Sun Damage Lasts a Lifetime

Sun ProtectionAfter a long, rough winter, it feels good to put away the jackets and get out the swim gear. As a melanoma oncologist, the summer is a double-edged sword as it also means that many people will be out in the sun doing irreversible damage to their skin. Not only can sun safety decrease your risk of skin cancer, it also can help protect you from the visible signs of aging. Who doesn’t want less cancer and to look younger at the same time? Unfortunately, some people believe they need a good burn or base tan to start the summer. Hopefully, I can change your mind about this with some basic information about skin cancer and a few tips on enjoying the summer without increasing your risk of developing skin cancer (or more wrinkles).

Skin cancer affects over three million people each year, making it by far, the most common cancer. The three most common skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal and squamous cell cancers are the most prevalent and originate from keratinocytes. These cancers are often referred to as “non-melanoma skin cancers.” They affect a little over two million Americans each year, with 80 percent of these being basal cell cancers. Most non-melanoma skin cancers are caused by repeated exposure of the skin to ultraviolet rays (primarily UVA and UVB) from sunlight or from artificial sources such as tanning beds. These rays damage the DNA in skin cells and cause them to grow and divide unregulated, thus producing a cancer. These types of skin cancers tend to stay in the skin, and therefore very few patients will die from basal or squamous cell cancers. It is estimated that approximately 2,000 people die each year from non-melanoma skin cancers.

In contrast, melanoma is a cancer that originates from melanocytes that normally make pigment to protect the other layers of the skin from sun damage. Melanocytes can also make non-cancerous growths like moles. The American Cancer Society estimates approximately 76,100 new melanomas will be diagnosed in 2014 with 9,710 deaths from this disease, making it the most deadly form of skin cancer. Lifetime risk of melanoma in the U.S. is about 1 in 50, and notably it is one of the most common cancers in those younger than 30. When diagnosed early, surgery alone has excellent survival rates. In the past there were few long-term survivors from advanced cases of melanoma. Fortunately, many novel therapeutic agents are being developed that have transformed the treatment of more advanced stages of melanoma with five new agents approved by the FDA since 2011. All of these new drugs are changing the landscape of melanoma treatment and patients are now not only living longer, but also with better quality of life.

Though melanoma development is more multi-factorial than basal or squamous cell cancer development, it is still linked to UV exposure through sunlight or tanning beds. The best way to decrease one’s risk of skin cancer development is to avoid long exposures to intense sunlight and practice sun safety measures. When outside, I recommend the use of broad spectrum sunscreen (SPF 30 or higher), use of sun protective clothing such as sun shirts and board brim hats, and avoid direct exposure between 10AM and 2PM when the intensity of the rays is the strongest. Sunscreen should be applied about 20-30 minutes prior to going outside and reapplied approximately every two hours. Because this is difficult to do, even for myself, I recommend barriers like sun shirts or umbrellas over sunscreen if possible.

Keep in mind the sun damage that occurs now will be with you for the rest of your life, so please don’t forget your sun protective gear on your way out to enjoy the beautiful weather.

About Dr. Kudchadkar

Ragini Kudchadkar, MDRagini R. Kudchadkar, MD is an assistant professor in the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University. She specializes in cutaneous oncology with an emphasis on the development of clinical trials for patients with metastatic melanoma. Dr. Kudchadkar previously worked as an assistant member of the Department of Cutaneous Oncology at the H. Lee Moffitt Cancer Center in Tampa, Florida. In addition to her clinical practice, Kudchadkar is involved in research that focuses on signal transduction inhibitors for the treatment of metastatic melanoma with a secondary interest in rare cutaneous malignancies such as advanced merkel cell and basal cell carcinomas.

Kudchadkar graduated from the Emory School of Medicine in 2003 and completed her internal medicine residency at Emory in 2006. She pursued her hematology and medical oncology training at the University of Colorado in Denver, CO, where she also served as chief fellow.

Related Resources

Melanoma Chat TRANSCRIPT
Dermatologist #1 Skin Care Rule – Wear Sunscreen!
Skin Cancer Prevention: Which Sunscreen is Best?

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