Skin cancer is the leading form of cancer in the United States. Basal cell carcinoma, squamous cell carcinoma and melanoma are the three most common types of skin cancer. In the Roaring Fork Valley, like most of the rest of the country, basal cell carcinoma is the most common form of skin cancer and accounts for about 80 percent of cases.
Basal cell carcinoma tends to occur in areas that receive the most sunlight — such as your head, neck and back of hands. The sun exposure we have as children is thought to be a major factor in causing this type of skin cancer. For this reason I strongly recommend to my patients who are parents to remember to protect their children’s skin, either with sunscreen or sun protective clothing.
Squamous cell carcinoma, which accounts for about 20 percent of skin cancers nationwide, is caused by cumulative damage by the suns harmful rays. Due to the abundance of wonderful outdoor activities we have in our valley, like skiing, hiking, rafting and biking, this cumulative damage adds up quickly causing sun damage and skin cancers.
Melanoma is the most dangerous type of skin cancer as it has the highest risk of spreading. Although it accounts for only about 5 percent of skin cancer cases, it’s the cause of more than 75 percent of the 12,000 annual skin cancer deaths in the U.S. Back in 2007, about 1 in 90 Americans would get invasive melanoma; now the number is 1 in 53.
So what can you do to prevent skin cancer? I tell patients they need to wear a broad spectrum sun screen daily whether they are planning on being inside or outside that day (UVA penetrates through the glass in your home and car causing skin cancers to grow). An SPF of at least 30-50 needs to be applied to the face and the back of your hands. You need to use a large amount of sunscreen to cover the body, such as during beach vacations where you would wear a swimsuit — one or two ounces or the equivalent of a shot glass. If you think about the average size of a bottle of sun screen at eight ounces, you would need a new bottle of sun screen after four to eight applications, so it wouldn’t last long as you need to reapply every two hours.
What about types of sunscreen? For daily use I recommend a moisturizer — since it’s dry here — containing a broad-spectrum sunscreen: UVA/UVB. I tell patients to use a brand they like to ensure they will use it. It doesn’t work if it is sitting in your cabinet and not on your skin. There are both physical sunscreens, such as zinc oxide and titanium dioxide, which physically block the sun from reaching your skin; and chemical sunscreens, which change the sun’s rays once they reach your skin making them less harmful, which include most of the rest of the sunscreens.
Bottom line is we want to prevent skin cancer and prevent signs of premature aging, and wearing sunscreen or sun protective clothing daily is proven to help. Everyone should be doing monthly self-skin exams, and should they find something that they are concerned about, something that has grown or changed or that is new, they should be evaluated. I would rather have someone come in and find out that what they have is a normal skin finding rather than having them wait and let a cancer grow because they are unsure if they should come in.
Dr. Kelly Thomas works at Glenwood Medical Associates, 970-945-8503.