Q: My dad was diagnosed with skin cancer and has had biopsies and treatments for his skin. I have a lot of moles and seem to get more each summer. Should I be concerned?
It’s great question, a growing problem and a topic that more people should care about.
More people have skin cancer than all other cancers combined. About one in five Americans will develop skin cancer in the course of a lifetime. Nearly 50 percent of Americans who live to age 65 will have skin cancer at least once, yet it’s a disease that is largely preventable.
There are different types of skin cancer including squamous cell carcinoma, basal cell carcinoma and, the most deadly skin cancer, melanoma. Fortunately, there are ways to prevent these cancers entirely and catch them early.
People with many moles, fair skin, light-colored hair or eyes are at higher risk for skin cancer. If you’ve had severe sunburns in the past, you’re also at higher risk. And, family history — if your dad had skin cancer at a young age — can be an indicator of cancer risk. Anyone can get skin cancer, regardless of skin color.
Because it’s so critically important, let’s start with prevention. To start, avoid tanning beds — period. There’s no such thing as a “base tan” or a “healthy tan.” Tanning beds drastically increase your risk of skin cancer, just as a bad sunburn increases your risk of skin cancer in the future.
After a long Minnesota winter, we all want to be out in the sunshine. But protect your skin. Anyone older than six months of age should wear a water-resistant 30 or higher SPF sunscreen, as well as lip balm with sun protection. When lathering your skin in sunscreen, a general rule of thumb is to use at least one ounce. In other words, a full shot glass! Reapply sunscreen every few hours.
In addition, wear tightly woven clothing that covers your skin, and wear a wide-brimmed hat to protect your face, ears, neck and scalp. (The new UV-proof clothing is fine but certainly not necessary.) UV rays from the sun are strongest between 10 a.m. and 4 p.m. Even when it’s cloudy, skin can be exposed to 80 percent of the sun’s harmful rays.
And here is the good news. If you heed this advice, by midlife, you will likely look much younger than your sun-worshipping peers.
Be a detective
The other key to cancer prevention is routine skin checks of moles and suspicious markings.
Most moles are not harmful, but some can change into cancer. There are many types, sizes and shapes, although most moles are brown, dome-shaped, and smooth with clear edges. It’s important to monitor these markings because some moles can turn into melanoma. The disease is usually curable if caught early, but late-stage melanoma is life threatening.
At our clinic, we tell patients to follow the “ABCDEs” of skin checks. Check each mole for these concerning patterns:
— Asymmetry: When one half looks different than the other half
— Border irregularity: When the borders are not clearly defined and are irregular
— Color Variation: When color varies from one area to another with variation in shades of brown, black or blue
— Diameter size: When it is bigger than a pencil eraser
— Evolving: When the mole changes in size, shape or color
If you have a questionable mole, take a picture of it. Then compare the images month-to-month. If there are changes, new skin growths, bleeding, itching, or pain, it’s best to consult a specialist. A biopsy can be performed on suspicious areas to test for skin cancer. If you have general concerns about moles and skin cancer, consult your primary care provider.
Michelle Napral is a nurse practitioner at the University of Minnesota Health Nurse Practitioners Clinic, 3rd Street & Chicago. Send questions to firstname.lastname@example.org.