Sea Sick: Spots that don’t heal could be skin cancer

May 4, 2018 by Keith Murray

Sea Sick: by Keith Murray

May is “Skin Cancer Awareness Month,” so that will be the focus of this month’s column. I realize that the vast majority of my readers spend a lot of time on the water and in the sun, and I bet just about everyone knows someone who has had skin cancer. In my family, both of my parents had skin cancer.

With 5.4 million cases in more than 3.3 million people diagnosed annually, skin cancer is the most common form of cancer in the United States. Fortunately, skin cancer is also one of the most preventable forms of cancer and highly treatable if caught early.

What is skin cancer? According to the American Cancer Society, “skin cancer starts in the cells of the skin. Some other types of cancer start in other parts of the body and can spread to the skin, but these are not skin cancers.”

There are three main types of skin cancers: basal cell carcinomas,  squamous cell carcinomas, and melanomas.

Basal cell and squamous cell skin cancers are the most common skin cancers. Both types are found primarily on parts of the body that are exposed to the sun, such as the head and neck. Sun exposure is the primary cause; with the more sun you get, the better your odds of getting these cancers.

According to the American Cancer Society, “basal and squamous cell cancers are much less likely than melanomas to spread to other parts of the body and become life-threatening. Still, it’s important to find and treat them early. If left alone, they can grow larger and invade nearby tissues and organs, causing scarring, deformity, or even loss of function in some parts of the body. Some of these cancers (especially squamous cell cancers) can spread if not treated, and can sometimes even be fatal.”

Melanomas are not as common as basal cell and squamous cell skin cancers but are often more dangerous than other skin cancers. They can occur anywhere on the body, but in men they are more likely to start on the chest and back. In women, the legs are the most common site. The neck and face of both genders are also common places for melanoma to start.

The good news is, like basal cell and squamous cell cancers, melanoma can almost always be cured in its early stages. However, if left untreated, melanoma may spread to other parts of the body, where it can be very hard to treat or deadly.

What kind of sunscreen should I use?

First, it is important to understand the difference between sunscreen and sunblock. Take a look at the ingredients before using any product. Sunscreens contain chemicals that absorb UV radiation. Sunblocks (also confusingly called physical sunscreens) contain minerals such as titanium or zinc that block UV radiation from reaching the skin. Sunblocks can offer broader UV protection than sunscreens. However, sunblocks are usually thicker and messier (think of the lifeguard with zinc oxide on the nose). Newer sunblock formulations offer transparency with broad-spectrum protection, which is usually what I recommend.

I am a big proponent of sun protective clothing. When I am out on the water, I wear a hat that covers my ears and a long-sleeve, breathable, sun-protective shirt. This allows me to be comfortable without having to worry about painful sunburns the next day and skin cancers in the future.

Is SPF 100 better than SPF 15?

Technically, yes, but the actual difference is minuscule. The AAD recommendation is to use a broad-spectrum sunscreen that is at least SPF 30 and to reapply it every two hours.

Is the sun bad for my skin?

Lots of sun exposure can cause premature skin aging (sun spots, wrinkles, thinning of the skin, skin cancer). However, exposure to UV light can also be used to treat conditions like jaundice, psoriasis, atopic dermatitis, lichen planus, etc. It is also how your body naturally produces vitamin D. Remember, moderation is the key; a little sun exposure is ok, but try not to overdo it.

10 things to watch for:

  1. Anything that appears and grows quickly.
  2. A lesion that bleeds and doesn’t heal.
  3. Be suspicious of lesions in sun-exposed areas (scalp, ears, nose, lips).
  4. Basal cell carcinomas can often have a pearl-like appearance.
  5. If you’ve had something removed before, be aware of changes occurring around the scar like redness, scaling or blood.
  6. Lots of patients with skin cancer tell me that they notice blood on their pillows or sheets.
  7. In pigmented lesions, look for  asymmetry, uneven or notched borders, diameter greater than a pencil eraser, and different shades of black, brown, tan, red, white or blue.
  8. Some advanced skin cancers can be very painful or itchy.
  9. Beware of hard, painless lumps beneath the skin on your neck.  They could be enlarged lymph nodes.
  10. Any pigmented lesion that you see changing over time should be shown to your doctor.  Changes include bleeding, itching, growing in width or height, and color changes.

EMT Keith Murray provides onboard CPR, AED and first-aid training as well as AED sales and service. His company can be found at Comments are welcome below.