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Health column: Location key for skin cancer

in Health

Location, location, location is the mantra of the real estate profession. But it’s also a key concept for skin cancer.

According to the American Cancer Society, 40 to 50 percent of Americans who live to age 65 will eventually develop at least one skin cancer. It’s by far the most common type. If skin cancer is not on your mind as you head outside this summer, it should be. But what does location have to do with it?

Location — Where you live: It’s pretty simple: the closer you live to the equator, the higher your risk of skin cancer. The number one risk factor for skin cancer is exposure to ultraviolet radiation and UV rays come primarily from the sun, which is strongest at the equator.

If you live or visit a high-risk area, you can lower your risk by protecting yourself from the sun. Stay inside during the mid-day hours when UV rays are at their peak. Wear protective clothing and a broad-brimmed hat to protect your head, face and ears. Apply sun screen with an SPF of 30 or higher every day, and reapply every few hours.

While the Northwoods is considered a low-risk area, the rules are the same – protect your skin. Ultraviolet rays are present and dangerous even on cloudy days.

Location — Where your ancestors lived: If your ancestors came from a northern climate such as Ireland, Scotland or Scandinavia, you probably have fair skin and maybe freckles. You may complain that your skin tends to burn rather than tan. And, in general, you have a higher risk of skin cancer – particularly if you live in a sunny place like Florida or Arizona for even a portion of the year.

Location — Where on your skin are cancers most likely? For nonmelanoma skin cancers, risk is directly correlated with cumulative exposure to ultraviolet radiation. The more time you spend in the sun over your lifetime, the greater your risk. That’s why many skin cancers develop late in life.

You may have noticed that freckles, sun spots and other skin blemishes that develop later in life appear mostly on skin that has been most exposed. These are also the locations where skin cancers are likely to develop: the face, scalp, ears, neck and hands.

Those are the places to absolutely protect against the sun. Be sure to apply sun screen daily to your face and hands. A baseball cap will cover your scalp but not your ears or neck. That’s why a broad-brimmed cap is recommended.

Most cancers that develop in these locations are basal cell and squamous cell carcinomas. They rarely kill. And when they spread, it is usually to nearby tissue.

But it’s important to remember that these are locations that also represent you to the world. A nasty skin cancer on your nose or ears can usually be removed but the treatment may leave behind an unsightly scar.

Location — How about melanoma? For melanoma, the most serious skin cancer, exposure to ultraviolet radiation is a risk factor … but in a less direct way. Frequent severe sunburns, particularly in youth, may pose a greater danger than cumulative exposure over a lifetime. As a result, the location of the cancer is not quite so easy to pinpoint.

For men, the highest risk areas are the upper back, chest and anywhere on the trunk. For women, the most common melanoma sites are the lower legs, back and arms.

In addition, there are numerous unexpected sites where melanoma can occur.

Both melanoma and squamous cell carcinoma may also appear on lips, inside of the mouth, nasal passages and genital tissues.

Other locations include the soles of the feet, the palms of the hand and the nail beds. African Americans and others with highly pigmented skin are relatively unlikely to develop skin cancers. When they do, however, the cancers may develop in these unexpected locations and are, unfortunately, more likely to go undetected.

All skin cancers, even melanoma, are treatable if detected and removed at an early stage. So it’s important to examine your skin on a regular basis and learn to recognize the signs.

There are many lesions on your skin and most are harmless. The cancer is usually the new guy on the block who appears out of the blue and doesn’t quite fit in with the others.

Map out all of the neighborhoods of your body and try to keep track of the spots, freckles, moles and other lesions. When a new one appears or if there is a change in an old one, it’s time to take action.

Regular self-skin exams or a yearly examination by a dermatologist is the best way to help people find early skin cancers. Ascension Medical Group at Westwood in Wausau is offering free skin cancer screenings during July. The skin cancer screenings will include a visual inspection of the skin and are provided at no charge during selected times, but space is limited.

To register or for more information, please call Ascension Nurse Direct at 800-362-9900.

Vijay Vanchinathan, MD, is a dermatologist with Ascension Medical Group at Westwood, 1901 Westwood Center Blvd., Wausau.  

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