Dr. Katie Beleznay

Vancouver Skin Care Specialist

Dr. Katie Beleznay is a leading dermatologist specializing in the latest treatments to repair and rejuvenate the skin

May is Skin Cancer Awareness Month

For the month of May the goal is to increase awareness around skin cancer.  Skin cancer is the most common type of cancer, but also one of the most preventable forms of cancer. So by raising awareness of the dangers of unprotected sun exposure and encouraging sun-safe habits, the goal is to help prevent skin cancer in the first place and also review how to screen your skin and find any worrisome spots early.

I had an opportunity to share some thoughts on the topic with CBC News in Vancouver:

Below is more detailed information on types of skin cancer, how to detect it, and how to prevent it.

 What is skin cancer?

Basal cell carcinoma is the most common form and accounts for 90% of all skin cancers. It is caused by long-term exposure to sunlight. It is the most easily treated.

Squamous cell carcinoma (SCC) is the second most common type. It is easily treated when found early, but in a small percentage of cases, this cancer spreads to other parts of the body.

Melanoma is the most serious type of skin cancer and is responsible for the most deaths. However, it can be cured if it is diagnosed and removed early. Melanoma can develop from a pre-existing mole that appeared normal but changes, or as an irregular appearing new spot. Over 7,000 people were diagnosed in Canada with Melanoma in 2017. Melanoma causes more than 1200 deaths in Canada every year. Melanoma is also one of the most common and deadly types of cancer in young adults 15 to 30 years old. Early diagnosis is the key to positive outcomes. 

How common is skin cancer?

Skin cancer is the most common type of cancer. Over 80,000 cases of skin cancer are diagnosed in Canada each year, It is also one of the most preventable because the most common contributor to skin cancer is overexposure to ultraviolet radiation such as from sun and artificial tanning beds. The rates have been steadily increasing over the previous years. In fact Canadians born in the 1990s have 2-3x higher lifetime risk of getting skin cancer (1 in 6) than those born in the 1960s which is about 1 in 20. Today approximately 1 in 5 people will develop skin cancer.

What does melanoma look like?

Melanoma can start as a new, brown or black spot on the skin's surface. It can also begin as a change in the shape or colour of an existing mole or coloured spot. Melanomas tend to be dark in colour — browns and blacks — although some are a mixture of colours including red, blue and white. They will typically grow and change, so the key is to look for change

What causes melanoma?

There are various factors that contribute to the development of melanoma, but excessive exposure to ultraviolet radiation, so sunlight and tanning beds is the main reason for the development of this type of skin cancer. Severe, blistering sunburns especially in childhood are thought to play an initiating role. However, sunburns at any time during life can also increase the risk. Indoor tanning is also a known risk of melanoma.

Who is at highest risk?

Fair skinned people (so those with freckles, blond, red hair, blue eyes) with skin that burns rather than tans are more likely to get this disease. Those with many moles (more than 50), or moles with an unusual colour or shape, or with large moles, have an increased risk. A close family history of melanoma is another risk factor. However, people with no risk factors at all may still get melanoma.

Where does it often appear?

Melanoma appears most commonly on the backs of men and legs of women. However, it can appear anywhere on the skin surface or in the mouth or eyes or palms and soles.

How do you prevent skin cancer?

Avoid the sun from 10 am to 4 pm (or during the most intense times of sun exposure) and protect yourself if you are outside during these times by seeking shade, covering up with clothing and wearing a wide brimmed hats.  Also don’t forget to use a protective lip balm with SPF.

Wear a broad-spectrum sunscreen with a minimum SPF of 30. Apply before you leave the house and reapply every two hours or more frequently during strenuous exercise or after swimming.

You can also look for the Canadian Dermatology Association logo on sunscreen products to ensure the product you are using is safe and effective.

Avoiding the use of indoor tanning beds will also reduce your risk of melanoma

Regular skin checks are important.  Have someone help check areas like your back and scalp.  Skin cancer can show up on parts of your bodies that are not always exposed to the sun, so even be sure to check the bottoms of your feet. Examining your skin on a regular basis can lead to early detection, treatment and in most cases, positive outcomes. 

Why should people check their own skin?

People are very successful at detecting melanoma on their own skin or that of a family member. Research shows that >half of melanomas are discovered by the patients themselves and a further 17% by their family members.

Checking your skin and detecting melanoma early can lead to a 90% cure rate. Melanoma has one of the highest cure rates if found early.

A skin self-exam is simple and takes only 10 or 15 minutes once per month.

Recent research shows those at risk for melanoma who had a friend or family member help with checking the skin found the disease at a much earlier stage and had a 63% lower death rate compared to those who did not check their skin.
 

What do you look for when examining your skin for melanoma? A-B-C-D-E

Asymmetry:

The first way to check a mole is by its shape. If you were to draw a line down the middle of your mole, and one side looks different than the other, you should ask your doctor to check it as it is asymmetrical

Border:

Another way to detect an abnormal mole is to look at its borders. If the borders of a mole are uneven and not smooth this is more suspicious.

Colour:

Healthy moles tend to be one uniform colour.  Having a mole with a variety of colors is a potential warning signal. A number of different shades of brown, tan or black could appear. A melanoma may also become red, white or blue.

Diameter:

The diameter (or size) of a mole can also signal you to ask your doctor to check it. A general rule is if the mole is larger than a pencil eraser (which is about 6 mm) there is a higher chance it is suspicious.

Evolution:

Evolution means to watch for changes to the mole over time. Moles sometimes change in size, colour, or shape. There may be other symptoms of change like itching, tenderness or bleeding. So if something is evolving or changing, it’s time to get it checked.

“The Ugly Duckling Rule” is another good rule to look for. You are looking for a change in a specific mole, but also how it compares to the moles around it.  Essentially you are looking for ‘outliers’ spots that are bigger, darker or irregular in any way compared to other spots”