Scared Sunless

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Local medical experts tell how we can care for our skin and stave off the most common form of cancer. By Allison Hersh.

I always thought the birthmark on my lower back was completely harmless.

Smaller than a dime and dark as black coffee, the round, flat spot my mother affectionately called my “beauty mark” had been checked by countless doctors over the years, all of whom gave it the medical thumbs-up.

That’s why it caught me off-guard when a local dermatologist took one look at my back and told me I needed a biopsy.  My lab results came back “pre-cancerous,” so my birthmark had to go.  A few injections and several stitches later, this potentially dangerous part of my body was history.

Skin Care

I’m one of countless Savannahians who have faced skin cancer worries due to what I’m told is a combination of genetic, lifestyle and environmental factors.

Dr. Rebecca Campen of Campen Dermatology says the climate in the Coastal Empire plays a major role.

“The strong year-round sun exposure and the fact that we’re located so close to the equator make skin cancer more prevalent in Savannah,” she explains.  “There’s a genetic component with melanoma, but basal cell and squamous cell cancers tend to be directly related to sun exposure.”

Sun exposure in childhood can make you more susceptible to skin cancer as you get older, she adds.  Campen sees a lot of cancers and pre-cancers on the left cheek and the left hand, which can be linked to sun exposure through a car window.  Whether you’re driving around town or frolicking at the beach this summer, she says it’s important to wear SPF 30 or higher sunscreen—no matter how much melanin you have.

“Skin cancer isn’t as common in individuals with darker skin because they have more pigment,” she adds, “but it can still happen.  It’s smart to wear sunscreen and limit sun exposure, regardless of your skin type.”

There are two main types of skin cancers: keratinocyte cancers, which include basal and squamous cell skin cancers, and dangerous melanomas.  Basal and squamous cell cancers develop from protective outer skin cells called keratinocytes, while melanomas develop from cells called melanocytes, which give skin its color.

Deadly Disease

We’ve all heard that advice, but we must not be following it.  Skin cancer accounts for nearly half of all cancers in the United States.  Each year, more than 3.5 million cases of basal and squamous cell skin cancer are diagnosed in the nation.   The American Cancer Society estimates nearly 77,000 new melanomas will be diagnosed this year.

Although there are no specific numbers for Savannah, dermatologist Dr. Claudia Gaughf of Chatham Skin and Cancer Care is alarmed by the number of skin cancer cases she sees in her medical practice.

“Over half of the patients we see come into the office to have a spot they found checked out, and we identify another mark they never saw as a problem,” she says.  “I always tell people, what doesn’t hurt you can kill you.”

That’s no exaggeration.  Every year, nearly 10,000 Americans die from melanomas.

Surgical oncologist Dr. Howard Zaren, the medical director at the Lewis Cancer and Research Pavilion at St. Joseph’s/Candler Hospital, explains that a melanoma most often develops in an existing mole that undergoes changes or in a new mole that spontaneously appears.  The real danger is the rate at which a melanoma can metastasize and spread to vital organs, bones and even the brain.

“Melanoma spreads through the lymph nodes and the bloodstream,” he says. “We are a sun-worshipping culture, but the price you pay can be significant.”

The key is to catch a melanoma early, when survival rates are highest.  Campen recommends having moles, freckles and other spots checked at least once a year.  If you’ve been treated for skin cancer, get screened every six months.

“Almost all early diagnoses are curable,” Gaughf emphasizes.  “Patients who do not experience a positive outcome are those who wait too long to be checked out.  They’ll say to me, ‘If I had just known…’”

We all Scream for Sunscreen

Here are five simple ways to win the battle against the most common—and most preventable—form of cancer. 

  1. Embrace your shady side.  Campen urges patients of all skin types to wear sunscreen, sunglasses and hats when outdoors.  Consider it an opportunity to flirt with old-fashioned Hollywood glamour.
  2. Protect your children’s future.  “One of the risk factors of melanoma is childhood sunburn,” says Gaughf.  Use a sunscreen of SPF 30 or higher on kids and have them wear protective SPF clothing.
  3. Think twice about tanning beds.  Zaren warns that tanning beds can increase the chance of developing a melanoma by 60 times.  Ask your salon about sunless options.
  4. Put your moles on the map.  “We can digitally photograph every pigmented mole on your body larger than a pencil eraser,” Zaren says.  “We place each mole on an electronic model of your body and can track any changes.”
  5. See a doctor at least once a year.  “And if anything bleeds, itches or changes in any way, you need to get it looked at,” Campen urges.  Look for asymmetry, jagged borders, color changes and newly developing moles.