Screening
“Screening” refers to checking for cancer in a person who is free of the symptoms of cancer. Periodic skin examinations by a health care professional and self-examinations are the key to diagnosing skin cancer at its earliest stage. When detected and treated early, most non-melanoma skin (basal cell and squamous cell carcinomas) cancers can be cured.
- Regular skin examinations by a health care professional. The American Cancer Society recommends regular skin examinations every 1 to 2 years from age 20 to 40 and annually after age 40. These examinations can be done as part of your regular health examination. In performing a skin examination, your doctor or nurse visually examines your entire body for changes in your skin that could signal possible problems. Regular medical checkups, including skin examinations, are important for anyone who has already had any form of skin cancer. If you don’t have a doctor, contact your local hospital or health department; they may offer free skin cancer screenings.
- In addition, check your skin on a regular basis and report skin changes to your doctor. It is recommended that you also examine your skin monthly for any new growths or changes to freckles, birthmarks, and moles. These changes can occur gradually or rapidly; any change should be reported to your doctor immediately. To examine your own skin, use a hand-held mirror and a full-length mirror to carefully check your entire body. Basel cell and squamous cell carcinomas may have one or more of these features:
- A sore or lump that develops a scab and does not heal
- A flat red or brownish patch that is scaly and may begin to itch
- A shiny, pale, or waxy lump
The following A-B-C-D self-examination guide, adapted from the American Academy of Dermatology, is a useful way to remember what to look for to determine if a suspicious mole or unusual spot on your skin may be a sign of melanoma and other skin cancers:
A = Asymmetry - It is unmatched from one side to another? Asymmetrical growths may be a cause for concern, especially if they change in shape or grow larger.
B = Border - Does it have irregular or indistinct edges? Normal appearing moles are sharply defined, round, and smooth. Those with ragged edges or a lopsided shape may be suspect.
C = Color - Does it have shades of color or a mottled appearance? Normal moles are often even in color; abnormal moles may have more than one color or varying shades of color.
D = Diameter - Is it larger than a quarter of an inch (6 millimeters)? Any growths larger than this should be checked by your doctor.
Prevention
Most types of skin cancer can be prevented by limiting exposure to the harmful rays of the sun and other manmade sources of ultraviolet (UV) radiation or rays, such as tanning beds and sunlamps. Research suggests that this may also decrease the risk of recurrence.
About Ultraviolet (UV) Rays
Sunlight is comprised of types of invisible UV rays: ultraviolet-A (UVA) and ultraviolet-B (UVB). Recent research indicates that both UVB and UVA rays damage the skin and cause skin cancer. UVC rays are another spectrum of sunlight that also can be potentially hazardous; however, the ozone layer blocks most of these rays from reaching the earth’s surface.
- UVB rays are the main cause of sunburn and non-melanoma skin cancer (basal and squamous cell), as well as a significant cause of melanoma skin cancer. Both UVB and UVA rays are present throughout the year; however, UVB rays are the most intense during the summer. When UV rays reach the surface of the skin, the skin reacts by producing melatonin, or tanning, to protect itself.
- UVA rays penetrate the deep layers of the skin and contribute to premature aging of the skin and skin cancer. UVA rays are also emitted by sun lamps and tanning booths and, despite a common misconception, are not safer than UVB rays. As with UVB rays, UVA rays— both from natural and artificial sources— can cause eye injury, wrinkling and premature aging of the skin, rashes and inflammations, and increase your risk of developing skin cancer.
The American Cancer Society and the American Academy of Dermatology recommend the following sun safety precautions:
- Avoid or limit sun exposure during the sun’s peak hours between 10 a.m. and 4 p.m. One way to reduce exposure to UV radiation is to remain indoors or seek shade during this part of the day. Bear in mind, too, that UV rays can penetrate clouds/overcast skies and glass.
- Prevent sunburn and avoid deliberate tanning, including tanning from artificial tanning devices such as sun lamps and tanning beds. Experts caution that there is no such thing as a healthy tan. Sunburns and suntans can cause skin damage that increases your risk of skin cancer over time. It’s important to use extra caution around water, snow, and sand because they reflect the damaging rays of the sun and can increase your risk of sunburn.
- Wear long-sleeved cotton shirts, long pants, wide-brimmed hats, and wrap-around sunglasses. The tighter the weave of clothing fabric, the better. Protecting the back of the neck and ears is important, too. Sunglasses with at least 99 percent UV absorption are ideal; if they are not labeled as blocking UVA and UVB light, you should not assume they will provide the sun protection needed.
- Use broad-spectrum sunscreens, or sunblocks, and lip balms with a sun protection factor (SPF) of 15 or higher on all skin exposed to the sun, even on cloudy days. (The phrase “broad spectrum” indicates that a sunscreen or sunblock protects against UVA as well as UVB rays.) Apply 15 to 20 minutes before sun exposure and reapply at least every 2 hours; use generously to ensure coverage. If you are exposed to water, either through swimming or sweating, a water-resistant sunscreen should be used. Sunscreen should not be used to prolong sun exposure, though. If you use sunscreen to stay out in the sun longer, you are getting the same amount of UV radiation as you would if you had remained outside for a shorter period of time without sunscreen.
- Be especially cautious if you’re taking an antibiotic or another medication that makes your skin more sensitive to the sun, such as tetracycline and sulfa drugs.
This content has been reviewed and approved by Myo Thant, MD.