Learn the facts about skin cancer in Florida

There was a time when Dr. J. Matthew Knight, a practicing dermatologist in Orlando for about 15 years, would diagnose about one case of melanoma a week. Last week, he diagnosed six cases in one day.

“There’s no doubt that the new cases of skin cancer, especially melanoma, are absolutely rising. Big time,” said Knight.

The rates of new melanomas have doubled in the past three decades in the United States. And while Florida’s new melanoma rate is on par with the national average, it too rose by 37 percent, from 17.5 cases in 100,000 people in 1999 to 24 cases per 100,000 people in 2016, according to the latest data available from the Centers for Disease Control and Prevention.

Skin cancer is the most common type of cancer in the United States. Basal and squamous cell skin cancers affect more than 5 million Americans each year. But they’re rarely deadly.

That’s not the case for the less common skin cancer type, melanoma.

More than 96,000 new people will be diagnosed with melanoma this year, and about 7,000 will die from it, according to the American Cancer Society.

In Florida, there were about 6,700 new cases of melanoma in 2016, according to the latest available data. That year, more than 600 Floridians died from the cancer.

The main risk factor for melanoma is exposure to ultraviolet radiation — UVA and UVB — from sunlight or tanning beds. Tanning beds, in fact, increase your risk of melanoma by 75%, according to the Melanoma Research Alliance.

The average age for melanoma diagnosis is 63. But melanoma is also the most commonly diagnosed cancer among young adults between 25 and 29 years old in the United States, young women.

“Melanoma is kind of a terrible actor. It acts unpredictably. It metastasizes readily. It’s just a bad actor,” Knight said.

We spoke with Knight and Dr. Bruce Haughey, a head and neck surgeon with an interest in malignancies at AdventHealth, to learn more about skin cancers and how to prevent them.

How do you know if you should go get your skin checked for cancer?

Knight: There’s no perfect answer to that. There are not enough doctors to screen everybody. But if you think you’re at risk, or you’re worried that you might be, it’s a simple task to get a skin exam at a dermatologist office. And certainly if you look anything like me, get your skin checked. I’m a native Orlandoan. I’m very fairskinned. I got innumerable sunburns as a child. I play golf every day. I had my first skin cancer at age 25. If you grew up in Central Florida, you’ve had sunburns and have a lighter or medium pigmented skin, or a relative that has a history of skin cancer, then you owe it to yourself to have a skin exam at a dermatologist office. At least once.

Haughey: If in adulthood an area of the skin is undergoing change, that’s a red flag to get it checked by a qualified professional.

Why is melanoma more common among older people?

Haughey: As each decade goes by, each of us gets more and more ultraviolet exposure, which increases what we call ‘the mutational burden’ in the skin cells and that predisposes us to skin cancer.

Knight: It’s kind of like smoking cigarettes. You don’t smoke a pack of cigarettes and then the next day get lung cancer. You get the DNA damage from heavy smoking and then 15, 20 especially years later is when you start to get the cancer. That’s just the way that cancer works.

What about squamous and basal cell skin cancers?

Knight: Basal cell cancer is not fatal. It doesn’t kill people. It’s a like a cavity in your tooth. It just sits there and gets bigger and festers. It can chew through parts of you as it grows. So if you had basal cell skin cancer and you didn’t treat it, it could destroy your eyelid or part of your nose or your ear. Squamous cell skin cancer is kind of that way too, but it can get into your lymph nodes. The main treatment for both is surgical removal.

Haughey: The commonest location for basal cells skin cancer is head and neck.

There are a lot of sunscreens out there. What should we buy?

Knight: If you really want to be safe, pick a sunscreen that’s SPF 30 and make sure it has zinc oxide in it and it’s broad spectrum, which means it also protects you from UVA. SPF only blocks UVB. So if you have a sunscreen with SPF one million that doesn’t provide UVA coverage, it’s not really protecting you against melanoma, as crazy as it sounds. You have to apply a whole shot glass of sunscreen every couple of hours, which not a lot of people do.

You don’t need sunscreen with more than SPF 30. Sunblocks with above SPF 30 are pretty much marketing hype. There are companies that market SPF 105 sunscreen for kids and the mom sort of squirts it on the kid and then up the kid goes in a bathing suit for three or four hours in the sun. That’s a setup for melanoma. That’s how you prime your kid to get skin cancer later in life.