Dermatologist
Dr. Nomphelo Gantsho is a registered Dermatologist providing a comprehensive dermatological care for all ages as well as aesthetic procedures. Consultation Room: CENTURY MEDICAL SUITES, 4 Park Lane, Central Park, Century City, Contact: +27(0)21 250 0211 and Email: info@CapeSkinDoctor.com
Head - to - toe self-examination of your skin every month, for new or changing lesions that might be cancerous or precancerous.
1. What to do:
2. What to lookout for:
Melanoma often resemble moles. While it is not the most common skin cancer, it causes the most deaths.
If you see one or more changes make an appoint with a dermatologist
SOURCE: This informative video has been sourced from the Tedtalk YouTube account - Presented by Mary Poffenroth
South Africa has the highest incidence of skin cancer in the world. Knowing how to protect yourself is essential in the fight against this common cancer, which if caught early can often be cured writes, Dermatologist, Dr Nomphelo Gantsho.
It’s well known that the sun is particularly harsh in the southern hemisphere, due to the depletion in the protective ozone layer around the earth. This means that educating everyone about the facts of skin cancer and going for regular screening at the dermatologist is essential practice to avoid skin cancer. It’s the downside of living in year round sunshine.
Who is most susceptible to skin cancer?
People of all colours and races get skin cancer – nobody is excluded. However, those with light skin who sunburn easily do have a higher risk.
Risk factors include:
What happens in the body to cause skin cancer?
Sometimes errors or mutations occur in the DNA of skin cells, and when these mutations grow out of control they can turn into cancer cells.
Are there different types of cancer?
Actually there are many different types, but the three most common types are BCC (Basal Cell Cancer), SCC (Squamous Cell Cancer) and Melanoma. These skin cancers have different subtypes so it’s difficult to describe how each looks like. There are many variants as well.
Can some of the types of skin cancer enter the blood stream and cause cancer elsewhere in the body?
All types of cancer can spread to other areas of the body, skin cancer included. Ranging from BCC which is generally slow growing, to Melanoma, which is very aggressive.
Are sunbeds safe?
No. A recent report has found a direct link between the use of sunbeds and skin cancer. Many sunbeds give out greater doses of UV rays than the midday Mediterranean sun.
What about fake, rub on tanning products – are they safe?
The main ingredient in fake tan is DHA, or dihydroxyacetone. It’s listed as a cosmetic ingredient under EU legislation, so it’s likely to be safe with normal dose and usage.
So what can the average person do to protect against skin cancer?
Broadly speaking, the best way to keep safe it to avoid long exposure to intense sunlight and practice sun safety. You can still exercise and enjoy the outdoors, but it just needs to be done safely. Always avoid direct sun exposure between 10am and 4pm.
Teach children the shadow rule – if your shadow is shorter than you, the sun’s rays are at the harshest.
Practise the SLIP, SLOP, SLAP and WRAP rule, which means:
Also avoid other sources of UV light, such as tanning beds and sun lamps which are dangerous. Importantly, everyone must get to check their skin regularly and report any changes to their dermatologist. Self-examination is essential, so everyone must check their skin often for any new skin growths or changes in existing moles, freckles, bumps and birthmarks.
How does the layperson know if they have skin cancer?
Any change on your skin – especially in the size or colour of a mole, growth or spot – must be checked by a dermatologist. Also any change in sensation, a spread of pigmentation, oozing, scaling or bleeding from a skin lesion must be assessed immediately. Always look out for pre-cancer evidence such as areas of skin that are red and rough to touch, as these can easily be treated with liquid nitrogen.
Can areas of the body that have never been exposed to the sun still get skin cancer?
Yes, they certainly can. Sun exposure is just one of the risk factors for skin cancer.
Other risk factors include:
Any of these can lead to skin cancer anywhere on the body.
Are there special precautions to be taken for children?
Most important is to educate children on the risks of sun exposure, and teach them the sun safety advice of slip, slap, slop, wrap and staying out of the sun between 10am and 4pm. Babies under a year old should be kept out of direct sunlight.
Which area of the body is skin cancer generally the most common?
The upper back and lower legs are common for melanoma in light skinned people and other skin cancers are found mostly in the areas most often exposed to the sun, such as the face and arms.
Dark skinned people should be vigilant of melanoma on the palms of their hands and soles of their feet.
If a person have never experienced bad sunburn, can they still get skin cancer?
Yes they certainly are, because sunlight is just one of the risk factors for skin cancer.
What should we look for on sunscreen to ensure we are being protected?
It is always best to encourage the use of the best sunscreen possible. Most contain a combination of ingredients for effective protection against damaging ultraviolet rays-both the deeply-penetrating UVA and the shorter-wave UVB.
Look for the CANSA sign or a circle around the letters UVA to indicate UVA protection too. In general, it’s easier to use the spray-on sunscreens for the body, and gel- or cream-based formulations for the face, ears and neck. Everyone is encourage to use sunscreens with an SPF of 30 +.
How is skin cancer treated?
There are many options for treating skin cancers, depending on the type, area, depth, severity, age and skin type of the patient. They will need to see a dermatologist and discuss the various options, which range from freezing (freezing using liquid Nitrogen), to radiation, excision (surgical removal), curettage (scraping out) and cautery, Laser, PDT (Photodynamic therapy), Mohs (micrographic surgery) , etc.
Dr Gantsho adds that: “Skin cancer is the most common of all cancers and its incidence is increasing. So encourage everyone to be more aware of their skin and anything that changes. Simple non-invasive treatments for early skin cancer or precancerous lesions can save time, money and heartache. Annual mole scans done by a dermatologist should be mandatory, especially for light skinned people.”
The audio extract of Dr. Nomphelo Gantsho's interview with Radio Tygerberg 104 FM Denise Williams, talking about dermatological matters (27 August 2014 at 20H15 for 0:37:42 min).
The majority of skin cancer is caused by damage to cells from ultraviolet radiation received from sun exposure. The effect is cumulative over a lifetime and skin cancer becomes much more prevalent in the latter decades particularly in patients with a history of multiple sun burns as a child. Skin cancer is very common in our area as many of our older population did not have access to sun blocking agents during their childhood.
COMMON TYPES OF SKIN CANCER
There are three common skin cancers: basal cell , squamous cell, and melanoma. Basal cell skin cancer does not metastasise (spread to other tissue) except in extremely rare cases and can usually be cured with initial treatment. Squamous cell cancer can spread to other tissues if advanced but is usually diagnosed and treated before this occurs. Melanoma is a dark skin cancer and will spread to other tissues if diagnosis is not done at an early stage and can be difficult to cure with medical therapy and can be fatal . These common skin cancer do have visual characteristics which can be seen on exam and prompt a biopsy.
YOUR VISIT
During your fist visit a comprehensive skin examination will be done in addition to examination of any skin growths (lesions)which are of concern to you. Any growths felt to be suspicious for skin cancer will be biopsied and a follow up appointment will be scheduled to review the biopsy results and discuss a treatment plan.
BIOPSY TECHNIQUE
A punch biopsy will be done on the majority of suspicious lesions. The area of the lesion will be anesthetized with local anesthetic and a 3 - 4 mm circular core will be obtained and sent for evaluation for cancer (histology). A single stitch is usually placed which will be removed at the next visit ,usually in one week. Dark lesions which are suspicious for melanoma will be completely excised so that the entire area can be evaluated since further treatment of melanoma is based on the deepest extension of growth.
TREATMENT
Should basal or squamous skin cancer be diagnosed ,the next step is usually surgical excision of the lesion in the office or hospital. Surgical excision will involve removal of at least 5mm of skin on both sides of the lesion to help assure complete removal of all the cancer. This is done using local anesthesia and for larger lesions ,sedation in the hospital out patient setting. Some very superficial cancers can be treated with Aldara or Efudex cream rather than excision.
PREVENTION
The chance for developing skin cancer can be significantly lessened by reducing exposure to the sun’s ultraviolet rays by using protective clothing and sun block and limiting total exposure time.