Preventing skin cancer: Advice for before, and after, sun damage occurs

It’s estimated that 20% of the U.S. population will develop skin cancer at least once in their lifetimes. What if there were a way to prevent certain skin cancers even after sun damage had occurred? Specialists at MUSC Hollings Cancer Center want to educate patients about the options available to them.

Joni Mazza, M.D., an MUSC Health dermatologist and skin cancer specialist, said catching skin cancers early, or before they form, is important. “We are seeing more and more people being diagnosed with skin cancer at a young age,” she said. “We don’t know if that is because of tanning bed use or increased exposure to sunlight, but it is definitely a concern.”

The best ways to prevent skin cancer are to use the correct sunscreen, wear protective layers like a hat and to limit your exposure to sunlight. Living in the Lowcountry, Mazza understands outdoor activities are a way of life. Even after sun damage has occurred, she said there are nonsurgical options available to patients to help to prevent certain types of skin cancer from forming.

“One of the treatments that a lot of people don’t know much about is called photodynamic therapy,” she said. “It involves the use of a topical solution that is activated by light, which causes it to target and kill precancerous cells.”

Photodynamic therapy (PDT) can be an especially important tool for patients at a high risk for skin cancer or those with a direct or family history of having skin cancer. The treatment is approved by the Food and Drug Administration for use on the face and scalp. Patients have a liquid treatment applied to the area of concern and then wait between 20 minutes and up to two hours before going under a blue light machine.

“Precancerous cells lose some of the properties that a normal skin cell has,” Mazza said. “The mixture used during PDT targets these abnormal cells and gets absorbed. Once the liquid is exposed to light, it is activated and the precancerous cells that have absorbed it are killed.”

Mazza said the precancerous cells targeted in the treatment could turn into squamous cell carcinoma if left untreated. Squamous cell skin cancers can appear as a firm, red bump or a flat sore that feels scaly. Mazza said these, unlike typical sores, will not go away on their own.

Squamous cell and basal cell are the two most common types of cancer. The deadliest form of cancer is melanoma, which is the third most common type of skin cancer diagnosed.

“Basal and squamous cell skin cancers tend to be less aggressive than melanoma, but they can still cause a lot of local tissue damage that can cause disfiguration,” she said. “Just because they are less aggressive doesn’t mean they are less serious.”

In addition to PDT, patients at high risk of skin cancer can use topical chemotherapy agents like fluorouracil cream or imiquimod creams, which also are absorbed by abnormal skin cells and kill them.

Multidisciplinary approach to skin cancer

Mazza said Hollings and MUSC Health offer patients what few others in the state can – a team consisting of every specialist needed to diagnose and treat skin cancer in a single location. “We have dermatologists to check patients for skin cancers. We also have surgeons and specialists to treat skin cancer no matter the type or stage.”

 

Mohs surgery can be used to treat basal and squamous cell and melanoma. Surgeons remove thin layers of skin affected by cancer, ensuring that surrounding tissue is spared, until only cancer-free tissue remains. If reconstruction is needed after Mohs surgery, the internationally recognized reconstructive team at MUSC Health can often complete it the same day as surgery.

For patients with melanoma, Hollings’ Jenny Sullivan Sanford Melanoma & Skin Cancer Program offers hope for a life in remission. The center has been designated a Melanoma Center of Excellence by the Melanoma Hope Network – one of the first 14 programs in the nation to receive the designation.

Hollings specialists were the first in South Carolina to administer T-VEC treatment for melanoma. During the treatment, medication is injected into melanoma spots that are on or beneath the skin or in lymph nodes. The targeted and precise treatment then multiplies quickly inside the tumor, causing the tumor to burst. This triggers the body’s immune system to recognize the tumor cells and kill them.

Mazza said advancements in skin cancer research have led to a number of ways that doctors can treat skin cancer. She said it is important for patients to know about their options and to be aware of any suspicious spots on their bodies. She encourages patients to reach out to trained specialists if they have a spot on their skin that they are worried about. Patients are encouraged to be screened annually. Patients deemed high risk should be screened every six months.

“It’s important for patients to know that you can get skin cancer anywhere on your body, whether that area has been exposed to direct sunlight or not,” she said. “We have had patients that were diagnosed with melanoma in their mouths or eyes. We’ve had skin cancer cases on the buttocks and the bottom of the foot. The most important thing someone can do is to monitor changes to their skin and seek medical attention if they are concerned.”

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