SALT LAKE CITY — A woman with a mole that makes her nervous, a jogger concerned about sunlight's effects on his skin and a man with a history of skin cancers who's trying to prevent more were among callers to Saturday's Deseret News/Intermountain Healthcare Hotline on skin cancer.
Topical creams may be prescribed for precancerous lesions, said Dr. Jason Hansen, a dermatologist at LDS Hospital and Intermountain's Memorial Clinic. His caller was curious if it could also reduce his risk of getting more skin cancer. Hansen told him it might, indeed, have some preventive value.
Dr. Brad Rasmussen, dermatologist at the Salt Lake Clinic and LDS Hospital, said the sun is most likely to damage skin between 9 a.m. and 5 p.m., during hot summer days, and skin protection such as a 30-plus SPF sunblock should be used. But he noted that while sun exposure is a very common cause of skin cancer, it's not the only factor. Genetics determines what type of skin you have and how well your DNA repairs when it's been damaged or how you fight off cancer cells, for example.
Prevention is essential. But so is checking your skin to look for signs of trouble. That means not only examining the face, hands, legs and other parts of your body that are readily visible, but using a mirror to see the rest or asking someone for whom it would not be awkward to look.
The recommendation is for a baseline examination by your family doctor or a dermatologist around age 20. The expert can then, based on your skin qualities, give you some idea of when you should be checked again as a routine screening. "Oh, you're fairly dark skinned and don't have many moles, so come back in five years," as Rasmussen put it. Experts may advise patients to come back yearly.
Anything that causes concern, though, should be checked immediately. Skin cancer is most curable when it is detected early. Dermatologists teach the ABCs: Asymmetry, Borders that are irregular, Color that varies and Diameter larger than a pencil eraser. The E has a double whammy: Elevation and Evolution. Either could be worrisome.
Rasmussen said that most worrisome skin issues can be resolved in a dermatologist's office, where the doctor can just remove it. The tissue is then sent for biopsy and to see, in cases where cancer is detected, whether they got a clear margin around it so only healthy tissue remains. Absent that margin, a patient might need to come back to have more tissue removed.
More complex cases are referred to a doctor like Hansen, who specializes in a type of skin cancer surgery called Mohs.
One caller asked about radiation. It is seldom used for skin cancer, said Hansen. Cutting the skin cancer out is typically the best treatment.
The hotline tackles a different topic the second Saturday of each month.