Preventing skin cancer
As South Africans we certainly have a shared love for the long, hot summer days that we relish. While we are happily throwing on flip-flops and shorts to head out to enjoy the beauty that surrounds us, let’s be mindful of the irreversible and harmful risks that sun exposure can result in, and reduce the risk of skin cancer.
Skin cancer is the most commonly diagnosed cancer worldwide, and South Africa is no exception. There are three main types of skin cancer:
- Basal cell carcinoma (BCC)
- Squamous cell carcinoma (SCC)
BCC and SCC are grouped as non-melanoma skin cancers. They are diagnosed more commonly, less aggressive and have less propensity to spread. Melanoma skin cancers are more aggressive and have a higher affinity to metastasise to lymph nodes and distant organs.
There are certain risk factors for skin cancer that are modifiable (something you can change), while others are non-modifiable (things you cannot change).
- Fair skin colour, blue or green eyes, and blonde or red hair;
- Increasing age;
- Family history of melanoma;
- Inherited genetic conditions that predispose to skin cancer like albinism or xeroderma pigmentosa;
- Presence of multiple or atypical moles;
- History of severe sunburns early in life;
- UV exposure from sunlight or tanning beds.
What is SPF?
SPF is an acronym for sun protection factor. The SPF is a relative measurement of how long the sunscreen will protect you from the UV rays of the sun. For example, if you typically start to become red and tanned after 10 minutes in the sun, then applying SPF 30 should protect you for a few hours. Factors such as your skin type, weather conditions, if you swim or sweat, all influence the SPF value you need to consider as well as the frequency of application.
- Wear a broad-spectrum sunscreen (SPF 30 to 50) and re-apply every two hours, and after swimming or sweating.
- Wear protective clothing; long-sleeves, a wide-brimmed hat, sunglasses and long pants.
- Avoid indoor tanning beds.
- Avoid tanning in the sun.
- Avoid direct sun exposure for prolonged periods and between peak hours.
- Examine your skin regularly and ask a loved one to have a look at your back and scalp.
- Take care to protect children from sun exposure.
The ABCDE’s of skin cancer
These are some of the worrisome features that you should look out for when you identify a mole or lesion on the skin:
Surgical excision involves removal of the lesion with a margin of healthy tissue to ensure no microscopic cells of tumour are left behind.
Mohs surgery involves removal of a single layer of cells at a time with an examination of the tissue under a microscope to assess if there are any cancer cells remaining. This process is repeated until there are no cancer cells seen.
Curettage and electrodesiccation is when a scraping instrument (curette) and electrical currents are used to destroy and remove small and superficial skin cancers.
Cryosurgery is the use of liquid nitrogen to freeze and destroy diseased tissue.
Chemotherapy can be delivered as a topical ointment that is applied to the affected skin. At the end of treatment, patients may have redness and some crusting on their skin, which typically heals in two to three weeks.
Radiat is the use of high-energy X-rays (photons) or electrons to kill cancer cells. Radiation can be used to treat patients who cannot or choose not to have surgery as primary treatment of skin cancer, or after surgery to reduce the risk of a recurrence in patients with high-risk disease.
- South African National Cancer Registry. Cancer in South Africa 2014 Johannesburg. www.ncr.ac.za. Accessed 14/08/2018.
- 2022. [online] Available at: https://www.uptodate.com/cutaneous-squamous-cell-carcinoma-cscc-clinical-features-and-diagnosis
- Likhacheva, A. et al. (2020) “Definitive and postoperative radiation therapy for basal and squamous cell cancers of the skin: Executive summary of an American Society for Radiation Oncology Clinical Practice Guideline,” Practical Radiation Oncology, 10(1), pp. 8–20. Available at: https://doi.org/10.1016/j.prro.2019.10.014.
MEET THE EXPERT – Dr Shivona Moodley
Dr Shivona Moodley has a special interest in breast cancer, gastrointestinal cancer, gynaecological cancer, head and neck cancer and prostate cancer. Dr Moodley works at the Sandton Oncology and West Rand Oncology Centres and is part of a team of eight oncologists that consult at the DMO locations.
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