Rhode Islanders are addicted to the sun. If they aren't at the beach or sailing, they are playing golf or gardening. Over the years they accumulate a lot of skin damage from excess exposure to the sun. Skin damage starts in early childhood and is cumulative resulting in skin cancers later in life. There are three main kinds of skin cancers: basal cell, squamous cell, and melanoma. None of these can be neglected. Skin cancer actually is the most frequent cancer and, except for melanoma, is not generally reported in cancer statistics.

Exposure to the sun or to other sources of ultraviolet light produces an acute response in the skin, with blood vessel dilatation, first degree burn (sunburn) or second degree burn (blisters). This exposure actually damages the surface and results in peeling, and permanent cell changes remain. An increase in pigmentation, so-called tanning, which is transient actually is a response to skin damage. Over the years, the damage accumulates in the skin and results in permanent changes with thickening of the skin, increased pigmentation, and ultimately, cancer formation.

The most frequent skin cancer, basal cell carcinoma, can be treated well by surgical excision and for larger lesions, chemosurgery will effect a complete removal with limited scarring. Local radiotherapy has also been used. Squamous cell carcinomas of the skin must be taken more seriously and excised widely because it can recur locally or spread to lymph nodes. Post-operative radiotherapy may be advised. By far, the most serious skin cancer is melanoma and in the last decade there has been a continuous increase in the number of these cancers. Melanoma is not a disease to be taken lightly. Wide surgical excision, sometimes with lymph node resection, is necessary.

Here in Rhode Island we can expect over 200 cases a year, probably because of the increased exposure to sunlight the population of Rhode Island experiences. It is important to remember that the death rate from melanoma in Rhode Island is 70% greater than the national average. A melanoma that is recognized at an early stage can be cured in 95% of cases, but once the lesion gets a ¼ inch thick, it is deadly and most people will die of the disease.

Early detection is critical. A mole which changes color or becomes irregularly colored, or becomes irregular in its outline, must be shown to a physician as soon as possible. One of the problems is that people do not examine their skin for changes and for moles. It is difficult to examine some parts of your own body and help from someone else is necessary or the use of a mirror is required. Awareness of the importance of early detection of this disease can make the difference between a life and death.

Skin cancers can be prevented by covering up, wearing a hat, and using sunscreen SPF 30 whenever going out into the sun. This kind of sun protection should be started at a very early age with very young children. There is some evidence that skin cancers later in life can be related to sunburn as a child and, certainly, continuous exposure of the skin to the damaging effects of the sun and other sources of ultraviolet throughout life takes its toll. Skin cancer is a disease that can be prevented and early detection, particularly for the squamous cell carcinomas and melanoma, can be life saving.

For more information and answers to specific questions contact the Rhode Island Cancer Council at Tel@ricancercouncil.org or call us at (401) 728-4800 or toll free 866-879-4100.

IT IS EASIER TO PREVENT CANCER THAN TO TREAT IT.

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