Skin Cancer Awareness Month - November 2013

With the December holidays just around the corner it is as important as ever for you to be sun smart and take measures to ensure that you and your children are protected from the harmful rays of the sun, cautions the Government Employees Medical Scheme (GEMS).

Now is a particularly good time to get smarter about the sun and its potential dangers not only to avoid painful sunburn, but also to prevent premature aging, skin damage caused by ultraviolet rays and most importantly, skin cancer.
 
November is Sunsmart Skin Cancer Awareness Month and given the high prevalence of skin cancer in South Africa, GEMS has elected to provide existing and prospective members with a few important pointers on the subject of excessive exposure to the sun. 

The dangerous rays of the sun
It is firstly important to note that the rays of the sun are dangerous and everyone is vulnerable to them. Research has shown that one in three cancers diagnosed is skin cancer and that 20 000 South Africans are diagnosed with this type of cancer every year. South Africa has the second highest incidence of skin cancer after Australia.

While many people think that a tanned body or a dark complexion protects their skin from sun damage, this is not necessarily the case. People with a fair skin that is prone to freckling are certainly more vulnerable to developing skin cancer, but the condition can occur in all skin types.

Black people are far less likely to develop skin cancer than Caucasians but are nevertheless still susceptible and also need to protect themselves from the harsh rays of the sun. Also keep in mind that there really is no such thing as a safe and healthy tan since tanning is a sign of skin damage.

Skin cancer risks
There are a number of environmental and genetic factors that can increase the risks of an individual developing skin cancer. These include exposure to sunlight, being badly sunburnt, a family history of skin cancer and the use of tanning devices. It should be noted that as few as five bad sunburns is all it can take to double your chances of developing melanoma, the most dangerous of the different types of skin cancer, later in life.

Skin cancer does tend to be more common in people over the age of 50 as it can develop as a result of a lifetime of sun exposure. The skin of children is particularly vulnerable and being sunburnt during childhood may increase the risks of developing skin cancer later in life.

There are three different types of skin cancer:
1) Basel cell carcinoma - This is a slow-growing cancer and seldom spreads to other parts of the body.
2) Squamous cell carcinoma - This type of cancer spreads more often than basil cell carcinoma but is considered rare.
3) Melanoma - This is the best-known form of skin cancer and it is also the most serious type. This can reach the lymph nodes in which case it is likely to spread to other parts of the body for example the liver, in which case it can be deadly.

The potentially deadly melanoma
The Skin Cancer Foundation of South Africa (SCFSA) says melanoma causes around three quarters of all deaths related to skin cancer. "It can usually be successfully treated if it is diagnosed and treated very early when the tumour is still small and thin, before it has had a chance to metastasise or spread to the lymph nodes and other organs of the body."

This is why it is so important to inspect yourself or your children for moles, warts and sunspots. Should you notice any change in these, you should immediately see your doctor. Remember, with skin cancers, self-screening is the operative word.

Sunburn and children
Sunburn is essentially an inflammation of the skin that has been caused by over exposure to the harmful rays of the sun. This in itself can create a number of complications such as heat rash, heatstroke and sunburn.

SCFSA says just a few serious sunburns in early childhood can substantially increase the risk of skin cancer later in life. "Children do not have to be on the beach or at the poolside to get too much sun," says the organisation. "The school playground, sports field and any prolonged, unprotected outdoor activity can cause sun damage. Because children have a larger proportion of skin to body mass than adults, severe sunburn can furthermore cause serious fluid and electrolyte imbalances. Apart from a good sunblock, children in particular should always wear hats and specially designed swimwear, which will cover their tender skins."

The importance of protecting yourself
With the above in mind, it is obviously critical to protect yourself and your children from the sun. This is best done by using sunblock in combination with protective clothing such as hats and clothing that blocks out the rays of the sun. It is also a good idea to stay indoors as far as possible during those times of the day when the sun's rays are at their strongest.

Choose a sun block with a high sun protection factor or SPF, particularly on those parts of your body which are most exposed to the sun. SPF really means that if you usually start to burn within five minutes of being in the sun, a sunscreen with an SPF of 15 will protect your skin for 15 times as long. You will therefore be protected from the sun for no longer than 75 minutes.

Applying sunscreen SPF 16 on a daily basis can reduce the risk of developing skin cancer by as much as 50%. It is suggested that you cover all skin directly exposed to the sun with a sunscreen with at least a protection level of SPF 30 while SPF 8 should be used on areas covered by clothes. Remember that sunscreen should be reapplied regularly especially if you are swimming or sweating heavily as this causes it to become diluted.

Also wear long trousers, long sleeved shirts and wide rimmed hats when you go out into the sun. The sun's rays can also cause damage to the eyes so be sure to use UV blocking sunglasses.

Keep in mind that UV rays reflect off cement, water, sand and even grass, so you can get sunburnt even in the shade and while you are driving. It is therefore a good idea to apply sunscreen to the exposed parts of your body in the morning before leaving home. Make sure you do the same for your children to get them into the healthy routine of applying sunscreen daily.

To protect you and your family from the sun follow these tips:

• Try to avoid being in the sun between 11h00 and 15h00 when the sun is at its strongest.
• Just like medicines, a sunscreen has a shelf life which impacts on its effectiveness. If your sunscreen is dated rather buy yourself a new bottle.
• Keep in mind that as you move inland, above sea level, the sun's rays become more intense, so be sure to protect yourself from the sun no matter where you are.
• Don't skip on sunscreen when it is slightly overcast, particularly not if you are on the beach, since ultraviolet light can penetrate light cloud cover.
• If possible apply sunscreen 30 minutes before going out into the sun, since many products take that long to be absorbed into the skin.
• Beware of the glare, particularly at the seaside, where you are unlikely to find natural shade. Do not rely on a beach umbrella alone since it cannot protect from the reflected glare of sun on sand.
• Keep in mind that UVA rays pass through glass, and a person sitting near a window (unless it is tinted for sun screening) is also susceptible to the damaging rays of the sun.

Prevention is better than cure
With all this in mind, remember that skin cancer and premature aging due to sun exposure are preventable. It is never too late to become "sunsmart"!

What do I do if I am diagnosed with skin cancer?
GEMS knows and understands just how difficult it is to be diagnosed with any form of cancer. To help its members with clinical and much needed emotional support, the GEMS's oncology Disease Management Programme is there to assist you every step of the way. The programme is especially designed to provide cancer sufferers with information, personal support and technical know-how about their condition and its effective treatment.

References
Skin Cancer Foundation of South Africa launches:  http://www.bizcommunity.com/Article/196/330/100315.html
Learning About Skin Cancer:  http://www.genome.gov/10000184
Skin Cancer Foundation:  http://www.skincancer.org/