By Claire Brinsden Jordan
THE SKIN-NY ON SKIN CANCER
May is Skin Cancer Awareness Month and while we live in paradise here in South Pinellas with lots of outdoor time, we are only about 2,000 miles from the equator where the sun’s rays are the strongest. Skin damage from harmful rays can occur in as little as 15 minutes of exposure. And on the beaches, we are subjected to the reflective rays off sand and water. It’s no surprise, then, that Florida has the second highest incidence of melanoma skin cancer in the United States according to the National Institutes of Health. In fact, one in 10 Floridians have been told they have skin cancer.
There are three main types of skin cancer, with melanoma being the most dangerous as it can spread to other parts of the body. Basal Cell Carcinoma (BCC) is the most common type that grows slowly and is less likely to spread. It usually appears as a flesh-colored, pearl-like bump or a pinkish patch of skin. Squamous Cell Carcinoma (SCC) is the second most common type and can spread if not detected early and treated. It typically looks like a firm, red nodule, or a flat lesion with a scaly or crusty surface. Melanoma is the least common type of skin cancer, but it is the most aggressive and will likely metastasize to other organs if not detected and treated quickly. It arises from melanocytes, the pigment-producing cells in the skin and often appears as a new mole or an existing mole that changes in size, shape, or color.
Staging refers to the degree to which the skin cancer has spread, based on the physical exam. According to the American Cancer Society, the earliest stage of skin cancer is stage 0 (also called carcinoma in situ, or CIS). The other stages range from I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more.
Anyone can get skin cancer, but you are at higher risk if you have fair skin, red, or blonde hair, blue or green eyes, and freckles. According to the American Academy of Dermatology, skin cancer rates are higher in women than men before age 50, but are higher in men after age 50, which may be related to differences in recreation and work-related UV exposure. Most melanoma cases are attributable to UV exposure. You should perform regular skin self-examinations as well as get an annual skin check by a dermatologist for early detection and prevention of skin cancer.
A NEW TREATMENT FOR MELANOMA
Recently, in February 2024, the FDA approved the first cellular therapy treatment for patients with melanoma that is either unable to be removed surgically or has already metastasized to other parts of the body. Amtagvi (lifileucel) is a T-cell immunotherapy derived from the patient’s own T-cells, which help the immune system fight cancer. Part of the patient’s tumor tissue is removed, and the T-cells are extracted, manufactured, then returned to the patient via a single infusion. Initial trials showed a positive response rate of 31.5%. The therapy does have some side effects but is a new weapon against aggressive melanomas that have not responded to PD-1 inhibitors or drugs targeting the BRAF gene.
SUN SAFETY & SUNSCREEN
You should apply sunscreen 30 minutes prior to exposure and reapply every 2 hours. If you are in the water, you should reapply more frequently, even if the sunscreen claims to be water-resistant or waterproof. While it’s important to protect your skin from the sun, make sure you choose a safe sunscreen, or you could do more harm than good.
Choose a sunscreen with an SPF of at least 30 with broad spectrum protection against both UVB and UVA rays. SPFs above 50 only refer to UVB protection, not UVA protection. UVA rays penetrate more deeply into the skin and are associated with a higher risk of developing melanoma.
Choose a mineral sunscreen with zinc oxide or titanium dioxide instead of a chemical sunscreen. OXYBENZONE is a chemical that enters the bloodstream and acts like estrogen. It can remain in your blood for several weeks and has been linked to endometriosis and low birth weights in females, and lower levels of testosterone and sperm in males. Chemical sunscreens are also toxic to coral and marine organisms.
Avoid SPRAY sunscreens which are difficult to apply effectively and evenly, but also contain harmful chemicals that can be inhaled.
Don’t rely solely on sunscreen. Use other methods of sun protection like umbrellas, hats, sunglasses, and clothing to minimize the use of sunscreen. Try to stay out of the sun as much as possible between 10am and 4pm, and always avoid indoor tanning beds. People on certain medications may be more sensitive to the sun. Making the effort to protect your skin, even on cloudy days when UV rays are still present, not only protects you from skin cancer, but also minimizes brown spots, fine lines, and wrinkles. Remember that your skin is the largest organ in your body, so treat it well!
