Monday, January 14, 2008

Take Nothing for Granted: Sun Protection a Year-Round Affair

Many of my readers will likely remember the story of Tiffany Berg, and her husband Paul – a two-time skin cancer survivor. After years of skiing, snowboarding, and failing to wear any sunscreen caught up to him Christmas 2004, when Paul was diagnosed with squamous cell carcinoma. What, at first, to be a pesky sore began growing up through the epithelial layer of his mouth, and through his nasal cavity. Unfortunately, the first round of “natural” treatments did not work. The squamous cell carcinoma returned. Yet, after several rounds of radiation, and serious re constructive surgery to repair his mouth and face, Paul's skin cancer was removed and he was deemed to be “cancer-free.”

Alas, Paul's skin cancer returned three years later. As of December 25, 2007, Paul had a two-inch tumor removed from his lower right jaw. The squamous cell carcinoma had returned. As such, the father of five is now undergoing six weeks of radiation treatment.

When Tiffany told me that Paul's skin cancer had returned, I was – in a word – stunned. I was reminded that we must not taking anything for granted—not even skin cancer!

While squamous cell carcinoma is generally 90-95% treatable when found in its early stages, it has the potential for metasis if left untreated. In other words, it can grow and spread to other parts of the body thus becoming potentially life-threatening. Hence, it is vitally important that we perform regular skin exams each month, and visit the dermatologist every year. Moreover, we must be vigilant about wearing an effective broad-spectrum sunscreen all year-round—even during the winter. So, winter sports enthusiasts beware – ultraviolet radiation is highly reflective off of water and snow. The UV exposure from above is akin to double-whammy; therefore, be sure to protect your skin—especially your face and mouth—with proper sunscreen. And remember, to reapply sunscreen at least once every two hours (every hour if you are skiing/snowboarding at particularly high altitudes for an extended period of time).

Consider the following statistics recently released from a study conducted by Patricia Ayanbadejo, a scientist for the Internet Journal of Dentistry and Primary Orofacial Squamous Cell Carcinoma:

“Squamous cell carcinoma of the orofacial region [mouth and face] is an insidious and potentially life-threatening malignant neoplasm representing more than 90% of all head and neck cancers”, Ayanbadejo says.

In layman's terms, this means that squamous cell carcinoma can be potentially deadly if left untreated, and that it accounts for nearly all head/neck-related cancers.

Yet, the good news is that since squamous cell carcinoma (like other skin cancers) is largely attributable to cumulative sun exposure, it is largely preventable. Skin cancer is preventable if we are proactive about proper sun protection—all day, every day, even on cloudy and cold days.

Ye winter sports enthusiasts have been warned. Take nothing for granted. Remember, ultraviolet radiation is reflective—highly reflective off of snow and water. Hence, it is imperative that you apply a quality broad-spectrum SPF 30 sunscreen to all exposed parts of your body—especially your face and lips. To learn more about how ultraviolet radiation works, and the importance of proper application (and reapplication) of a quality sunscreen, please read the hyperlinked articles. For a free sample of Blue Lizard Australian Sunscreen to take with you as you hit the slopes (or whenever you venture outdoors), please contact The Cancer Crusaders Organization at

Skin cancer is preventable only if we are proactive about proper year-round sun protection, as well as regular skin exams. So, be sure to take the proper precautions NOW to protect yourself from a future skin cancer diagnosis. Parents of young children under the age of 18, should adequately protect their children from UV exposure especially since 80% of one's lifetime sun damage occurs before age 18.

Additionally, if you have had skin cancer removed in the past, be sure and follow-up with your dermatologist-oncologist so to avoid recurrence. “Regular examination of the skin, especially of the head and neck if you have had orofacial skin cancers removed in the past is particularly important during the first two years of treatment, when 90% of recurrences develop,” says Ayanbadejo. “Local recurrence, or development of new primary tumors, is particularly common in patients who have been treated for cancer in the upper aerodigestive [lips, mouth, tongue, nose, throat, vocal cords, and part of the esophagus and windpipe] tract,” she says. “These patients are not only at risk for cancer in the head and neck region (recurrences and second primaries) but also of developing cancer in other parts of the body, particularly the lungs or esophagus.”

Again, skin cancer is preventable. Yet, it is also the most common cancer in the world. As such, it is imperative that we make sun protection a year-round affair, even during the winter months. While we may think that sun exposure will not directly effect us now, the cumulative exposure can—and does—lead to a heightened risk for skin cancer in the future. As Paul Berg once said in an interview conducted in 2005, after his second bought of skin cancer, “as kids we had no idea that the sun could hurt us.”

With that, take nothing for granted. Be proactive and protect your skin—all day, every day—for life! Skin cancer is not a summer-time only disease; rather, sun protection is a year-round affair.

For more information, check out the American Academy of Dermatology.

(Note: Special, updated edition of ONLY SKIN DEEP? An Essential Guide to Effective Skin Cancer Programs and Resources coming soon.)

Wednesday, January 2, 2008

An Introduction to The World's Most Common Cancer – Skin Cancer

A Growing Epidemic

Recently, the National Cancer Institute reported that the overall cancer mortality in the United States has been slowly declining since 2006. Breast cancer, prostate cancer, and colon cancer have seen a reduction in number of deaths; however, melanoma—the most lethal form of skin cancer is continually on the rise. In fact, the American Academy of Dermatology (AAD) reports that more than 1.3 million Americans will be diagnosed with a form of skin cancer this year alone. They further report that melanoma skin cancer kills more women in their 20s and 30s than any other cancer—even exceeding lung and breast cancer, which were once considered to be the two most common cancer-related deaths for women in 2005. To bring this issue into more stark perspective, melanoma skin cancer incidence in the United States has increased by more than 6,000% in the past century, according to the both the AAD; every hour someone in the United States succumbs to melanoma skin cancer.

Before we examine why the skin cancer rate is increasing by near epidemic proportions in the U.S., and abroad, we must first understand what skin cancer is; how it develops, the different types, the signs and symptoms, including risk factors.

As mentioned in a previous article, cancer is the uncontrolled growth of mutated, abnormal, and immature cells in the body. Therefore, simply put, skin cancer is the uncontrolled growth of immature cells in the skin.

Skin Cancer Basics

That said, there are three basic types of skin cancer – basal cell carcinoma, squamous cell carcinoma and melanoma—the deadliest form. Basal cell carcinoma, the most common form of skin cancer, refers to the location from which the lesion derives. In other words, the encyclopedic definition of basal cell carcinoma is a cancer that originates in a layer of skin (the basal layer) beneath the epidermis (the top, uppermost layer). Basal cell carcinomas are typically seen as a raised nodule, much like a wart or a lump, or even as reddish scaly sore. Basal cell carcinomas may also have a glossy, pearl-like tone to them.1 While basal cell carcinomas seldom metastasize (spread), they can, if left untreated, spread to the lymph or blood vessels. Fortunately, basal cell carcinoma is 90-95% treatable if caught and treated while in its early stages.

The second most common form of skin cancer is, as mentioned earlier, squamous cell carcinoma. Akin to basal cell carcinoma, squamous cell carcinoma originates from epithelial tissue (a sheet of closely packed tissue that lines both external and internal bodily organs). Squamous cells are flat and often overlapping; they compose the epidermis and line certain internal cavities such as the mouth. Like basal cell carcinoma, squamous cell carcinomas usually appear on areas of the body that have been [over] exposed to ultraviolet radiation from the sun and tanning beds. Common areas for a squamous cell carcinoma to appear include the face (nose, inside/outside of the mouth), scalp, neck, ears, chest, hands, and legs. In rare instances, squamous cell carcinoma can be found in other parts of the body that are typically not exposed to UV rays (i.e., the prostate or vagina). Yet, in nearly all instances, squamous cell carcinoma appears as the result of prolonged, over-exposure to ultraviolet radiation.

You will notice that squamous cell carcinoma looks much like a sore. A persistent sore that will not heal after four or more weeks may be indicative of a possible squamous cell carcinoma. When in doubt, consult a board certified dermatologist. When properly treated, in its early stages, the cure rate for squamous cell carcinoma is approximately 90%. However, squamous cell carcinomas left untreated may spread to the lymph nodes and other surrounding areas, perhaps even becoming a malignant melanoma - an aggressive, and potentially lethal form of cancer.

Melanoma skin cancer may be the rarest form, but it is the most dangerous and lethal form of skin cancer. Whereas, basal cell and squamous cell carcinomas share similar characteristics, melanoma is in a class by itself. It is an entirely separate form of skin cancer. Melanoma is also unique in comparison to other cancers in myriad ways. This is largely due to its particularly aggressive nature. In fact, more than 85% of skin cancer-related deaths are due to melanoma.

Once uncommon, melanoma kills more women in their 20s and 30s than any other form of cancer, according to the American Academy of Dermatology. In fact, we have seen a 10% increase in melanoma incidence since 2006. It is estimated that 105,750 new cases of melanoma will be diagnosed in the U.S. this year alone, with more than 8,000 of those resulting in death. In other words, melanoma kills another American every hour.

Deadly, but Preventable

Despite these staggering statistics, melanoma – like other skin cancers – is largely preventable. Because more than 90% of skin cancers are caused by prolonged over-exposure to ultraviolet radiation from the sun and tanning beds, it is preventable. Yet, melanoma is a very serious, even potentially deadly form of cancer.

So as to provide you with a clearer understanding of what melanoma is, let us dissect it. If we cut word melanoma in half, we have two separate words – mela and noma. The root mela comes from the word melanocytes, which are cells in the skin (located beneath the epidermis) that are responsible for producing pigmentation. The latter half of the term – noma – comes from the word carcinoma, which is a term referring to cancers of the body's external tissues and organs such as the skin. In fact, skin is the largest bodily organ!

Contrary to popular belief, melanoma is not a disease restricted to individuals with fair skin. Anyone with skin is at-risk for melanoma. While it is true that fair-skinned persons are at higher risk for melanoma skin cancer (Caucasian-Americans are 20 times more likely than African Americans to develop melanoma), melanoma is not a respecter of persons. In fact, popular Jamaican Reggae singer Bob Marley died of malignant melanoma, at age 36. So, simply put, anyone can get melanoma. Hence, it is imperative that we are proactive about protecting our skin from over-exposure to ultraviolet radiation, and are equally proactive about monthly self-skin exams and annual visits to the dermatologist.

To learn more, check out ONLY SKIN DEEP? An Essential Guide to Effective Skin Cancer Programs and Resources. (Revised, Special edition due out soon!)

Copyright. Danielle M. White, The Cancer Crusaders Organization 2005-2008.