Skin cancer: Know the warning signs

This content is sponsored by MedStar Washington Hospital Center

Skin cancer is the most common cancer in the United States and worldwide, according to The Skin Cancer Foundation. More than 9,500 people in the U.S. are diagnosed with skin cancer every day and more than two people die of the disease every hour, the foundation found. While skin cancer is very common, there are steps you can take to prevent it.

Skin cancer can be caused by the sun and the top reason people get it is cumulative exposure to UV rays from the sun or tanning beds, said Dr. Sanna Ronkainen, a dermatologist at MedStar Washington Hospital Center. Fair-skinned individuals are most at risk, although Dr. Ronkainen said she has seen African American patients develop skin cancers as well. No patient populations are completely safe. Also, family history or personal history of skin cancer can play a role in a patient’s risk.

“Here at MedStar Washington Hospital Center, we see patients of all walks of life from the whole spectrum of ages. For patients coming in for skin cancer, we’ve seen everything from teens to people who are elderly. So it really can be anybody who walks in the door,” she said.

At MedStar Washington Hospital Center, the most common types of skin cancers the doctors come across are basal cell carcinoma, squamous cell carcinoma and melanoma. Basal and squamous cell cancers are non-melanoma skin cancers that show up on sun-exposed areas as a pimple that doesn’t heal or a rough spot that bleeds easily. They are more common with older patients, Dr. Ronkainen said.

Melanoma is well known to most and is a more dangerous type of skin cancer, Dr. Ronkainen said. It often manifests as a dark spot on the skin or change to an already-existing mole, she said.

There are measures you can take to help prevent skin cancer, Dr. Ronkainen said. Keeping a close eye on your skin and looking for changes can help. Being diligent about sun protection is also crucial, Dr. Ronkainen said.

“Certainly I love going outside and exercising outside and enjoying the good weather when we have it here in The District, but being mindful that those UV rays do add up over time is important,” she said.

One of the best ways to prevent damage from UV rays is to stay out of the sun during its harshest hours — between 10 a.m. and 2 p.m. Also, Dr. Ronkainen recommends patients put on sun-protective clothing and wear sunscreen.

Choosing the right type of sunscreen can be a challenge – as there are many different brands and SPF levels. Dr. Ronkainen recommends physical blocker sunscreens with zinc, titanium, or iron oxide, as they are less irritating to skin; however they can feel chalky, and can leave users with a white residue, making them feel and look like there’s glue on the skin.

Chemical sunscreens go on more smoothly, however there has been recent data from the FDA noting that these chemical sunscreens can be absorbed into the blood (though the significance of this is not known).

At the end of the day, it’s about using something that works for you and using it often. Testing out several different types can help you land on what works best for you.

“I always say the best sunscreen you can put on is the one you don’t mind putting on,” Dr. Ronkainen said.

So what’s the best SPF level? Dr. Ronkainen recommends wearing SPF 30 or above every day and putting that on in the morning as part of a moisturizing routine. When on vacation at the beach or being active in the sun, it’s wise to wear between SPF 30 and SPF 50.

Skin cancer is treated differently depending on the subtype and attributes of the skin cancer. Typically, most skin cancers require excisions — where the physician cuts the spot out and a little rim of healthy skin around it. On some occasions, skin cancers can be treated with a topical cream or through Mohs surgery — a procedure that requires examining the skin removed around the spot to determine if the edges show signs of cancer.

“Sometimes (Mohs surgery) can take a little bit longer than doing a general skin cancer surgery, however, it does spare as much of the healthy tissue around the skin cancer as possible to try and minimize any cosmetic defect there,” Dr. Ronkainen said.

There can be major implications if a patient doesn’t treat their skin cancer. For basal cell cancer, not treating it can cause discomfort, and the cancer can erode into the layers of skin below it or even the bone. Melanoma or squamous cell skin cancer left untreated can travel to lymph nodes and can spread to other parts of the body, which can require chemotherapy treatments instead of just having the spot cut out.

MedStar Washington Hospital Center offers comprehensive care to its patients, said Dr. Ronkainen, and reassurance in seeing the same dermatology team throughout treatment for skin cancer.

“It’s nice because we have a specialized surgeon who does Mohs surgery here. We also have multiple dermatologists who feel comfortable doing general local excisions for simple skin cancers, so it’s nice to see your own dermatologist for the procedure that they initially diagnosed by biopsy.”

Read more and listen to a podcast with Dr. Ronkainen here.

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