If God had intended Caucasians (those of us with white skin)
to live in the tropics he would have given them dark skin.
Just look at the statistics. Australia has the highest incidence
of skin cancer IN THE WORLD. A third of Australia is in the
tropics (Tropic of Capricorn) and Australia is full of Caucasian
sun worshippers.
The fact is that pigmented skin, as well as commonsense,
both act as a protective mechanism against skin cancer. You
don’t see any Balinese lying on the beach sun baking
and when they do go to the beach, they are always wearing
broad-rimmed hats and long sleeved protective clothing. ….and
we think we’re smart! Laying prostate on the beach at
midday is about as sensible as taking a bath in a tub full
of enriched uranium – they are both highly CARCINOGENIC
(cause cancer).
The concept of having “a tan” has (in the past)
been equated to a certain lifestyle: a symbol of easy living,
and a life of living on sun drenched sands. How well you enjoyed
your tropical holiday could be judged by the shade of your
tan; all very well so long as you don’t mind succumbing
to a deadly melanoma a little later on in life.
So just how prevalent is skin cancer in Caucasians? Well,
it’s very hard to say but the main risk factor affecting
skin cancer (S.C.) is how long you have lived in the sun.
Referring to Australia again, 1 in 3 Australians will develop
skin cancer, most of these however are Caucasians who have
lived in Australia most of their lives. In other words, if
you were born in some dreary place where it is overcast and
rains most of the time (like England!), then moved to Australia
at age 30, you are much less likely to get S.C. than someone
born and bred in Australia. It is a fact that farmers who
have spent all their life in Australia have a near 100% chance
of developing S.C.
The good news is that the majority of skin cancers won’t
actually kill you (not immediately any way!). Sure, you might
loose part of your nose or face but what the heck you can
still go to the beach!
Basically there are 3 types of skin cancer:
Basal Cell Carcinoma (B.C.C.) - the most common form of skin
cancer and certainly the easiest to treat.
Squamous Cell Carcinoma (S.C.C.) - this one is easy to treat
if detected early, but it can kill you if you ignore it.
Malignant Melanoma – this is the most dangerous form
of skin cancer will DEFINITELY kill you if you do nothing.
The main predisposing factors that cause S.C. relate to the
FIRST TEN YEARS OF LIFE. So chances are that for most of you
reading this article, it will be too late to avoid early life
sun exposure. For the sake of your children however it would
be worth noting the following factors that will put you (or
your children) in a higher risk bracket:
1. Skin color -the fairer you are, the more chance of SC
developing later in life.
2. Blistering and burning - laying in the sun and getting
burnt or worse still blistering is like having a picnic on
the grass outside the Chernobyl reactor on the day of the
meltdown. The sun is a form of radiation just like a nuclear
reactor.
3. A family history of S.C. - if your mother or father had
S.C. then your chances of getting one are greater; at this
stage however no one knows exactly how much greater.
Some tips on how to lower your risk for skin cancer are:
1. Intermittent sun exposure. Going to the beach every day
for say 20 minutes is actually safer than going for a big
burn once a month.
2. Avoiding direct sun exposure between the hours of 11am
and 3pm when sunlight is most intense.
3. Wear a sun block whenever you or your children are out
in the sun. Remember that this does not necessarily mean going
to the beach. Sporting activities are also a time of increased
and prolonged exposure. Remember to reapply every 3 hours
especially where there is high humidity (as in Bali) or after
swimming.
What do skin cancers look like?
This is a very good question. I thought that as a health conscious
person, and having been made aware of skin cancer detection
(courtesy of the Australian Governments massive public awareness
programs), that I would know a skin cancer when I saw one.
Not so! I think most of us would expect a skin cancer to be
a spot or a mole that changes size or color, and bleeds or
becomes irritated in some way. This, in many cases is true,
however I have seen a great deal of cancerous skin lesions
that did not fit this description at all, in fact some that
I have seen looked completely harmless, without pigment (color),
and certainly not the large fungating growths that we expect
to see. Often the patient may complain only of local irritation,
with a slight skin discoloration. On the other hand, I have
seen large, hairy, bleeding brown barnacles that have turned
out to be nothing but an over large sun spot (keratosis),
and have needed no treatment at all. I guess the lesson in
this is to leave the diagnosis up to the experts. Diagnosis
is relatively simple, and often an experienced practitioner
in this field will know just by looking at the spot, or they
may take a biopsy (small sample of skin) to confirm the malignancy
(or absence of).
How are skin cancers treated?
Treatment will depend entirely on the type of skin cancer.
Many small B.C.C.’s, S.C.C.’s, or other pre-cancerous
lesions (not quite cancer yet, but are considered a risk),
may be removed with liquid nitrogen, laser or minor skin surgery.
Malignant melanomas on the other hand are a different story.
This type of skin cancer has roots that lay deep under the
skin, and will require a large area and depth of skin as well
as muscle tissue to be removed. If there is lymph involvement,
the glands may also need to be removed, and chemotherapy or
radiotherapy may also be necessary. Not a nice thought at
all. With this in mind, there is not one of us that can exempt
our selves from skin cancer screening….when was the
last time you had a good look at the back of your neck or
shoulder blades to see what may be growing there?
So for all of us that like going to the beach, the best thing
we can do to prevent skin cancer is in the form of an annual
skin check preferably with a doctor familiar with skin cancer
diagnosis and treatment, who can reassure you that the hundreds
of little black spots you have aren’t going to turn
into malignant melanomas. That’s all for now, until
next edition, stay happy, stay healthy and don’t forget
your sun screen!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
