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Ranjana’s story
Ranjana* is a 51-year-old first-generation Indian American who lives in Utah. Her best friend from school days, Ragini*, was recently diagnosed with melanoma, a type of skin cancer, which caused her a lot of emotional distress, physical discomfort, and financial burden. Ranjana recently came across the information that the state of Utah has one of the highest rates of skin cancer in the US. Ranjana is anxious and has contacted us with a need for guidance on the prevention of skin cancer.
Q: How common is skin cancer?
Dr. Sharma: Ranjana, skin cancer is the most common cancer in the United States. It is estimated that, in the U.S., about 9,500 people are diagnosed with skin cancer every day. However, skin cancer is the most preventable of all cancers, provided they are detected early. There are three common types of skin cancers:
- Basal cell carcinoma, which is the most common type and usually develops in sun-exposed skin. It is slow-growing and often appears as a waxy bump or an open sore,
- Squamous cell carcinoma is the second most common, and may appear as a firm, red bump, ulcer, or non-healing sore, and
- Melanoma, which is the least common but the deadliest, can spread more easily. It usually develops from an existing mole.
Q: What are the causes or risk factors of skin cancer?
Dr. Sharma: The risk factors for developing skin cancer include exposure to ultraviolet (UV) radiation from the sun, using tanning beds, a history of sunburn, a history of skin cancer, having more than 50 moles (especially atypical), a family history, and a weakened immune system. While skin cancers are more common among white people, they can affect any race or socioeconomic status. Likewise, they can affect any age group, but are more common in people over 50 years.
Q: How can skin cancers be detected early?
Dr. Sharma: Ranjana, regular skin self-examination and periodic examination by a dermatologist are helpful for the secondary prevention of skin cancer. An easy acronym to remember for skin self-examination of moles and skin spots for identifying melanomas is: ABCDE, where A stands for asymmetry – in this case half of the moles do not resemble the other half on the body; B stands for the border, which is irregular, ragged, or notched; C stands for color or multiple shades of mole colors; D stands for diameter greater than 6 mm or the size of a pencil eraser; and E stands for evolving changes in size, shape or color of the mole over time.
Q: What can we do to prevent skin cancer?
Dr. Sharma: The key to combating skin cancer lies in prevention. The first and foremost preventive tool is to regularly apply sunscreen. Sunscreen helps block harmful UV radiation from the sun, which is a major cause of skin cancer. Use of broad sunscreen with an SPF of 30 or higher protects against both UVA and UVB. There are two main types of sunscreens: mineral (or physical) and chemical.
Mineral sunscreens use zinc oxide and titanium dioxide to block UV rays by reflecting them off the skin’s surface. Chemical sunscreens absorb UV rays and convert them into heat, which is then released from the skin. Mineral sunscreens leave a white cast on the skin, while chemical sunscreens are rather invisible on the skin.
Sunscreen comes in various forms, including lotions, creams, gels, sticks, and sprays. Sunscreen should be applied thoroughly to all exposed parts of the body and must be reapplied every two hours, especially after swimming and sweating. Sunscreen should be applied every day, even on cloudy days, as UV rays can penetrate clouds.
Q: What are other ways to prevent it?
Dr. Sharma: Some other ways to prevent skin cancer include seeking shade while out in the hot sun, wearing protective clothing such as hats, sunglasses, long sleeves, and pants to cover exposed parts, and avoiding sunburns.
Q: Staying consistent with sunscreen use can be a challenge. How can we stick to the practice?
Dr. Sharma: Ranjana, I conducted a study in Florida, published in the journal Healthcare, which identified that the use of a fourth-generation multi-theory model (MTM) of health behavior change could significantly influence people in adopting behavior change. According to this theory, to start the use of sunscreens, the person must be convinced that the advantages of using sunscreen outweigh the disadvantages, they must have confidence in their ability, and they must have access to and availability of sunscreens. To maintain continued use, they must actively reflect on behavior change, convert feelings into goals, and mobilize support from family and friends.
Q: Can you share some additional resources on skin cancer?
Dr. Sharma: Here are some additional resources from which you can find more information:
- Cleveland Clinic’s website on skin cancer includes information on management and treatment.
- Mayo Clinic’s website on skin cancer with photographs.
- Skin Cancer Foundation’s website provides information on skin cancer.
- Skin Cancer Resource Center of the American Academy of Dermatology Association.
- Practical Stress Management, an ebook from Science Direct, with individual chapters on various aspects of managing stress that help someone to cope with skin cancer.
If you have questions, reach out to Dr. Sharma at editor@indiacurrents.com
*Names changed on request.