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Life After Cancer A Roadmap for Cancer Survivors

Skin Cancers and Sun Exposure
Bernard Gordon, MD and Ernest H. Rosenbaum, MD

Excess sun exposure can damage the skin causing premature aging and sometimes cancer. A skin protection program is vital.

Skin cancers are one of the most common second cancers, especially for those treated with radiation therapy, thus survivors should take extra care to protect their skin from sun exposure. This includes regularly using sunscreen with sun protection factor (SPF) of 15 or more, wearing protective clothing, avoiding outdoor activities from 10 am to 3 pm when the sun's rays are most intense, and not tanning.

Be aware of changes to your skin. Any non-healing sores, changes in skin lesions, moles or freckles merit a physician examination.

The Dangers of Excessive Sun Exposure

Sun exposure is not only unhealthy but also causes nearly 90% of the cosmetic changes associated with aging, such as wrinkling, a leathery appearance to the skin, irregular pigmentation, and aging spots. It may also lead to photodamage, which can evolve into several forms of skin cancer, the most deadly one being malignant melanoma . It has been estimated that using sunscreen on a regular basis during the first eighteen years of life could reduce the incidence of skin cancer by up to 70%.

Analyzing the Power of the Sun

The sun's radiation is made up of infrared, visible, and ultraviolet (UV) rays. It's the ultraviolet rays, UV-A and UV-B, which affect the skin. - UV-B rays penetrate your skin's top layer (epidermis) and are the principle cause of sunburn and skin cancer. They are the strongest and most potentially damaging rays and are most common between 10 am and 3 pm

- UV-A rays penetrate the skin even more deeply, reaching into the underlying skin layers of connective tissue. They play a major role in aging and are strong all day long, all year long. When your skin absorbs UV rays, the exposure triggers the production of melanin, a natural sunscreen pigment, creating what is known as a tan. The skin remembers each exposure, and with each burn the skin's ability to protect itself weakens. Over years, damage to the skin's basic structure from sunlight can lead to premature aging and possibly skin cancer.

Precancerous Skin Lesions

Excess sun exposure can lead to the growth of actinic keratoses or solar keratoses - rough, scaly skin lesions that can be a precursor to cancer. People with such precancerous skin lesions are at risk for developing squamous, basal, or melanoma cancers due to excess sun exposure.

Fortunately, 90-95% of people with this type of skin cancer can be cured. There are three basic types: basal cell, squamous cell, and melanoma. Basal cell and squamous cell carcinomas are designated non-melanoma skin cancers .

Precautions to Avoid Excess Skin Damage

- Avoid the midday sun (10:00 am - 3:00 pm).
- Cover up. Light, long-sleeved shirts and long pants can help shield you against the sun's ultraviolet rays. Umbrellas may be needed to deflect strong, direct sunlight or reflected light off the beach or water.
- Use sunscreens. A Sun Protection Factor (SPF) of 15 or higher offers protection.
- Avoid tanning salons (Increased risk for melanoma).

The best cure for skin cancer remains early detection, prompt treatment, and follow-up preventive care measures. Recognize warning signs of a disease through regular skin self-examination. Even more important, however, is to protect yourself from the sun's rays. By avoiding the peak hours of ultraviolet radiation, and by wearing sunscreen and protective clothing, you can keep skin cancer from happening to you.

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