Our skin, the largest organ that we possess, plays a critical role in how we interact with the world around us
Everyone knows that first impressions are important. So what are some of the first things people notice when they meet you? Our skin allows us to take in beneficial compounds from our environment while protecting us from all the harmful compounds surrounding us. Even as early as infancy, skin contact between parents and their newborns is essential to set regular physiological homeostasis. Due to its essential role in our health and wellbeing, and its constant exposure to the elements, we hope to highlight the importance of skincare and ways in which we can maintain healthy skin.
What is skin cancer, types of skin cancer, what increases the risk of skin cancer?
Although regular sunlight exposure is essential for our health, too much exposure without the proper protection can lead to severe UV damage and eventually skin cancer. There are many different types of skin cancer with varying pathologies of disease and drastically different patient outcomes. Over 80000 cases of skin cancer are diagnosed in Canada every year. Most skin cancer diagnoses are classified as basal or squamous cell carcinomas (1). These types develop on areas of the skin that have had a high frequency of exposure over your lifetime, such as the head, neck, and shoulders. Due to carcinomas developing later in life and often much slower than aggressive subtypes, patients will have a better chance of detecting and resecting cancer with surgery and having positive clinical outcomes. Unfortunately, approximately 5% of the population receiving a cancer diagnosis will have a much more aggressive and dangerous type of skin cancer, malignant melanomas. Unlike the other types of skin cancer, melanomas often develop very quickly, aggressively, and randomly on the body. Fortunately, when detected early, the 5-year survival rate for melanoma is 99% (1).
The best way to lower the risk of any skin cancer is to prevent prolonged exposure to the sun. Health Canada provides specific cautions regarding the period between 11 am and 3 pm when the UVB index is most intense. Regardless of the type of cancer that may develop, the impact of sun exposure on human skin has been comprehensively investigated by the scientific community. Although critical to bone health and metabolism, UVB rays can disrupt the organization and packing of DNA inside our cells (2). Regardless of current fitness level, diet, or predisposing genetic factors, sustained exposure to the sun will increase your risk of developing skin cancer. For this reason, tanning beds have also come under scrutiny in the past few years, and oncologists often urge the public that there is no such thing as a healthy tan (3).
How to detect skin cancer?
Due to the inevitability of experiencing UV exposure daily, it is essential to take the proper steps to limit our risk of developing skin cancer. Early cases of skin cancer can often appear as sun spots, moles, or any type of abnormal growth observed on our skin (3). While these blemishes are often harmless, it is important to closely monitor them for any changes that might be an indication of a more severe pathology. The ABCDE approach (4) outlines some key factors to consider when examining your skin for blemishes that could be early signs of skin cancer:
- The blemish is asymmetrical
- The borders are uneven, scalloped, or notched
- The blemish has many different shades or colors
- The blemish has a diameter greater than 6mm
- The blemish is evolving or changing in color, size, shape, or heigh
If you see any of these warning signs on your skin, visit your health care provider as soon as possible for further screening and management.
To give yourself the best chance of detecting cancer early, we recommend leveraging the new technology of liquid biopsy cancer screens. While the typical ABCDE can be conducted every day to actively search for signs and symptoms, circulating-tumor DNA (ctDNA) tests go straight to the molecular level and have much greater sensitivity to detect early signs of skin cancer. While cancer is often only thought of in a clinical setting via a diagnosis, our immune system functions daily to protect our bodies from developing spontaneous cancer growths (5). A ctDNA test scans for traces of cells that were killed before they had the chance to develop into a clinically defined cancer. Therefore this technology allows us to pick up traces of cancer cells long before a specific diagnosis, creating the best opportunity for a positive outcome.
Frequency of screening for safe skin
With different strategies available to prevent and screen for cancer, the most powerful factor in a cancer diagnosis is time. Being able to learn the self-guided ABCDE protocol in combination with physician-guided cancer screening technologies allows for the strongest defense we have against skin cancer.
Dr. Rohan Bissoondath,