We only have one skin, a unique, delicate, valuable and irreplaceable suit. It must last us a lifetime and, therefore, we have to exercise extreme care. Coinciding with the European Skin Cancer Prevention Day -June 13-, Quirónsalud specialists help us to delve into this disease and how to avoid it.
In a few days we will inaugurate the summer. After months of work, schedule and movement limitations, it is time for many to rest, go out and relax. Also, to sunbathe and, with it, to expose oneself to the dangers that this entails. Because while we recharge with energy and activate vitamin D, our skin suffers and we run the risk of suffering from one of the most frequent cancers.
“The diagnosis of skin cancer increases year after year due to inappropriate sun exposure habits,” says Dr. Josep González Castro, Specialist in Medical-Surgical Dermatology and Venereology, Director of IDERMA, Dermatology service of the Dexeus University Hospital in Barcelona. We talk about both melanoma and non-melanoma cancers. According to data from the AEDV (Spanish Academy of Dermatology and Venereology), more than 78,000 new cases of skin cancer are diagnosed annually in Spain, almost 95% belong to non-melanoma skin cancer (basal cell carcinomas and squamous cell carcinomas), with approximately 75,000 new affected each year. For its part, the incidence of melanoma – the rarest but with the greatest potential for aggressiveness – is 9.7 per 100,000 people per year (which represents around 4,000 new cases).
More than 78,000 new cases of skin cancer -melanoma and non-melanoma- are diagnosed annually in Spain
“The good news – points out Dr. González Castro – is that thanks to the new advances it is possible to detect them in time and that the chances of cure are greater. Despite the increase in the number of skin cancer cases in Spain, mortality from this disease has stabilized. A fact that could also be due to a greater awareness on the part of the population regarding the importance of early diagnosis ”.
Types of skin cancer
Non-melanoma skin cancer is the most common and is caused by a mutation in the DNA of cells found in the epidermis, the most superficial layer of the skin, and can be of two main classes: basal cell carcinoma, the most common form. common, and squamous cell carcinoma.
Dr. Jose Carlos Pascual, dermatologist at the Quirónsalud Torrevieja hospital, explains that the real incidence of these cancers is very difficult to determine since, as they are pathologies with high cure rates “when treated early and appropriately”, in many cases are not registered.
Melanoma is the least common but most aggressive tumor
For its part, the origin of melanoma is in the melanocytes of the epidermis, the cells that produce the brown pigment that gives the skin its color. It is a rare but much more aggressive skin tumor “since it can spread to other parts of the body through the blood or the lymphatic system,” says Dr. González Castro. “Melanoma can be treated successfully in its early stages, but it is difficult to cure once it has metastasized,” he continues.
Causes: The dark side of the sun
Regarding risk factors, in all pathologies the main factor is “chronic or intense exposure to ultraviolet radiation”, explains Dr. María Calvo Pulido, Head of the Dermatology Service of the Ruber Juan Bravo hospital complex. Therefore, both melanoma and non-melanoma cancers appear in photo-exposed areas of the body, mainly the face, décolleté, back or arms. Other factors such as the phototype, presence of moles, hereditary factors, immunosuppression or age, among others, also influence, but without a doubt “the best prevention is sun photoprotection from childhood, avoiding sunburn”, highlights the specialist.
The sun is an essential source of vitamin D but it is convenient to know what is the appropriate exposure time so as not to damage our skin
The sun is the main source of vitamin D in the body and, therefore, doctors agree that moderate sun exposure is necessary to maintain good health, but the appropriate “amount” is always less than you think ”, Says Dr. González Castro. While Dr. Calvo Pulido points out that “a daily exposure of between 8-15 minutes would be enough to generate the dose of vitamin D that your body needs”, Dr. Pascual states that “sun exposure of the back of the arms and the hands for about 30 minutes would be enough ”. The truth is that there is “some controversy” on the subject and the minutes of exposure would vary depending on “our phototype, the season of the year and the time slot in which we are,” says Dr. González Castro referring to the tables prepared by the AEDV. In the following, in particular, the recommendations for the general population are collected in order that they can obtain the benefits of the sun without health risks.
In addition, it is important to make people aware of the use of sunscreen with appropriate filters for our skin type, glasses and hat and, of course, of the need to “frequently self-examine the skin in search of new lesions and go periodically to the dermatologist for a dermatological review, especially of spots, moles and warts ”, continues Dr. González Castro.
Along with prevention measures and early diagnosis, treatment is key when it comes to controlling this disease. “Surgery”, explain the three dermatologists, is at this time the most appropriate and effective treatment for melanoma and non-melanoma skin cancer. “At IDERMA we apply the most advanced, minimally invasive and plastic-resconstructive surgical techniques, such as Mohs Surgery”, although in some cases it is also necessary to “start a complementary pharmacological treatment exclusively or also associated with radiotherapy”, explains Dr. González Castro. “Radiation therapy, chemotherapy and, more recently, immunotherapy” are also used in the more aggressive cases of squamous cell carcinoma, although rare, says Dr. Pascual. For basal cell carcinomas “there are topical cream treatments, which are modifiers of the immune response, light treatments and photosensitizing drugs such as photodynamic therapy and for cases of more advanced or inoperable disease there is an inhibitor of a signaling pathway (via Hedgehog) abnormally activated in basal cell carcinoma ”, Dr. Calvo Pulido tells us.
As we can see, although both groups of cancer, melanoma and non-melanoma, are tumors developed in the skin and are closely linked to sun exposure, the truth is that they differ both in characteristics and in treatments. For this reason and, taking advantage of the European Skin Cancer Prevention Day, Quirónsalud specialists help us to delve into these pathologies, how to avoid and treat them.
Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.