The Enid News and Eagle, Enid, OK

April 19, 2013

Avoid skin cancer by covering it up

By Judy Rupp, columnist
Enid News and Eagle

— Is the sun your friend or your enemy? The answer is: both. If that’s confusing, so is the news that’s coming from health experts.     

Recent studies have found that many Americans are deficient in vitamin D, which is crucial to bone health and has many other health benefits. As a major source of vitamin D, sunlight is definitely your friend.    

But skin cancer is the most common malignancy in this country, with more than two million Americans being diagnosed each year. As the No. 1 environmental risk factor for skin cancer, sunlight is pretty clearly your enemy.

Rules for skin cancer prevention circulated by the Centers for Disease Control sound a bit uncompromising:     

“The sun’s UV rays can damage your skin in as little as 15 minutes.” “UV rays from the sun can reach you on cloudy and hazy days, as well as bright and sunny days.” “Your best bet to protect your skin is to use sunscreen or wear protective clothing when you’re outside — even when you’re in the shade.”    

Making the argument for sunlight as a source of vitamin D are many reputable medical experts. An article in the Harvard Health Letter [June, 2004], talked of “solar-phobes: people so concerned about getting skin cancer that they stay inside or cover every bit of skin.” Getting outside into the sun has physical and psychological benefits for all ages, they argue.    

Considering these opposing views, you can decide for yourself by learning some basic information about skin cancer and your potential risks.    

There are three common types of skin cancer, named according to the cells that become cancerous.    

BASAL CELL CARCINOMA is the most common and also the least serious, highly treatable and rarely spreading to distant organs.

Most basal cell cancers occur on the face, neck or hands — areas most commonly exposed to the cumulative effects of sun exposure.    

SQUAMOUS CELL CARCINOMA, the next most common type, also occurs usually on skin that has been exposed to sun, including the ears, lips and mouth as well as other areas of the body. In persons with dark skin, however, it may appear on places not exposed to the sun such as the legs and feet. It is more dangerous than basal cell carcinoma but less so than melanoma.    

MELANOMA, the least common type of skin cancer, does spread and, if not treated in a timely manner, can be fatal.    

In males, melanoma is commonly found on the head, neck or between the shoulders and hips. In women, the most common sites are skin on the legs or between the shoulders and hips. In dark-skinned individuals, melanoma sometimes occurs under a finger or toenail, on the palms of the hands or the soles of the feet.    

Symptoms include a mole or freckle that changes in size, shape or appearance or a new spot that has an irregular outline and usually more than one color.    

For all skin cancers, the number one risk factor is exposure to the ultraviolet rays of the sun. For basal cell carcinoma, cumulative exposure over a lifetime seems to be a major factor. For squamous cell, both cumulative and recent exposure has been linked to actinic keratoses — rough, scaly growths on sun-exposed skin that can be pre-cancerous.    

For melanoma and even for some squamous cell carcinomas, cumulative exposure is less important than the amount of sun and the timing. A bad sunburn before your 20th birthday may be more dangerous than low levels of sun exposure over a lifetime.

Fair-skinned individuals from northern Europe living in sunny climes are clearly at high risk. And in Australia, doctors have made significant strides toward preventing skin cancers by promoting a policy of “slip, slap and slop.” Any time you go out in the sun, you should slip on some protective clothing, slap on a wide-brimmed hat and slop on generous quantities of sunscreen with an SPF of 15 or higher. The sunscreen should be broad spectrum, protecting against both UVA and UVB.    

Clothing with a tight weave, covering both arms and legs, is recommended; a T-shirt has an SPF of less than 15; so slop on some sunscreen if that is all you’re wearing on the top. A baseball cap leaves the neck and ears exposed. Either apply sunscreen to exposed areas or wear a wide-brimmed hat. The principles are fairly straightforward, and, if you’re concerned about getting enough vitamin D, you can take a supplement.     

The choice is yours. You don’t have to be either a sun worshiper or a solar-phobe to take reasonable efforts to protect your skin from your friend and enemy, the sun.

Rupp is a certified information and referral specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.