Sun and cancer: how to protect yourself

Sun and cancer: how to protect yourself

UV rays, whether A or B, are responsible for skin cancer. This has increased by… 400% in Belgium in twenty years. Update on good prevention advice.

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Our mentalities of northerners who are amazed when the temperature rises and who set up golden skin as an ideal of beauty are struggling to evolve. We believe we are sheltered from the dangers of the sun in Belgium, the historic kingdom of gray skies, but climate change is at work. This Saturday, at the peak of the heat wave, the MRI predicts a UV index of 8, which should in principle alert us and imply redoubled caution. Somehow, the message is starting to get through (it’s now rare to see young children walking around without hats or protection like in the 70s), but errors of judgment remain legion.

I have never known a cancer that progresses as quickly as skin cancer”, testifies Thomas Maselis, dermatologist and president of Euromelanoma Belgium, organization of prevention in the matter. “In 2000, 11,000 new cases of malignant skin cancer were diagnosed in our country; in 2018, 45,733 were detected. So we are at more than 400% increase in 18 years. 40% of all male malignant cancers in Belgium are skin cancers. And we now know that one in five Belgians will suffer from this type of cancer before the age of 75.” Hence the crucial role of prevention. Especially since the skin, the only fully visible organ, can be monitored by everyone.

To each their own UV meter

Why such an increase? The population is aging, of course. “Our body “holds out” much longer and is exposed to much more UV during its existence.” The thinning of the ozone layer since the end of the last century also plays a role, since it now allows more dangerous short UV rays to pass through. Finally, today’s adults are still paying for their own parents’ mistakes in their behavior towards them in the past. “Mass tourism developed strongly at the end of the 20th century, continues Thomas Maselis. People were going south, the kids were playing in the pool all day, and their skin was burned in the evening. At the time, there was also intense UVA exposure in sunbeds. However, between the alteration of DNA by UV rays and skin cancer, between 5 and… 60 years can pass..”

When you have a relatively dull skin and you are not subject to sunburn, you tend to relax the gestures of protection against the sun. However, it is not necessary to burn to be threatened. The mere accumulation of hours of tanning can in itself cause skin cancer. Hence the notion of “UV meter” introduced by Euromelanoma’s 2022 campaign. The president of the Belgian association specifies: “What counts is not so much the age in absolute terms, but the amount of UV to which one has been exposed, which can vary according to the profession or according to the hobbies. Before 2000, it was believed that UVA rays were not carcinogenic, that only UVB rays – responsible for sunburn – were. However, we now know with certainty that UVA rays are also carcinogenic, but their harmful effect occurs in another way.”. Hence the importance of checking that the sunscreen you use also blocks UVA rays and of… avoiding sunbeds.

Another deleterious impact of UV rays on our health: they reduce our immunity locally. “We all get skin cancers very early in life, which are normally eliminated by our immune system, continues Dr. Maselis. But if we locally reduce our immunity, cancers are more likely to grow.

Afraid of his shadow

The temperature is not a relevant indicator for knowing when to be extra careful under the rays. The only objective and reliable factor is the UV index, published daily in the press and on all weather apps worth their salt. “From an index 3, you must protect yourself against the sun. Beyond 5, protect yourself even better, and beyond 7, be even more careful.“If you don’t have access to this information of the day, a good way to know the degree of intensity of UV rays is to look at… its shadow. “If our shadow is longer than us, it means that UV had to travel a very long way to pass through the atmosphere, which filtered out more bad rays..” Conversely, when the sun hits us vertically and does not create shadows, it is better to take shelter.

The first protection is the shade: that of parasols, trees, etc., reframes the dermatologist. The second protections being clothes in a very opaque fabric – dark colors like black absorb UV rays better than white -, but also hats, sunglasses…“Sunscreen with anti-UVA and anti-UVB filters only comes in 3rd place. Especially since it is still too often misused. To play its protective role, it must in fact be applied at a rate of 2 mg per cm² of skin, i.e. 35 g on average for the whole adult body, to be renewed after sweating, bathing or in any case both. hours… The president of Euromelanoma Belgium points to another misuse of sunscreen: “If they are used for longer exposure to the sun, their effect will be deleterious and will even increase the number of skin cancers! A solar filter is just used to stay the same time in the sun but being better protected. At noon, if we expose ourselves for half an hour without protection, we will be red. A cream makes it possible to avoid burning during these thirty minutes in the middle of the day. But it’s not about staying 3 or 4 hours exposed, because that would blow up our UV meter”. Another bad habit, that of preparing your skin before going on vacation, by going to the sunbed, which is also recognized as carcinogenic.

When to worry?

There are three types of skin cancer, which take different forms. The most common (70%), basalioma or basal cell carcinoma is most often manifested by small wounds that do not heal and bleed, and by red patches on the chest that grow. Their edge is shiny, composed of fine pearls. Its “advantage” is that it does not metastasize.

Squamous cell carcinoma or squamous cell carcinoma represents 20% of all skin cancers. “It can metastasize but only at a late stage, says Doctor Maselis. It is found especially on areas strongly irradiated by the sun, horizontally under the rays, which are called “solar terraces”: the top of the skull of bald men, the top of the ears, the nose, the lower lip , the cheeks… These cancers begin with actinic keratosis, which is why we are making the population aware of this frequent skin condition from the age of 50: it consists of a small red patch with desquamation which gets better then gets worse, then gets better , and so on sometimes for years. Then at some point, this plaque thickens, the crust too, and it becomes cancer. Precancerous stage, actinic keratosis is easily treated with cryotherapy, therefore liquid nitrogen, or with creams containing chemotherapy.

Finally, the best known skin cancer is also the least common (10%) but by far the most dangerous: melanoma. The best way to detect it is to examine yourself in front of the mirror every three months. “Melanoma arises from melanocytes, which produce a black color. When you see a mole that is different from the others, you should always pay attention to it.”, warns the specialist. Euromelanoma offers the ABCDE technique during this self-exam: asymmetry (both sides should look alike), edge (it should be more or less the same everywhere), color (max 1 or 2 shades per spot, beyond that it’s doubtful), diameter (below 6 mm, so the eraser of a pencil is often benign), evolution (when you see a stain changing, it is better to consult). If in doubt, go to the general practitioner or dermatologist.

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