Skin cancer

Richard McNutt, M.D., General Surgeon

Being outside and enjoying the sunshine it is part of what makes being “up-north” so unique – a blessing for all of us who live here. However, that sun carries with it not only light we can see, but light we can’t see called infrared radiation (IR) and ultraviolet (UV) radiation. When you look at a rainbow, you see red, orange, yellow, green, blue, indigo and violet. The light actually starts before the red, as infrared, and continues after the violet, as ultraviolet – we just can’t see those colors.

UV light has the ability to change the cells that make up our skin. The part affected is the DNA deep inside the cell: UV light can break DNA. I always thought DNA was this permanent thing that defined who we are. It turns out, DNA in our cells can be broken and repaired by our body’s natural defenses. Damage to DNA left unrepaired can lead to cancer; melanoma is one of those cancers.

Most health care providers are taught that avoiding sun exposure during high UV months is the most effective way to reduce our risk of developing melanoma. You can still go outside – just take reasonable precautions with sun exposure. The UV index may be useful in deciding how much skin to expose and for how long. This was developed in 1992 in Toronto, Canada.

There are also things that increase our risk of developing melanoma that may help you decide how much sun exposure you personally want:

  • fair complexion
  • skin that freckles but doesn’t tan
  • blue or green eyes
  • red or blond hair
  • history of many bad sunburns as a child or teenager
  • large moles or lots of little ones
All of these factors increase the risk of developing sun-related melanoma.

When I think about melanoma, I am reminded of the patients I have cared for with the disease, as well as friends and family who have dealt with this really nasty cancer. My younger brother was a mountain climber and spent quite a bit of time at high altitudes where the sun shines in a thin atmosphere and the UV index can be very high. He developed a malignant melanoma on his nose that required surgery and a skin graft.

The key to an improved outcome in treating melanoma is an early diagnosis. Prevent what you can, diagnose early, treat completely and follow up. The great part is that with melanoma – prevention, early diagnosis and follow up can be done at home. Look at your skin or have someone who loves you look at your skin on a regular basis. If you find something that wasn’t there before, get it checked out. There is an easy checklist that helps decide what is worrisome. Remember,
  • Asymmetrical
  • Border irregularity
  • Color variation
  • Diameter over 6 mm
  • Evolution
If there is something on your skin that isn’t round, has multiple colors, is wider than a pea or has grown, changed color or is new, then see your health care provider. I encourage people to take pictures of any areas that they wonder about and compare them over time. As far as treatment goes, surgical removal is the cornerstone. If cancer is the diagnosis, chemotherapy and immunotherapy are making advances that are improving survival rates.

Remember to take care when you enjoy the great outdoors, but do get out there and enjoy it. With care the risk is small and the benefits for both your physical and mental health are incredible

Contact Richard McNutt, M.D., General Surgeon at (920) 965-7411

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