What you need to know about skin cancer

Risk factors and protection
Sun exposure is the key cause of skin cancer, but other risk factors include having fair or freckled skin, light-coloured eyes, lots of moles, using tanning beds or having a family history of the disease. “Some people may have an underlying gene that makes them more susceptible,” says Dr. Cheryl Rosen, head of the division of dermatology at Toronto Western Hospital and University Health Network. “We can't do much about our genetic risk, nor can we avoid the outdoors altogether, but we can control our level of sun exposure and take appropriate steps to protect our skin,” she says.

• Use enough sunscreen. “One of the mistakes people make in terms of preventing skin cancer is that they don't put on enough sunscreen,” says Rosen, which puts them at risk for sunburns. “And the more sunburns you have, the more you increase your chances of skin cancer.”

Most people apply only about half the amount of sunscreen they should, says Rivers, who notes that we should use copious amounts to thoroughly cover all exposed skin; we should be going through several bottles of the stuff over the course of a summer.

But even if you apply it as thick as a coat of paint, you may still be at risk. That's because while medical research has clearly proven the benefit of sunscreens in protecting against squamous cell carcinoma, no data specifically prove they prevent basal cell carcinoma or melanoma. Though sunscreen hasn't been proven to prevent these two cancers, it does prevent sunburns and the development of sun-induced moles, both of which can contribute to a higher risk for skin cancer. The B.C. Cancer Agency website notes: “Perhaps it is too early to show that sunscreens help to prevent basal cell or melanoma as the use of good sunscreens was not sufficiently prevalent until 10 years ago.”

• Cover up. “Keep your T-shirt on,” says Rivers. Wear loose-fitting pants and long-sleeved shirts made from closely woven material for the best protection. Wear a wide-brimmed hat. And continue to use sunscreen.

• Teach your children well. It's easy to protect your children's skin from the sun's rays when they are little. Most of the time they'll stand there passively while you slather them with sunscreen. But the trick is to instil positive sun protection habits that last into their teen years and beyond. The best way to do that is to be a good role model and apply sunscreen to yourself as well. “There is data to prove that if parents take care, kids are more prone to do so as well when they get older,” says Rivers.

A 2000 study by B.C. Cancer Agency researchers involving 309 Vancouver children in grades 1 to 4 found that kids who use a broad-spectrum sunscreen with sun protection factor (SPF) of 30 as a matter of routine develop fewer moles and can have a lower cancer risk later in life.

Common types of skin cancer
There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Treatments usually include surgery, and may also include radiation and chemotherapy, depending on the type and extent of the cancer.

• Basal cell carcinoma: The most common form of skin cancer. It grows slowly and rarely spreads.
Prime cause: UV radiation from the sun.
Who's most at risk: People who are fair-skinned with blond or red hair. Incidence increases with age.

• Squamous cell carcinoma: When this type arises it rarely spreads,
but treatment is required to prevent the possibility.
Prime cause: Frequent sun exposure.
Who's most at risk: Those who have had frequent sun exposure.

• Malignant melanoma: This potentially fatal skin cancer may spread and can invade lymph nodes and other organs.
Prime cause: Excessive sun exposure and blistering sunburns -- especially in childhood.
Who's most at risk: People who have many (more than 50) moles, an immediate family member with the disease and those with sun-sensitive skin such as redheads. If caught early, the five-year survival rate is almost 90 per cent.

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