En español l Even superheroes aren't immune to skin cancer. Popular X-Men actor Hugh Jackman made headlines in May when he posted a photo on Instagram showing a bandage on the right side of his nose. To make sure everyone got the message, he wrote: "Another Basal Cell Carcinoma ... PLEASE! PLEASE! WEAR SUNSCREEN!"
It was the second bout of skin cancer for The Wolverine star, whose big-screen healing powers apparently weren't enough to prevent the disease. And he was recently treated a third time in October 2014. Jackman is not alone: About 1 in 5 Americans will be diagnosed with skin cancer in their lifetime, making it the most common form of cancer in the nation.
Despite all of the information about skin cancer, including the dangers of soaking up the sun and using tanning beds, diagnoses are on the rise. A 2014 study published in the journal Mayo Clinic Proceedings found that the incidence of skin cancer increased almost eightfold between 1970 and 2009 among adults ages 40 to 60.
To reduce your risk, here are nine things you need to know about skin cancer.
1. Your past could catch up with you
Ladies, you may be good about putting on sunscreen now, but if you had at least five blistering sunburns between the ages of 15 and 20, you have an 80 percent higher risk of developing the most deadly form of skin cancer, melanoma, in your 40s to 60s. Researchers at Brown University and Rhode Island Hospital analyzed data on nearly 109,000 nurses, all Caucasian, in 14 states who were followed for 20 years. The study, published in May, found that those who were badly sunburned in early adulthood had a 68 percent higher risk for slow-growing skin cancers — such as basal cell carcinoma and squamous cell carcinoma. So if you had a history of sunburns back in the day, you need to be even more scrupulous about using sunscreen and checking for suspicious growths now.
2. More men are getting melanoma
Up to 50 percent of Americans over age 65 will be diagnosed with at least one form of skin cancer, according to the National Cancer Institute in Maryland, and men have seen their melanoma rate increase the most of any age group over the past four decades. A 2013 study published in the Journal of Clinical Oncology found that the deaths of older men from melanoma more than tripled.
Medical oncologist Patrick Ott of the Dana-Farber Cancer Institute in Boston, an assistant professor at Harvard Medical School, believes that the cumulative impacts of sun exposure combined with low sunscreen use have contributed to the increased rates of melanoma in older adults. "It takes years, sometimes decades, for cancer to develop," Ott explains. While rates in older adults are on the rise, it's not too late to reduce the risks. He advocates limiting sun exposure, slathering on sunscreen with a minimum sun protection factor (SPF) 30 and wearing protective clothing, including long-sleeved shirts and wide-brimmed hats.
3. People of color are susceptible to one particularly deadly form of skin cancer
It's the skin cancer that killed famed reggae singer Bob Marley, and it's not related to sun exposure. Called acral lentiginous melanoma, or ALM, it is the most common melanoma diagnosis among African Americans, Asians and Hispanics, and typically strikes people in their 60s. ALM is often mistaken for a bruise, wart or nail fungus — in fact, Marley initially thought he just had a bruised toenail. It often appears in areas where it can go undetected, such as the soles of the feet, between fingers or under toenails and fingernails. "If you have dark pigmented skin, it can look like a normal variant," explains Maral Skelsey, director of dermatologic surgery at Georgetown University Medical Center in Washington, D.C.
While awareness is key, Skelsey notes, "there is nothing you can do to reduce your risk [of ALM]." She recommends making an appointment with your dermatologist for regular skin checks and getting any new spots or changes to existing pigment checked immediately.
4. Alcohol increases your risk
You'll have a lower risk of malignant melanoma if you trade that bottle of beer for a bottle of water. A literature review published in the February 2014 issue of the British Journal of Dermatology found that drinking more than a pint of beer or a glass of wine per day increased the risk of melanoma by 20 percent; the more alcohol you drink, the higher the risk is, according to lead researcher Eva Negri. "Sun exposure, and particularly sunburns, is the key factor for melanoma, [and] alcohol consumption increases susceptibility to sunburn," Negri says.
It appears that alcohol reduces the immune response to UV radiation, leading to increased cell damage and the formation of skin cancer. The other problem with drinking in the sun: If you're tipsy, you're also less apt to remember to reapply sunscreen.
5. Don't forget your feet
Skin cancer can be sneaky. While a mole that pops up in a conspicuous place such as your nose or forearm might catch your attention, a cancerous spot can also start on the soles or top of your feet, where they are harder to see. Research published in the Journal of Foot and Ankle Surgery found that the five-year survival rate for melanoma on the foot and ankle was 52 percent — compared with 84 percent for melanoma found elsewhere on the body — because the signs are difficult to spot. "Even if you examine your skin carefully, there could be areas that are hard to see," says Georgetown's Skelsey.
Those who live alone and don't have a spouse to check for rogue moles are at increased risk. A 2014 study looked at more than 27,000 melanoma patients between 1990 and 2007 and found that men living alone were significantly more likely to die from melanoma — probably because their melanoma was diagnosed at a later stage of the disease, researchers said.
6. The little blue pill could cause big problems
A study published in the April issue of the JAMA Internal Medicine found that men who take Viagra could be at increased risk of melanoma. Researchers found that men currently taking the erectile dysfunction drug had an 84 percent higher risk of developing melanoma than men who aren't. Men with a history of taking Viagra had almost double the risk of developing this form of skin cancer than those who had never used the drug — possibly because the drug affects the BRAF gene, which is associated with more invasive melanomas.
But that doesn't mean men should think twice about using these drugs, says dermatologist June K. Robinson, a research professor at Northwestern University's Feinberg School of Medicine in Chicago. She notes that the study didn't specify the dosage of Viagra medication or how long it had been used. Instead, she advises men using Viagra to take extra care in protecting their skin and to get annual preventive skin cancer screenings. Any new or changing moles should be checked out immediately, she adds.
7. Hispanics are a high-risk population
Over the last two decades, the incidence of melanoma among Hispanics has increased almost 20 percent, according to the New York-based Skin Cancer Foundation. Research shows that 1 in 3 Hispanics has sunburned in the past year and more than 43 percent reported "never" or "rarely" wearing sunscreen. "There is a belief that [Hispanics] are not at risk, and so there is less evaluation of them," explains Maritza Perez, associate professor of clinical dermatology atMt. Sinai Icahn School of Medicine and senior vice president for the Skin Cancer Foundation.
A lack of health insurance or poor access to health care also can contribute to the problem. Just 1 in 14 Hispanic adults reports having a skin cancer screening compared to 1 in 4 Caucasian adults, according to researchers at the Cancer Institute of New Jersey. As a result, "Hispanics are diagnosed at more advanced stages and have a poorer prognosis and survival," Perez explains. To increase awareness, the Skin Cancer Foundation launched CancerdePiel.org, a Spanish language site with information about the importance of skin cancer prevention.
8. Let the doctor check your birthday suit
Don't be bashful. Those who get their skin checked regularly for any suspicious moles or spots have a lower death rate, because their cancer can be detected in its earliest, treatable stage. Researchers at Henry Ford Hospital in Detroit studied patients (whose average age was 60) and found those who were diagnosed with melanoma between 2001 and 2007 and who saw their doctors at least once in the five years prior to their diagnosis had death rates 70 percent lower than patients who didn't see their doctors.
"A regular mole, if it's not recognized in time, can grow and the cancer can spread and become a lot more deadly," says Harvard's Ott. During an exam, your doctor will look for new moles or moles that show the "ABCDE" signs of melanoma: asymmetry, irregular borders, multiple colors, increasing diameter and evolving or changing borders.
9. There are new treatment options
Surgery, chemotherapy and radiation are not the only treatments for skin cancer. Targeted therapies include oral medications that attack specific cancer cells and are believed to be more effective and have fewer side effects than treatments such as chemo and radiation. Since 2010, four new drugs have been approved by the U.S. Food and Drug Administration (FDA) to treat melanoma, and several more are in clinical trials.
The FDA also has approved two immunotherapy drugs since 2011. The medications, given through an IV infusion, stimulate the immune system to fight back against cancer cells. Researchers at Memorial Sloan Kettering Cancer Center in New York found that immunotherapy treatment reduced the risk of melanoma death by 32 percent. Despite the introduction of new cancer-fighting drugs, as well as 10-year survival rates of up to 95 percent, Ott notes : "Melanoma is still a very serious diagnosis, and prevention is still the best strategy."
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