presents another risk factor, adds Rundle. “The higher your elevation, the more ultraviolet (UV) light you’re exposed to,” he says. “And while both UVA and UVB cause damage to the skin, UVB is more important in the development of skin cancer, as that wave length does more damage to DNA.”
Another consideration is snow, which reflects UV light. So, while you might not think to slather on the SPF when you’re bundled up in cold weather, it’s crucial. The same is true for cloudy or overcast days, says Rundle.
Three Main Types of Skin Cancer
It’s helpful to have a basic knowledge of the different types of skin cancer, so you can stay on top of signs that a mole or skin growth might be something to talk to your doctor about. The Skin Cancer Foundation (www.skincancer.org) provides guidance on what you need to know about the different kinds of cancers, how to spot them, and what your dermatologist will do if you’re diagnosed:
(A) Basal Cell Carcinoma (BCC)
BCC are the most frequently occurring form of all cancers, with more than 4 million cases diagnosed each year. BCC occur when lesions or uncontrolled growths arise in the skin’s basal cells, which line the deepest layer of the outermost layer of skin.
What to look for: They often look like open sores, pink growths, red patches, shiny bumps, or even scars. While BCC almost never spreads beyond the original site, it should be treated immediately.
Treatment: For small lesions, your dermatologist might use a technique called curettage and electrodesiccation, where the growth is scraped off with a curette (sharp instrument) and desiccated (burned) with a needle. Another common treatment option is Mohs surgery, where a qualified dermatologist examines the skin cells during the surgery to get rid of all of the cancer while sparing as much healthy skin as possible.
(B) Squamous Cell Carcinoma (SCC)
This is the second most common type of skin cancer that results when sun damage leads to an uncontrolled growth of abnormal cells in the skin’s outermost layer.
What to look for: These typically appear as persistent, thick, rough, scaly patches that may bleed when irritated. They’re sometimes mistaken for warts; other times, they look like open sores with a raised border and crusted surface. The skin around SCCs typically shows signs of sun damage (think wrinkles, pigment changes, and loss of elasticity).
Treatment: In most cases, SCCs are treated the same way BCCs are, with either Mohs Surgery or curettage and electrodesiccation. If your SCC is just on the surface of your skin, your dermatologist might do a procedure called cryosurgery, where your lesion is frozen with liquid nitrogen.
This is the most dangerous type of skin cancer, and one that should be on Coloradans’ radars, considering we’re diagnosed at a slightly higher rate than the rest of the country. Melanoma develops when damage to skin cells caused by sun exposure or tanning beds triggers mutations that lead skin cells to multiply rapidly and form malignant tumors. These tumors originate in the skin’s melanocytes, which produce the skin’s pigment.
What to look for: Melanomas often look like moles, but they can also be skin-colored, pink, red, purple, blue or white. They tend to have an asymmetrical shape, uneven border, dark or uneven color, and are greater than 4 mm in diameter (the size of a pencil eraser).
Treatment: First, your doctor will do a biopsy, where the mole is removed and sent to a lab for analysis. If it’s melanoma, your doc will remove the primary melanoma tumor and will test its borders to be sure all of the cancer is gone. Your dermatologist may also test the nearest lymph nodes, to be sure the cancer hasn’t spread.
Did You Know? More than 13 million cases of skin cancer will be diagnosed this year. More people will be diagnosed with skin cancer this year than all other cancers combined. Source: www.skincancer.org.
Are You Doing Monthly Skin Exams?
If you’re skimping on self-skin checks, here’s a statistic that might inspire you to make it a priority: Up to 57 percent of melanomas are detected by patients themselves, according to one recent study. And all it takes is just five minutes to do a thorough job, says Rundle.
When you look at your moles, think of the ABCDEs:
- Asymmetry (perfect circles are OK; lopsided shapes are not)
- Borders (even is good, uneven is bad)
- Color (you want it to be uniform, not varied)
- Diameter (bigger than 4 mm isn’t great)
- Evolution (look for moles that have grown or are inflamed, itch, or bleed)
If you find a spot that looks suspicious, see your doctor or dermatologist immediately. This is especially true if you have more than 50 moles, large or unusual moles, a history or family history of skin cancer, fair skin, or have had excessive sun exposure or a history of tanning bed use —all of which put you at a greater risk of melanoma.
“There is a lot of anxiety associated with skin cancer, but it’s important to make the appointment,” says Rundle. “Skin cancer is highly treatable, but the sooner you catch it, the better the outcome.”
4 Best Skin-Cancer Prevention Steps You Can Take
Staying out of the sun this summer is, well, not going to happen. That’s OK, say dermatologists — as long as you follow this advice:
1. Don’t use tanning beds. Using an indoor tanning bed before age 35 can increase your risk of melanoma by 59 percent, and the risk increases with each use.
2. Seek shade. Choose the shade over sun when you can. Rundle says it’s a small step you can take to prevent excessive sun exposure.
3. Wear protective clothing. Hats, lightweight long sleeve shirts, and clothing with UV protection built in can help keep you protected from the strong, Colorado sun.
4. Use sunscreen. Look for SPF of 30 or higher, which blocks 97 percent of UV rays. You’ll also want to choose one that says “broad spectrum” on the label, which means it will protect against both UVA and UVB rays. Finally, opt for a water-resistant formula if you’re active, and remember to reapply after lots of sweating.
The Real Truth About Sunscreen
Here are the biggest myths — and the facts you need to know about the correct use of sunscreen and what it really takes to stay protected from the UV rays that cause skin cancer.
Myth No. 1: It’s fine to forgo sunscreen at first, because getting a “base tan” will prevent burns all summer.
Truth: A tan is essentially one big scab all over your body. The melanin in your skin only turns brown as a protective response, says Rundle. Once that protective melanin has appeared, it means damage has been done — and you’ll continue to do damage if you don’t protect your skin by using sunscreen.
Myth No. 2: Sunscreen isn’t necessary if your skin doesn’t burn.
Truth: Just because you don’t burn doesn’t mean you’re immune to skin cancer or that the sun won’t damage your skin. The Skin Cancer Foundation reports more than 90 percent of the visible changes attributed to skin aging (think wrinkles, sun spots, and dry patches) are caused by the sun. Studies show daily sunscreen use can reduce skin aging in all of us — despite the color of our skin.
Myth No. 3: Sunscreen isn’t necessary on cloudy days.
Truth: Even if the sun isn’t shining, its harmful UV rays still reach you. That’s why Rundle says wearing sunscreen all year is crucial — not just during the sunny, summer months.
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