MELISSA A. GRIER

Summer is here, so that means that many people will be heading to sunny spots like the beach, lake, pool or parks. While the season is all about enjoying the outdoors with friends and family, it is crucial to stay protected from the sun and be informed about skin cancer.

Unrepaired damage to DNA in our skin caused by too much exposure to ultraviolet radiation (ie, sunshine and tanning beds) can lead to genetic mutation and rapid growth of abnormal cells, ultimately resulting in malignancy.

Abnormal skin lesions are classified as “precancerous” and “cancerous.” The precancerous variety includes actinic keratosis and dysplastic nevi (atypical moles). The presence of either of these places a person at higher risk for developing skin cancer.

Basal cell carcinoma, the most commonly occurring form of skin cancer, originates in the deepest layer of the epidermis. These cancerous lesions are the result of cumulative or occasional intense sun exposure. Squamous cell carcinoma is the second most common skin cancer and results from cumulative sun exposure over the course of a lifetime. Melanoma is the most dangerous type of skin cancer. It originates in melanocytes, the pigment-producing cells within the basal layer of the epidermis. When detected early, melanoma is typically curable. However, when undetected, it can metastasize to other parts of the body and becomes more difficult to treat and cure. Merkel cell carcinoma is a very rare and aggressive form of skin cancer that typically affects fair-skinned individuals over the age of 50.

Sun protection and skin cancer prevention techniques may seem, but some people may still seem unsure of the proper protocol. The basics should include seeking shade between 10 am and 4 pm.

Daily use of a broad-spectrum (Ultra Violet A&B) sunscreen with an SPF of at least 15 should be recommended for the areas of skin that are most frequently exposed to the sun (face, ears, neck, etc). During extended, intense exposure, an SPF of 30 or higher is recommended 30 minutes prior to sun exposure. Reapplication should occur every two hours or immediately after swimming or excessive sweating. Sunscreen should be used on infants over 6 months old; newborns should be protected from sun exposure. Protective clothing, such as lightweight long-sleeved shirts, wide-brimmed hats, and sunglasses with UVA/UVB protection should also be encouraged. Finally, a monthly skin self-exam and a yearly visit to a physician or dermatologist for a thorough skin assessment are recommended.

Photosensitivity or sunburn occurring after minimal sun exposure, is a known side effect associated with certain types of certain anticancer therapies. High-soder methotrxate, dacarbazine, 5-Flourouracil, trans retinoic acid, and vinblastine are chemotherapy agents known to cause photosensitivity. Cetuximab, panitumumab, vandetanib and vemurafenibare biotherapy agents and targeted therapies associated with photosensitivity. Patients receiving active treatment with any of these agents should receive education about sun protection prior to starting treatment, with follow-up education provided periodically throughout the treatment regimen.

Articles

While the summer months are the perfect time for outdoor activities with friends and family, it is crucial to protect yourself from skin cancer. 

MELISSA A. GRIER

Summer and Skin Cancer: Staying Safe in the Sun

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