Mid-Summer Skin Cancer Alert

It's the middle of summer, and perhaps you haven't been careful about avoiding the sun so far this season.

We all have to walk outside in the sunshine, some of us play sports outside, and others just lie in the sun at the beach.

And all those rays can take their toll on your skin, perhaps even inviting skin cancer.

So, this is a good time to check out your skin for any signs of damage, or worse, cancer.

On The Early Show Saturday, Dr. Andrew Alexis, head of the Skin of Color Department at St. Luke's/Roosevelt Hospital in Manhattan, talked about the different kinds of damage the sun can do, what we should look for on their skin, and how to protect ourselves from the potentially deadly dangers of the sun.

He also pointed out that people with dark complexions are far from immune to getting skin cancer from exposure to the sun.

According to Dr. Alexis:

Skin cancer is the most common form of cancer in the United States. More than one million skin cancers are diagnosed each year. One-in-five Americans will develop skin cancer over the course of a lifetime.

There are three basic types of skin cancer: melanoma, the most dangerous and deadly; basal cell carcinoma, the most common; and squamous cell carcinoma, the second most common form.

About 90-percent of non-melanoma cancers are associated with exposure to ultraviolet (UV) radiation from the sun. Up to 90-percent of the visible changes commonly attributed to aging are caused by the sun.

The incidence of Melanoma is increasing faster than that of almost any other cancer.

More than 20 Americans die each day from skin cancer, primarily Melanoma. One blistering sunburn in childhood or adolescence more than doubles a person's changes of developing melanoma later in life.

But there are things we can do to help prevent skin cancer, among them using high-strength sunscreens, and retinol containing face and body creams.

Ultimately, doctors agree that, while you must be free to enjoy the outdoor activities you love while the weather is good, you must limit your time in the sun, and protect yourself while you're out there.

IS THERE ANY WAY OF TELLING JUST WHAT TYPE OF PERSON WILL DEVELOP SKIN CANCER?

There's no one-size-fits-all; it depends on your skin type and your response to UV radiation.

IS THERE ANY SUCH THING AS A SAFE TAN?

The bottom line is, no one should have intense sun exposure. Sunbathing, lying out -- all of that is definitely not advised. Being active and participating in outdoor sports are important, but you should do it while taking sun protection precautions. In general, everyone should practice safe-sun habits and use protection of some kind. The degree of protection will vary with skin type and type of activity, and how long you plan to be out. An SPF of 30 or greater or broad spectrum sunscreen protects against UVA and UVB, so that's very important. Keep in mind that 50-plus is the highest manufacturers can put on labels.

WHAT ARE THE TYPES OF SKIN CANCER?

Melanoma is most serious. Basal cell carcinoma is the most common, and has the best prognosis, since it's easily treated when it's limited to the skin and soft tissue, and doesn't spread to other organs. But it can advance and invade surrounding tissue if it's not diagnosed early. It's only the second-most common type among African Americans. Squamous cell carcinoma is the most prevalent form in Caucasians, and the second most common overall.

CAN PEOPLE OF COLOR, SUCH AS AFRICAN AMERICANS, BE HURT BY THE SUN?

All skin cancers are more common among Caucasians, but they occur in all skin types, and the order of frequency varies among different populations, largely due to genetic and other risk factors, including environmental factors. It's a complete myth that African Americans can't be hurt by sun, an important misconception to clarify. African Americans are at less risk, but they are still at risk for skin cancer. For some cancers, they present differently, so they look different, and they tend to be present on locations on the body that are less commonly looked at. When melanoma occurs in dark-skinned people, it will often appear on the bottom of the foot, in the mouth, on the genitals, and on fingers. African Americans, Asians and, some studies now show, Latinos, are seeing the signs of skin cancers in those places. People don't think to check there.

NOW THAT WE'RE HALFWAY THROUGH SUMMER, WHAT SHOULD WE DO TO MAKE SURE WE'RE OK?

Examine your own moles, become familiar with your own skin, identify any changes in moles, such as changes in color, size or shape, and see if a mole suddenly itches, forms a scab, or bleeds. The patient is the best first defense, if they know their own skin. Everything that changes isn't bad, but if you do see a change, bring it to the attention of a dermatologist. A mole that has more than one color, that's not symmetric, has two sides that don't look similar, or is larger than the head of an eraser, should be checked. Not all are bad, but only a trained eye or biopsy can determine if what you're seeing is bad.

CANCER ISN'T ALL THAT RESULTS FROM TOO MUCH TIME IN THE SUN, RIGHT?

The other big issue is aging of the skin, called photo-aging. These are the features of aging that are exacerbated by chronic sun exposure, such as wrinkling, thinning of the skin, and spots. The more you protect your skin from the sun, the younger your skin will look.

WHAT CAN WE DO TO PROTECT OURSELVES IF WE'RE IN THE SUN?

First, you should continue to participate in sports and recreational activity, but protect yourself with broad-spectrum sunscreens: Nutrogena, L'Oreal Anthelios SX, Coppertone are all examples of those. Broad-spectrum means it protects against UVA and UVB rays. For after-sun treatment, Retinoid creams and gels can reverse damage. Over-the-counter, there are a number of products that contain Retinol. Retinoid are Vitamin A derivatives and you can also get them by prescription for deeper penetration and more biological effects. Once a patient is in the office, I'm more likely to prescribe a retinoid, because it usually means he or she has tried the OTC products and need something stronger, if they have more damage.

WHAT ARE SOME BASIC TIPS?

1. Examine your skin, and get to know it.
2. Protect your skin, put on sunscreen before you leave your home every day and, if you have to be out, don't do your errands around the peak sun hours.
3. To reverse damage, use products that contain retinoids, or use procedures, done by dermatologists, such as laser, microderm abrasion, and chemical peels for sunspots.
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