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The most common cancer is also one of the most preventable: 'Practice Safe Sun' to protect your skin

May is Skin Cancer Awareness Month, and with the weather warming up and people starting to spend more time outdoors, it seems like a good time for a reminder about the signs of skin cancer and what can be done to prevent it.

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Keeping an eye on your moles is one easy way to protect yourself from skin cancer and catch it early on. Dermatologists recommend using the ABCDE approach to inspecting moles, which means watching for: Asymmetry, border (shouldn't be scalloped or poorly defined), color, diameter (shouldn't be bigger than a pencil eraser), and evolving (shape, size and color shouldn't be changing). (File Photo)

May is Skin Cancer Awareness Month, and with the weather warming up and people starting to spend more time outdoors, it seems like a good time for a reminder about the signs of skin cancer and what can be done to prevent it.

Skin cancer is the most common form of cancer in the U.S. and worldwide, but it’s also one of the most preventable -- it’s “the cancer you can see,” as the Skin Cancer Foundation says. Knowing what to look for leads to earlier detection and saves lives, and by taking a few simple precautions, people can significantly reduce their risk of developing skin cancer in the first place.

Dr. Daniel Kim, a dermatologist at Essentia Health in Fargo and Detroit Lakes, said skin cancers “are not all that uncommon” among the patients he sees; the Skin Cancer Foundation states that at least one in five Americans get skin cancer by the age of 70.

The good news is that, when diagnosed and treated early enough, 99% of all skin cancer cases are curable.

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Dr. Daniel Kim, Dermatologist at Essentia Health

Kim said many of his patients have physical characteristics that put them at a higher risk of developing skin cancer: lighter skin, freckled skin, skin that burns or reddens easily, blue or green eyes, a large number of moles, and blond or red hair. People who are older, have a family or personal history of skin cancer, or who are on immunosuppressant drugs are also higher-risk.

Skin cancers are typically categorized as either melanoma or nonmelanoma. Melanoma is a cancer that develops in the skin’s melanocytes, cells that lie in the deepest part of the epidermis and produce the pigment melanin. Nonmelanoma skin cancer refers to any cancers that form in the basal, squamous or Merkel cells of the skin.

Melanoma is less common than other types of skin cancers, but is the most dangerous due to its ability to spread to other organs rapidly if not treated early, according to the Skin Cancer Foundation.

Treatment options for melanoma are dictated by how deep they go into the skin, said Kim. Superficial melanomas can usually be surgically removed with relative ease, but when they’re thick or have spread to other parts of the body, which can happen when they’re not caught early on, then immunotherapies, radiation, medications and other treatments may be needed.

“There are a lot of things that have dramatically changed how we treat melanomas,” Kim said. “It used to be a death sentence (to be diagnosed with melanoma) up until five or 10 years ago. Now, there are some amazing immunotherapies and medications available.”

Even with these newer treatment options, statistics on cancer.org show melanoma kills more than 7,000 men and women in the U.S. every year. Death from basal and squamous cell skin cancers is less common, and that death rate has been dropping in recent years.

What hasn’t been dropping, and in fact has been steadily on the rise, is the number of skin cancers getting diagnosed. The American Cancer Society attributes the increase to a combination of factors including better skin cancer detection, people getting more sun exposure, and people living longer.

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Kim said doctors today focus a lot of their attention on prevention and early detection of skin cancer, because, “When you catch it early, the prognosis/survival rates are actually very good.”

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Skin damage and cancer risk from the sun is cumulative over a lifetime; having five or more sunburns doubles your risk for melanoma. Protect yourself from sunburn by wearing sunscreen and protective clothing, and seeking shade whenever possible. (File Photo)

How to spot it

Unusual-looking moles are the most widely known ‘red flag’ of skin cancer. Moles that have jagged edges, are multicolored, asymmetrical, larger than a pencil eraser, new, or are changing dramatically, are all worth getting checked out, as these can all be signs of melanoma.

“The majority of melanomas come from new moles that came out of nowhere,” said Kim, adding that while it’s common to develop new moles through your thirties and even into your early 40s, any new mole that springs up beyond that is something to alert your doctor to.

Nonmelanoma skin cancers may present as open sores on the skin that don’t heal like they should, red and raised patches that may crust or itch, a shiny pink or pearly white bump, a wart-like growth, a persistent red patch, painless firm and shiny lumps, or other skin irregularities. Visit cancer.net for a more comprehensive list.

Regular self-examinations are crucial to spotting these sorts of irregularities. Doctors don’t typically conduct full skin exams on their patients, and thus at least 60% of skin cancers are found by patients and their loved ones (that number may actually exceed 75%, depending on the source).

Self-exams should be performed in front of a full-length mirror in a brightly lit room, with a hand mirror at the ready. People should inspect every part of the body, including inside the elbow folds, in-between toes, the soles of the feet, the scalp, and in all the hard-to-see nooks and crannies on the body where the shine doesn’t shine. Since skin cancers can also form in the mouth, oral tissues like the gums and palette should also be looked at.

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Kim said skin cancers are rare in younger kids, but do start to become more common among later adolescents. Parents should be aware of the signs and watch for skin irregularities on their children, as well as themselves.

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(Information and image from the American Academy of Dermatology)

How to prevent it

The biggest -- and most preventable -- risk factor for skin cancer is unprotected exposure to ultraviolet rays (UV) from the sun or indoor tanning beds. The Centers for Disease Control and Prevention says making sun protection an everyday habit “will help you enjoy the outdoors safely, avoid getting a sunburn, and lower your skin cancer risk.”

The American Academy of Dermatology Association urges people to “Practice Safe Sun” in three basic ways: Seek shade (especially when the sun’s rays are the strongest, between 10 a.m. and 2 p.m.); wear sun-protective clothing (wide-brimmed hats, sunglasses with UV protection, lightweight long-sleeved shirts, and even clothing with an ultraviolet protection factor, or UPF, on the label) and; use sunscreen.

The most protective sunscreens are broad-spectrum, water-resistant and are an SPF of 30 or higher, but when it comes to sunscreen recommendations, Kim just tells his patients the best one is “the one that you’re going to use.”

Something is better than nothing, he explained, so whether it’s a spray or lotion, higher or lower SPF, chemical or physical blocker, wearing any sort of sunscreen will offer better protection than wearing none.

Remember that sunscreen should be applied 15 to 20 minutes before outdoor activity, and needs to be reapplied every two hours or after swimming or excessive sweating. As a rule of thumb, Kim said, it takes about two pea-sized amounts of sunscreen to cover the face, and about a shot-glass full to cover the whole body.

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Even on cloudy days, or when you think you’ll be staying in the shade, some degree of sun protection is still important, Kim said. For these situations, “using SPF moisturizers is a good idea… not only to prevent skin cancers, but also as anti-aging (protection).”

SPF stands for sun protection factor; it tells you how long the sun’s rays would take to redden your skin when using the sunscreen compared to the amount of time it would take without it -- so if you use an SPF 15 product, for example, it would take you 15 times longer to burn than if you weren’t wearing any sunscreen.

For more information about sunscreens and other protective measures against harmful UV rays, review cancer.net’s tips for protecting your skin from the sun .

In general, Kim said, his philosophy about sun protection is that ‘more is more.’ When patients ask him why they should take precautions, his response is simply, “Why not?”

To make an appointment with Dr. Kim or any other Essentia Health dermatologist in Detroit Lakes, call 218-844-2347.

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(Information and image from the American Academy of Dermatology)

Skin Cancer Statistics

From skincancer.org

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  • Skin cancer is the most common cancer; over 5 million cases are diagnosed in the U.S. each year.

  • One in five Americans will develop skin cancer by the age of 70.

  • More than two people die of skin cancer in the U.S. every hour.

  • Having five or more sunburns in your lifetime doubles your risk for melanoma.

  • When detected early, the five-year survival rate for melanoma is 99%.

  • Sun exposure is also strongly associated with skin aging: An estimated 90% of skin aging is caused by the sun. People who use sunscreen with an SPF of 15 or higher daily show 24% less skin aging than those who do not use sunscreen.

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