From OncoLog, May 2013, Vol. 58, No. 5
House Call: Myths and Facts About Skin Cancer
MYTH: Dark skin protects against skin cancer.
FACT: Naturally darker skin doesn’t prevent skin cancer. Although skin cancer is less common in African American and Hispanic populations than in Caucasian populations, African American and Hispanic people who develop melanoma (an aggressive type of skin cancer) are more likely to die from the disease than are Caucasian people with melanoma.
The most likely reason for this difference in patients’ outcomes is that dark-skinned people are less likely to seek treatment for skin lesions before the disease has reached an advanced stage. For example, acral lentiginous melanoma, the most common melanoma in African Americans and Asians, often goes unrecognized because it affects parts of the skin where cancer is not expected, such as the palms, soles, and nail beds.
MYTH: Tans are healthy and shield the skin from damage.
FACT: A “base tan” may delay sunburn, but it will not prevent damage from ultraviolet radiation. In fact, tanning is the body’s attempt to defend itself against previous exposure to ultraviolet radiation by increasing the amount of pigment in the skin. This means that the DNA in suntanned skin has already been damaged by ultraviolet radiation. This DNA damage can lead to mutations that cause cancer. Also, a substantial amount of ultraviolet radiation will still penetrate any tan.
Whether caused by sunlight, a tanning bed, or a sun lamp, no tan leaves your skin healthier than it was before. Some tanning salons claim to use “safer” rays than those from the sun, which usually means ultraviolet A but not ultraviolet B rays. However, both types of ultraviolet rays can cause skin cancer.
MYTH: Skin cancer develops only on parts of the body that have gotten too much sun.
FACT: Although skin cancer most often occurs in areas that are frequently exposed to direct sunlight, cancer can also develop on skin that is usually covered by clothes or in shadow.
Because cancer can occur anywhere on the skin, a doctor performing skin cancer screening examines all areas of the skin. If you notice unusual spots or changes to existing moles anywhere on your skin or if you have multiple risk factors for skin cancer, talk to your doctor about skin cancer screening.
MYTH: Only elderly people develop skin cancer.
FACT: Skin cancer doesn’t happen only to older people. The two most common types of skin cancer, basal cell carcinoma and squamous cell carcinoma, do occur mostly in people more than 40 years old because these cancers are linked to a person’s built-up exposure to ultraviolet radiation over many years. Melanoma, however, is linked to the sudden damage caused by sunburn and thus is more likely in young adults than other skin cancers. In fact, according to the Skin Cancer Foundation, melanoma is the second most common of all types of cancer in people 15–29 years old and the most common cancer in those 25–29 years old.
MYTH: Only people who don’t use sunscreen and spend too much time in the sun get skin cancer.
FACT: Even though limiting your sun exposure can reduce your risk of getting skin cancer, the risk is not reduced to zero. Genes also influence the risk of developing skin cancer. So someone who wears sunscreen conscientiously but has a family history of skin cancer might develop the disease.
The risk of skin cancer can remain high for some people who use sunscreen because they are not using it properly. You should apply sunscreen (SPF 30 or higher) half an hour before sun exposure so it has time to penetrate the skin, and you should reapply sunscreen regularly, especially after swimming.
Even people who avoid outdoor activities are at risk for skin cancer because they too are exposed to ultraviolet radiation. People get most of their ultraviolet radiation exposure through routine activities like walking a dog or trying to find a parked car. Avoiding sunlight when it is strongest—between 10 a.m. and 4 p.m.—can reduce your exposure, as can wearing a hat and long sleeves during routine activities.
Knowing the facts and taking sensible precautions can help protect you and your family against skin cancer.
— S. Bronson
For more information, talk to your physician, visit www.mdanderson.org, call askMDAnderson at 877-632-6789, or visit the Skin Cancer Foundation.