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A cancer survivor's guide to sun safety

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iStock_000019589751Small.jpgBy Brittany Cordeiro

The summer sun is shining. But as you head outdoors to enjoy it, be mindful. More than two million Americans will be diagnosed this year with a cancer that is almost totally preventable -- skin cancer. The primary cause of skin cancer is too much sun exposure.

"If you're a cancer survivor, you should take extra precaution," says Jeffrey E. Gershenwald, M.D., professor in Surgical Oncology and co-leader of our Melanoma Moon Shot. While the same sun safety tips apply to those with or without a history of cancer, survivors of skin cancer, including the most aggressive type -- melanoma --, are at increased risk of developing a second skin cancer or melanoma.
 
We asked Gershenwald what you need to know about sun exposure and sun protection if you're a cancer survivor. Here's what he had to say.

How common is melanoma as a secondary cancer?
The median age of diagnosis of melanoma is about 50. Of those individuals diagnosed, melanoma may or may not have been the primary cancer. Really, everyone is at risk for skin cancer.

Your risk increases if you have a family or personal history of skin cancer. So, melanoma and skin cancer survivors need to be mindful of that history and moderate sun exposure. 

Some individuals with a history of other cancers may be at increased risk of melanoma or other skin cancers, but it's advisable to ask your physician. There isn't enough data to say for sure whether or not you're at risk of developing skin cancer if you've had another primary cancer.

Are there any common misconceptions about secondary skin cancer, or skin cancer recurrence, that survivors should be aware of? 
To start, people are at risk for having more than one type of skin cancer, so surveillance and screening are important for survivors, especially skin cancer survivors. People also need to know there is no safe amount of indoor tanning, and the "pre-vacation" indoor tan is neither a safe nor recommended approach to sun safety.

Even a little bit of tanning bed use increases your risk of skin cancer. In fact, the U.S. Food and Drug Administration (FDA) recently announced stricter rules on tanning beds, including "black box" warning labels stating that they shouldn't be used by anyone under age 18.

Also, one application of sunscreen at the beginning of the day isn't sufficient for all-day wear. You should reapply sunscreen every two hours, or after swimming or getting wet. And, using sunscreen isn't a ticket to seek out more sun exposure. It's part of a multi-pronged approach to moderate sun and ultraviolet (UV) exposure.

What sun safety tips would you recommend for survivors?
If you're a cancer survivor, you should follow the same sun safety tips as people who do not have a history of skin cancer. 

  1. Moderate sun exposure. Seek shade when the sun's UV rays are the strongest, between 10 a.m. and 2 p.m. Or plan outdoor activities around those times.
  2. Apply sunscreen. Use sunscreen that is labeled broad spectrum. This means it covers both types of the sun's dangerous rays, UVA and UVB rays. Sunscreen also should be at least SPF 30 and water resistant. (Learn how to read new sunscreen labels.) Apply sunscreen liberally every two hours and cover all areas of your body that are exposed.
  3. Wear protective clothing. This includes a long-sleeve shirt, wide-brim hat and sunglasses. Many companies even sell clothing with built-in ultraviolet protection (UPF). If you're near water, sand or snow, be mindful. The sun can reflect off those surfaces and burn or damage your skin. 
  4. Don't use indoor tanning beds.

Also, try to check your skin monthly, using the ABCDEs of melanoma guide. It'll help you get to know your skin and spot any areas of concern right away.

How often should survivors check their skin for changes, and are there any particular changes they should look for or places they should look for moles?

It depends on what kind of cancer they are a survivor of. Certainly, people with a history of skin cancer should check their skin monthly and see their physician for a skin exam at least annually.

If caught early, most skin cancers are very treatable and curable, and a lot of skin cancers are local problems only. But, advanced stage skin cancer can become a more significant health issue.

Remember, moderation can go a long way. It doesn't have to be a black or white decision, but tailor your daily practices to embrace skin cancer prevention. The higher your risk of skin cancer, the more you should try to follow the sun safety guidelines.

Get additional tips on sun safety and other healthy habits in Focused on Health, MD Anderson's healthy living e-newsletter.

Melanoma is one of the cancers MD Anderson is focusing on as part of our Moon Shots Program to dramatically reduce cancer deaths. Learn more about our Melanoma Moon Shot.

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