How to protect yourself, and your children from skin cancer

Skin cancer is one of the most common types of cancer in Canada. UV radiation from the sun is the main cause of skin cancer, though artificial UV sources like sunlamps and tanning booths are also cancer-causing.

Although anyone can get skin cancer, the risk is greatest for people who have:
· fair or freckled skin
· had sunburn during childhood
· lots of moles, particularly a mole called dysplastic nevus
· family history of melanoma
· used tanning beds
· severe skin damage, including burns
· a history of immune disorders, skin keratoses, or previous skin disorder treatment
· had exposure to certain substances, including arsenic and petroleum

There are 3 types of skin cancer: basal cell carcinoma, squamous cell carcinoma (together referred to as nonmelanoma skin cancer), and melanoma. The outer layer of the skin is made up of squamous cells. Basal cells are found below the squamous cells. Melanocytes are in the deepest layer of epidermis. Melanoma develops from melanocytes. The most common are basal cell carcinomas, slow-growing cancers that seldom spread to other parts of the body. Squamous cell carcinomas also rarely spread, but they do so more often than basal cell carcinomas. The most dangerous of all cancers that occur in the skin is melanoma. Melanoma can spread to other organs, and when it does, it often is fatal.

Both basal and squamous cell cancers are found mainly on areas of the skin exposed to the sun — the head, face, neck, hands, and arms. However, skin cancer can occur anywhere.
Though changes in the skin are not sure signs of cancer, it is important to see a doctor if any symptom lasts longer than 2 weeks. Don’t wait for the area to hurt — skin cancers seldom cause pain. 95% of skin cancers can be cured if they are discovered and brought to a doctor’s attention before they have a chance to spread. Check your skin regularly.

Signs of malignant melanoma
See your doctor immediately if…
· An existing mole or dark patch is getting larger or a new one is growing.
· A mole has a ragged outline (ordinary moles are smooth and regular).
· A mole has a mixture of different shades of brown and black (ordinary moles may be dark brown but are all one shade).

The following signs do not necessarily mean that you have a melanoma, but you should still look out for them. If your mole or dark patch does not return to normal within two weeks, don’t ignore it – see your doctor.
· An inflamed mole, or one with a reddish edge.
· A mole that starts to bleed, ooze or crust.
· A change in sensation of a mole, like a mild itch.
· A mole that is bigger than all your other moles.

Signs of non-melanoma skin cancer:
· A new growth or sore that does not heal within four weeks.
· A spot or sore that continues to itch, hurt, crust, scab or bleed.
· Persistent skin ulcers that are not explained by other causes.

How do I avoid skin cancer?
Even sunscreen does not offer total protection from the sun’s rays, and using it is only one way to reduce your risk of skin cancer. UV rays are the strongest at noon, so seek out the shade between 10AM and 3PM whenever possible.

How do I use sunscreen properly?
· Try to apply it 15-30 minutes before going out in the sun.
· Apply to clean, dry skin and rub in lightly.
· Use generous amounts (golf ball-size quantities for small children).
· Re-apply every two hours or more frequently if washed, rubbed or sweated off.
· Put on before make-up, moisturiser, insect repellent.

Check your skin regularly. The most common warning sign of skin cancer is a change on the skin, especially a new growth or a sore that doesn’t heal. Skin cancers don’t all look the same. For example, skin cancer can start as a small, smooth, shiny, pale, or waxy lump. Or it can appear as a firm red lump. Sometimes, the lump bleeds or develops a crust. Skin cancer also can start as a flat, red spot that is rough, dry, or scaly. Check all moles regularly, looking for unevenness in colour

In treating skin cancer, the doctor’s main goal is to remove or destroy cancer completely, leaving as small a scar as possible. To plan the best treatment for each person, the doctor considers the type of skin cancer, its location and size, and the person’s general health and medical history. Treatment for skin cancer usually involves some type of surgery. In some cases, radiation therapy or chemotherapy (anticancer drugs) or a combination of these treatments may be necessary.

National Institute on Aging http://www.nia.nih.gov/health/agepages/skin.htm
Nursing Standard Magazine, http://www.nursing-standard.co.uk/archives/residentpdfs/patientcards/6skincare.pdf