Skin cancer is nasty stuff to deal with. Volatile, unpredictable, and only sometimes treatable. We have written on this issue previously but feel as though there is no amount of education on the topic that is too much. Because of this, we are bringing this piece to TSLMS members, as well as the general browsing and reading public. What is important about this piece is that it is a guide that will help people living in different climates to take more precautions based on their risks associated with where they live. 

 

Skin Cancers Impact

In our previous piece on Helping Your Patients Cope With Skin Cancer we wrote:

One of the worst things that a person can find out is that they have cancer. The National Cancer Institute has cataloged the ten most common emotions that people feel when they get this news. Among them are: anger, fear, guilt and loneliness. Some people report feelings of hope. If they survive they usually feel gratitude. Generally speaking, in the wake of a cancer diagnosis, many people are afraid they are going to die. The hard truth is that between 35 and 40% of the population will be diagnosed with cancer at some point in their lives. (Source). The good news is that survival rates are high, with up to 70% of those diagnosed go on to live healthy lives. There were close to 100,000 cases of skin cancer diagnosed in 2018 in the US, and close to 13,500 deaths from the same. (Source).

The impacts of a skin cancer diagnosis have broad ripples across the individual’s physical and mental health and finances, as well as that of their family and friends. These impacts extend out to their employers and communities, too. In fact, according to the American Academy of Dermatology Association:

• About 4.9 million U.S. adults were treated for skin cancer year from 2007 to 2011, for an average annual treatment cost of $8.1 billion.2
  • This represents an increase over the period from 2002 to 2006, when about 3.4 million adults were treated for skin cancer each year, for an annual average treatment cost of $3.6 billion.2
• The annual cost of treating nonmelanoma skin cancer in the U.S. is estimated at $4.8 billion, while the average annual cost of treating melanoma is estimated at $3.3 billion.2
• Researchers estimate that there were nearly 34,000 U.S. emergency department visits related to sunburn in 2013, for an estimated total cost of $11.2 million.

These numbers are staggering and should be enough for everyone to start paying more attention to what can be done to prevent skin cancers.

 

Skin Cancer 101

Very briefly described by the Skin Cancer Foundation, skin cancer is “out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The main types of skin cancer are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), melanoma and Merkel cell carcinoma (MCC). The two main causes of skin cancer are the sun’s harmful ultraviolet (UV) rays and the use of UV tanning machines.”

These UV rays are delivered to earth in several different wavelengths: UVA, UVB and UVC. As noted by the Food and Drug Administration (FDA), these are all forms of energy that, like most light (energy), is invisible to the naked human eye and is measured on the electromagnetic spectrum and can penetrate the skin causing photoaging and skin cancers.

The most common form of UV radiation is sunlight, which produces three main types of UV rays:

• UVA
• UVB
• UVC

UVA rays have the longest wavelengths, followed by UVB, and UVC rays have the shortest wavelengths. While UVA and UVB rays are transmitted through the atmosphere, all UVC and some UVB rays are absorbed by the Earth’s ozone layer. So, most of the UV rays you come in contact with are UVA with a small amount of UVB.

Like all forms of light on the EM spectrum, UV radiation is classified by wavelength. Wavelength describes the distance between the peaks in a series of waves.

• UVB rays have a short wavelength that reaches the outer layer of your skin (the epidermis).
• UVA rays have a longer wavelength that can penetrate the middle layer of your skin (the dermis).

UVC radiation is the most damaging of all, but luckily is filtered out entirely by Earth’s atmosphere and so it does not reach the ground or impact people. 

 

Who Is Most Impacted By Skin Cancer

So are all people everywhere in the world equally as affected by UV radiation? Or are some of us safer than others? The World Health Organization (WHO) actually tracks this and has published information based on scientific data collected that shows the season and latitude ranges for UV radiation across the world. They call it the UV index. That guide can be used by anyone anywhere to understand if they are at greater or lesser risk of significant UV radiation. 

South America holds the record for the strongest UV rays measured in a spike that occurred due to a unique environmental factor in 2003. (Source). Washington DC, Alaska, and Texas have the lowest melanoma rates according to a piece published by the Weather Channel; whereas Delaware, Utah and Vermont have the highest. Tennessee, where we hail from, falls into the high mid-range.