Skin cancer: Even more than skin deep

Skin cancer … just the thought of suffering from it is overwhelming. But we have to think about it because here’s something even more overwhelming:

One in five Americans will be diagnosed in their lifetime. And 3.5 million cases in over 2 million people are diagnosed each year. That’s more than all new cases of breast, prostate, lung and colon cancers combined. And these numbers are rising. Fast.

There are three main types of skin cancers: less invasive slow growing basal cell carcinoma, more aggressive squamous cell carcinoma, and the highly aggressive and invasive melanoma skin cancer. The former two are classified as non-melanoma skin cancers; also included in this group are other less common and slower growing types.

Basal cell carcinoma (BCC), the most common type, is unlikely to spread, so it’s the least dangerous. It usually shows up as a raised area of skin that may be red or dark pink in color, shiny or patchy, mainly on areas like the face, ears, scalp, and back that get more sun exposure. Although it’s the least dangerous, if not addressed properly with minor surgical removal, it can be disfiguring.

Squamous cell carcinoma (SCC) is more dangerous because it’s more likely to spread and metastasize. This type often shows up as scaly red patches, elevated growths with depressed centers, wart-like growths or crusty lesions. SCC can be more invasive if left untreated – even deadly, killing around 2,500 people each year. Like BCC, it tends to show up mostly on areas of the body that get more sun exposure.

Melanoma is the most dangerous form of skin cancer. It’s caused by damaged skin cells that mutate to multiply rapidly and form invasive tumors. The tumors start in the pigment producing cells in the skin, and often look like black or brown moles, although they sometimes show up as skin colored, pink, white, or other colors. If left untreated, chances of metastasis are high. About 10,000 people die each year from this type of cancer. However, if detected early it’s almost always curable with surgery, although chances of developing new melanomas remain high.

Learn your ABCs

For early detection of melanoma, there’s a simple method that helps us remember what to look for. It’s called the ABCDE method.

A: Asymmetry – Look at the lesion or mole for symmetry. If it’s asymmetrical, it can indicate a cancerous lesion.

B: Borders – Does the mole have well defined borders? If not, this is another sign, as melanomas tend to have uneven borders.

C: Color – Moles or lesions that have unusual colors, like different shades of brown, black or mottled colors can indicate melanoma.

D: Diameter – Measure the size of the lesion. If it’s larger than a pencil eraser (1/4 inch or so), this could be another sign. However, melanomas can be smaller, so if other signs from this list are there, it’s important to get checked.

E: Evolving – Is the lesion changing in size, shape, color or producing new symptoms such as bleeding? Any changes should be reported to your dermatologist.

Sun damage

Over 90% of skin cancers are attributed to over-exposure to ultraviolet rays from the sun, as well as from tanning booths which are proving more dangerous than regular sun. However, it’s a critical balancing act. Getting enough natural sunlight on your skin is the main way that we produce vitamin D, one of the most important nutrients that boosts immunity and fights cancer, including skin cancer.

However, depending on your skin tone, you don’t need a full day of sun exposure. Current recommendations for vitamin D synthesis are to stay in the sun half the amount of time it would take for your skin to change color. For very light skinned people, this could be 15 minutes a day; very dark skinned people, up to two hours. Beyond this, however, the ultraviolet radiation from UV rays can ultimately damage skin cells and their precious DNA, leading to increased risks of abnormal cells which can later turn into skin cancer. People most at risk for all types of skin cancer are those with light skin, freckles, blonde or red hair and blue eyes.

The truth about sunscreen

With the increases in melanoma and other skin cancers, public health officials have been urging people to increase their sunscreen use. New public health guidelines suggest it be applied daily and often, particularly in sunny climates.

On one level, that seems like a good idea. Sunscreen can prevent the DNA damage caused by too much sun exposure, right? Maybe – but unfortunately, there’s more to this story. While the right kind of sunblock can help protect against skin cancer, many brands contain chemicals that can damage cells, disrupt hormones and even cause cancer. Essentially, we may be trading one bad outcome for another.

The Environmental Working Group (EWG) analyzed 500 sunscreens and recommended only 39. They found a number of problems. First, they questioned the SPF ratings, reporting that many of them were exaggerated. But even more concerning, many commercial sunscreens contain potentially harmful ingredients that cancel their anticancer benefits.

For example, many of the products tested contained retinyl palmitate, which the FDA believes can damage skin cells and cause skin cancer. Many sunscreens also contained oxybenzone, which can disrupt hormones and alter cellular signals, potentially leading to hormone related cancers and other conditions down the road.

Beyond the EWG analysis, sunscreen chemicals may increase the prevalence of free radicals, unstable atoms and molecules that damage DNA and fuel inflammation and tissue damage. In addition, compounds like titanium dioxide have been shown to cause gene damage in mice. Other sunscreen chemicals have also been linked to hormone disruption. Essentially, we need to be very careful with the chemicals we’re putting on our skin – these untested potential toxins absorb directly into the bloodstream. Be particularly careful with aerosol sunscreens, and don’t use them on your children, since kids can easily inhale these chemicals as well.

Healthy alternatives

Perhaps the best topical defense against sun damage is good old fashioned zinc oxide, which provides broad-spectrum mineral-based protection and is shown to be safe. However, avoid the products that boast the invisible, absorbable “nano” forms of zinc – this new nano-technology has raised questions about the safety of these minute particles absorbing into the body.

I also recommend taking a holistic approach to sun protection. Research shows there are a variety of nutrients, supplements and compounds that can help boost the body’s ability to protect against excessive UV exposure.

One of the most important steps we can do to boost our skin’s protective mechanisms is to increase intake of antioxidants, a number of which have been shown to improve resistance to UV damage. Lycopene, abundant in tomatoes, is a good choice. Another example is resveratrol found in red wine, grape skins and other sources. Green leafy vegetables are a great source of carotenoids, which enhance skin pigmentation and sun protection.

Another interesting supplement that has been receiving attention recently is an extract from a fern plant called Polypodium leucotomos. High in antioxidants, oral intake of this extract is shown in studies to significantly protect against sunburn and UV skin damage.

Honokiol, a unique compound extracted from magnolia bark, is a potent antioxidant that’s shown in preclinical studies to protect against skin cancer. It’s also a powerful anti-inflammatory and anti-cancer ingredient, natural anti-anxiety aid and effective antibacterial agent.

It can be difficult to sort through all the conflicting information about sunscreens, and the many choices available. My best recommendation is to bolster the body’s existing defenses with nutrients shown to protect against sun damage, and use a broad spectrum, mineral sun blocker like zinc oxide. Moderate your time in the sun and wear a hat and protective clothing as much as possible. If you look at the dress of cultures in desert areas, you see the wisdom of covering up with something light and airy. As our earth continues to heat up, sun protection becomes essential – so it should be comprehensive, not a trade-off between dangers.