As a melanoma oncologist with Emory Healthcare, Ragini Kudchadkar has mixed feelings about summer. She knows that after a long, rough winter, and a rainy spring, it feels good to put away the jackets and get out the swim gear. However, the arrival of summer also means that many people will be out in the sun doing irreversible damage to their skin.
Kudchadkar advocates sun safety for people of all ages. Not only can sun safety decrease your risk of skin cancer, she says, but it also can help protect you from the visible signs of aging. "Who doesn’t want less cancer and to look younger at the same time?" she asks.
How common is skin cancer? What is melanoma? How do you reduce your risk? Kudchadkar, an assistant professor in the Department of Hematology and Medical Oncology at the Winship Cancer Institute, offers the following summary:
Skin Cancer
Skin cancer affects over three million people each year, making it by far, the most common cancer. The three most common skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal and squamous cell cancers are the most prevalent and originate from keratinocytes. These cancers are often referred to as "non-melanoma skin cancers." They affect a little over two million Americans each year, with 80 percent of these being basal cell cancers. Most non-melanoma skin cancers are caused by repeated exposure of the skin to ultraviolet rays (primarily UVA and UVB) from sunlight or from artificial sources such as tanning beds. These rays damage the DNA in skin cells and cause them to grow and divide unregulated, thus producing a cancer. These types of skin cancers tend to stay in the skin, and therefore very few patients will die from basal or squamous cell cancers. It is estimated that approximately 2,000 people die each year from non-melanoma skin cancers.
Melanoma
In contrast, melanoma is a cancer that originates from melanocytes that normally make pigment to protect the other layers of the skin from sun damage. Melanocytes can also make non-cancerous growths like moles. The American Cancer Society estimates approximately 76,100 new melanomas will be diagnosed in 2014 with 9,710 deaths from this disease, making it the most deadly form of skin cancer. Lifetime risk of melanoma in the U.S. is about 1 in 50, and notably it is one of the most common cancers in those younger than 30. When diagnosed early, surgery alone has excellent survival rates. In the past there were few long-term survivors from advanced cases of melanoma. Fortunately, many novel therapeutic agents are being developed that have transformed the treatment of more advanced stages of melanoma with five new agents approved by the FDA since 2011. All of these new drugs are changing the landscape of melanoma treatment and patients are now not only living longer, but also with better quality of life.
Sun Safety
Though melanoma development is more multi-factorial than basal or squamous cell cancer development, it is still linked to UV exposure through sunlight or tanning beds. The best way to decrease one’s risk of skin cancer development is to avoid long exposures to intense sunlight and practice sun safety measures. For outside, Kudchadkar recommends the use of broad spectrum sunscreen (SPF 30 or higher), use of sun protective clothing such as sun shirts and board brim hats, and avoid direct exposure between 10 am and 2 pm when the intensity of the rays is the strongest. Sunscreen should be applied about 20-30 minutes prior to going outside and reapplied approximately every two hours. Because this is difficult to do, the doctor recommends barriers like sun shirts or umbrellas over sunscreen if possible.
"Keep in mind the sun damage that occurs now will be with you for the rest of your life," Kudchadkar says, "so please don’t forget your sun protective gear on your way out to enjoy the beautiful weather."