ntjRtduThere are many things to celebrate in the month of May – Cinco de Mayo, the Tulip Festival and Mothers’ Day, farmers’ markets are opening up for the season, and Victoria Day, the first long weekend kicking off summer.  May is also abundant with awareness days and weeks, and May itself marks Mental Health Awareness, Asthma & Allergies Awareness, and – the subject of this post, one that really hits home for me – Skin Cancer Awareness Month.

Just over two years ago, in early March 2012, my fair-skinned, strawberry-blond, copiously befreckled husband stepped out of the shower, and as he was dressing, I noticed a particularly dark spot on his left shin – something I could not recall having seen there before.  I had just completed an advanced pathology course, and knowing how to spot potentially cancerous moles was one of the subjects covered in the lectures.  Kevin’s freckles are generally small and a light reddish-brown colour, even the larger mole- or birthmark-like spots, and this one was dark and shiny, with an irregular pinkish border on one side.  I urged him to have it checked out by our GP, who removed it for biopsy.

kevin's melanoma
Kevin’s suspicious mole, Mar 3/12, later confirmed stage 0 melanoma. Note the colour and irregular border. This mole was approx. 0.5cm in diameter.

He got the call at work, and called me afterward to share.  Sure enough, the results had came back, in a bad news/good news kind of way.  The bad news: it was melanoma.  The good news: it was only stage 0 – we had caught it just in time.  I still can’t quite describe the mixture of emotions running through me at that moment – fear and panic (“I was right to be concerned!”), relief and gratitude (“We caught it early, thanks to that course!”), and juuust a touch of hysteria (“I need to take care of you!  What happens now?  Let’s go load up on vitamin D, sunscreen, and new hats, right now!”).  Not surprisingly, he took the rest of the day off, not for himself, but for me.

Though they were sure they got it all when they did the biopsy, the area around the cancerous mole would be removed as a precaution in August: 1cm deep and 1″ around, and a skin graft from a spot a few inches away applied to the excised area.  The excised tissue was tested and he was pronounced cancer-free, but he must go for full-body dermatological check-ups every 6 months until the 5-year mark.  Edit: he recently had one of these check-ups, and since he’s been clear for nearly 2 years, he now only needs to go annually.

skin cancer blog post may 2014 kevin's scars
Jan ’13 (5 months post-op) – Kevin now has 2 sizable scars on his left shin, where the melanoma was excised (bottom) & where the skin graft was taken (top).

In the time between and following Kevin’s diagnosis and surgery, this story prompted many friends and family members to become more vigilant and check their own skin for irregular spots.  Now I’m sharing it with you, and I hope you’ll take these steps to protect yourself and someone you love:

Know the signs and check yourself.  If you have any freckles or moles, do a monthly “spot check”.  Be aware of the ABCDE visual signs of skin cancers.  Look in the mirror in good light – use a handheld mirror where necessary.  Get a friend or loved one to look at spots on your back or other hard-to-see places.  Take good-quality pictures of new or possibly unusual spots, preferably with a ruler or small object for measurement references to compare with next month’s pictures of the same spots.  Be consistent – use the same camera and lighting sources.

Load up on vitamin D.  First, get your blood levels checked.  Ask your GP to add vitamin D to your blood work.  Unfortunately, this is not covered by OHIP (unless you meet certain criteria) and may cost around $50.
Why is vitamin D important?  Recent and growing research is showing that vitamin D helps modulate the immune system, an important factor in preventing and managing cancer cell growth.  Additionally, vitamin D is synthesized in the skin with sun exposure, and may provide some protection from the harmful rays of the sun.
Around 15 minutes per day of unprotected sun exposure in the summer can be enough to boost levels adequately, if not for the full year, then at least for the season.  However, as Canadians, we have less sun exposure in general, and are thus more susceptible to vitamin D deficiency, not just in the winter, but year-round (and especially with this winter having lasted so long, I suspect many people may be more deficient than usual).  For this reason, it is imperative to have your blood levels tested in the late winter-early spring when levels are naturally lowest, and supplement accordingly year-round.
In terms of supplementation, the RDI for vitamin D is 1000IU for adults and 400IU for children per day – if no deficiency currently exists.  Those who are deficient (showing <30ng/ml or <75nmol/L) need more than this to bring levels back to optimum (40-60ng/ml or 100-150nmol/L).  As an example, my first vitamin D blood test showed a very surprisingly low 25nmol/L, and I took between 2000-4000IU of lanolin-sourced emulsified vitamin D3 per day for over a year (with the higher amount in the winter and on very cloudy days), until my next annual physical, where my blood test showed 126nmol/L.  I recommend at least 2000IU per day for adults on a regular basis, and more for those who are immune-compromised (e.g. autoimmune, inflammatory conditions, digestive disorders, etc) or suffer from seasonal affective disorder.

Protect your skin.  “Slip on a shirt, slap on a hat, slop on some sunscreen.”  I grew up with this mantra for sun protection, and it still holds true.  Cover up wherever possible.  After you’ve gotten some unprotected sun exposure for vitamin D synthesis, apply sunscreen.  Look for natural brands with an SPF of at least 30 at your local health food store, eco shop, or larger supermarkets, or try finding one online or through independent cosmetics retailers.  If there is a “tester” tube available, try it first to be sure you like the feel of it on your skin, as some may be thick and greasy, which could clog pores and exacerbate breakouts; and/or leave a white residue on skin and clothing.  I likeAubrey Organics, Nature’s Gate, and Arbonne Baby Care sunscreens.  The protection factor (SPF) weakens over time, so it’s best to replace your sunscreen annually.
Avoid tanning, including tanning beds.  Over time this damages your skin, leading to premature aging, and increases your risk for skin cancers.  People with fair complexions, many freckles or moles, blue eyes, and blonde or red hair (such as Kevin) are at higher risk.
Remember too that your skin absorbs about 60% of whatever you put on your skin into your bloodstream within just minutes after application!  Avoid products containing known carcinogens, such as parabens and phthalates.
Sunburns (even just one bad one) also increase the risk of skin cancers.  While after-burn care may not reduce your risk, it’s still worth doing to get relief.  Try fresh aloe vera gel or chilled chamomile tea on your skin, or a natural after-sun or calendula cream to cool the burn.  Coconut oil is also soothing.  Up your intake of antioxidant vitamins A, C, E, and minerals zinc and selenium, all of which are crucial to good skin health.  Orange, yellow, and red fruits and vegetables, as well as cruciferous vegetables and dark leafy greens, are great sources of vitamin A and C.  Nuts and seeds, particularly Brazil nuts, macadamias, pecans, and almonds are abundant with vitamin E, zinc, and selenium.  These nutrients are also available together in supplement formulas (look for “ACESZ” or similar).

So enjoy the sunny days of summer – and keep your skin safe.

How do you care for your skin in summer?

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