By David Kates
It seems like an obvious point, and yet it’s a message that still hasn’t gotten through to a lot of people: sun safety is a year-round endeavour that requires us to protect ourselves whenever we’re exposed to sunlight, wherever we are, and whatever we’re doing.
It’s a message Dr. Lisa Kellett, a dermatologist at DLK on Avenue in Toronto, is emphatic about getting across to the general public: it’s not just about actively sunbathing. Whether you’re walking around the city, sitting on a patio, or hitting the ski slopes in winter, you still need to be thinking about your sun exposure.
“The cells in your skin don’t care whether you’re sitting on a beach or in a café,” says Dr. Kellett. “They’re still getting sun. So I think people have to realize that they’re getting lots of incidental light even while not sitting on a beach.”
It’s something that holds true for a variety of situations you might not even have considered. For example, if you’re sitting behind glass – in your car, or next to a window at your office – you still need to be aware of it, because glass typically blocks UVB rays, but not UVA.
Why is protection important?
Dr. Kellett mostly sees patients who are concerned about the cosmetic issues associated with sun exposure. And she uses a variety of treatments – from microdermabrasion, to vitamin A and vitamin C topical regimens, to laser treatments and photodynamic therapy, among other things – to repair sun damage and (to some extent) prevent the development of skin cancer.
Most of these procedures address unsightly spotting and pigmentation of the skin. But Dr. Kellett is quick to stress that the real damage – and skin cancer in particular – can take years to manifest itself.
“The damage that occurs has a lag time of about 20 years,” she says. “So it’s not like you go outside and get a burn and all of a sudden, you get skin cancer.”
In fact, she adds, people tend to get most of their sun exposure before the age of 20. The majority of the damage from this exposure cannot be repaired once it has occurred.
“There are multiple things that we try to use, such as vitamin As and lasers and things like that,” she says. “But the skin does have a memory, so the best thing is prevention.”
Skin cancer: a growing problem
The message of prevention – of protecting yourself from the sun’s harmful ultraviolet rays – is particularly prescient in light of a new report this week, Canadian Cancer Statistics 2014, released by the Canadian Cancer Society.
The report contains some staggering numbers on skin cancer. Melanoma, the deadliest form of skin cancer, is identified as one of the fastest growing of all cancers: 6,500 new cases of malignant melanoma are expected to be diagnosed in 2014, while an astonishing 76,100 new cases of non-melanoma skin cancer diagnoses is projected for this year. 1,050 Canadians will die from melanoma this year.
Incidence of melanoma, as well as deaths from it, continue to rise – despite the fact that those rates are going down for many other types of cancer. The incidence rate of melanoma in men increased two per cent annually from 1986 to 2010, from nine to 15 cases per 100,000. In women, the increase during that same period was 1.5 per cent annually, or from eight to 12 cases per 100,000.
One in 59 Canadian men, and one in 73 women, will develop melanoma in their lifetime. And non-melanoma skin cancer is incredibly common, representing at least 30 per cent of all new cases of cancer.
How well are we protecting ourselves?
Despite those alarming statistics – and despite the fact that health care professionals have been stressing the need for proper sun care for decades – many of the numbers in the Canadian Cancer Society’s report suggest that people are still not getting the message. From 1996 to 2006, the proportion of Canadians spending two hours or more in the summer sun grew; however, there was a significant drop in the number of people who reported wearing protective clothing and hats.
Dr. Kellett notes some inconsistencies in our attitudes towards sun protection. “The interesting thing is that I think we’re doing a better job of protecting our children,” she says. “So it’ll be interesting to see how skin cancer rates correlate to that over the next 20-25 years.”
In the meantime, she sees a greater degree of concern among women than she sees among men. And with the women she sees, they’re more often worried about the immediate cosmetic effects of sun damage than they are about getting skin cancer, which may be years or decades down the road.
Still, if these concerns lead to a more vigilant regime of sun protection, Dr. Kellett is satisfied. “There’s such a lag time between your exposure and when you actually get skin cancer, people don’t relate the two,” she says. “So any way we can keep people out of the sun is probably a good idea.”
Protection and prevention: A few tips to avoid getting burned
What are the things we should be doing to protect ourselves? Dr. Kellett offers a few pointers:
Skin cancer by the numbers