The Importance of Sunscreen
- What Jessica Zbinden-Webster thought was a harmless “blocked pore” under her eye at 26 turned out to be skin cancer, leading to surgery, a skin graft, and years of recovery. Now cancer-free, she’s urging people to wear daily SPF and pay attention to skin changes that don’t heal or look concerning.
- One of our experts says people should be using broad-spectrum sunscreen with a minimum SPF of 30 and reapplying every two hours.
- In addition, people should be regularly visiting a dermatologist and checking their skin for spots that look suspicious. If a spot on your skin falls under the ABCDE criteria, you should see a dermatologist promptly.
- The acronym ABCDE stands for Asymmetrical moles, Borders or Bleeding, Colors, Diameter and Evolution. See here for a further breakdown of the criteria.
Now, eight years after her diagnosis, Zbinden-Webster is cancer free and sharing her story to help others be aware of the dangers of the sun and check their skin.
Read MoreShe continued, “It actually started to really imperceptibly grow and then began to sort of ulcerate in the middle, so there was like a little bit of a dip.
“But as I said, I didn’t fit any of the stereotypes for skin cancer. I wasn’t an older person, and I didn’t use sunbeds. So the last thing I thought was that it was going to be something serious.”
Looking back at the moment she realized the small “blemish” was more than a facial imperfection, she recalled rubbing he3r eye at work and noticing the small bump on her face was bleeding.
“That’s the point at which I thought, yeah, ‘this isn’t just problem skin.’ This could be something quite serious,” she explained, saying that prompted her to make an appointment with her doctor the next morning.
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“I was very freaked out, and he basically diagnosed me on the spot. He looked at me and just said, ‘You’ve got skin cancer, and we need to urgently refer you for treatment.'”
Zbinden-Webster, who doesn’t describe herself as a “sun worshipper,” suspects her cancer was simply due to “playing outdoors in the 90s.”
She ultimately needed surgery and a skin graft done before being considered cancer free, as she needed her “lower eyelid removed” to take out the tumor and surrounding skin.
Over the course of four years, Zbinden-Webster had the cancer removed and then follow-up laser surgeries to help with her healing journey.
“It’s not just skin cancer … it’s something that can really affect you over a long period,” she warns.
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Despite her experience, Zbinden-Webster, in a message to her younger self in a video clip shared on Instagram, says, “scars heal” and “skin is amazing.”
“Start wearing sunscreen regularly now. SPF50 is the best. It’s not just for summer holidays,” she urges. “It prevents daily UV damage which accumulates in skin cells and becomes damaged.”
Which Sunscreen Should I Choose To Prevent Cancer?
“UV damage can’t be reversed, just prevented, so apply sunscreen generously. [Skin cancer] It’s mostly caused by sun exposure in your childhood and adolescence,” Zbinden-Webster.
She further advised others to “honor and protect” the skin your in.
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In another Instagram post, she urged, during the hotter months, “Prioritize enjoyment, but prioritize your safety, too.
“Here’s what I’ll be doing: taking sunscreen out with me, staying shaded during the middle of the day, reapplying SPF regularly, making memories.”
She continued, “Sun safety isn’t a choice between enjoying sunshine and staying safe. It’s a blend of both.”
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How to Protect Your Skin From Cancer
The Skin Cancer Foundation estimates that more than 5 million cases of skin cancer are diagnosed in the United States every year, making it the most common cancer in the U.S.
WATCH: Top 5 Ways to Help Prevent Skin Cancer
As the warmer weather months are upon us it’s important to remember to protect your skin from skin cancer this summer.
Dr. Dendy Engelman, a board-certified dermatologic surgeon and associate at Manhattan Dermatology and Cosmetic Surgery, previously told SurvivorNet that protecting your skin is easy with these simple steps:
- Sun avoidance during peak hours: This means from 10 a.m. to 2 p.m. It doesn’t mean you should never go outside during the middle of the day, but make sure you’re protected when you go outdoors.
- Cover your skin and eyes: Wearing a wide brim hat or sunglasses will protect your face, the top of your head, your ears and the delicate skin around your eyes.
- Wear an SPF of 30 or higher: Plenty of facial moisturizers have SPF built into them. Dr. Engelman recommends reapplying every few hours, or after excessive sweating or swimming.
- Get an annual skin check: If you happen to notice anything out of the ordinary in between checks (like the signs outlined in this article), schedule an appointment to talk to your doctor as soon as possible.
- No-go to tanning beds: Tanning beds can significantly increase your risk of developing melanoma. If you feel like you’re just too pale, Dr. Engelman recommends a sunless tanner.
Learning More About Melanoma
Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.
WATCH: How do you perform a skin check using the ABCDEs?
You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:
- The palms of your hands or soles of your feet
- On your eyes or mouth
- Under your nails
SurvivorNet experts recommend avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma. Tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided. Many dermatologists recommend using spray tans to reduce the risk of melanoma skin cancer.
What Are the Symptoms of Melanoma?
The most important thing to look out for when it comes to finding melanoma is a new spot on your skin or a spot that is changing in size, shape, or color, SurvivorNet’s medical experts say.
When you check your skin, use the acronym ABCDE as your guide:
- Asymmetrical moles: If you drew a line straight down the center of the mole, would the sides match?
- Borders: Is the mole irregular or jagged?
- Colors: Are there multiple distinct colors in the mole?
- Diameter: Is the mole larger than 6 millimeters (mm), about the size of a pencil head eraser?
- Evolution: Has the mole’s color, shape, or size changed over time?
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If you answered “yes” to any of these questions, our experts say it’s time to see your dermatologist for a skin check.
Melanoma Treatment Options
Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.
If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery, but which kind you’ll have.
WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma
For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.
In general, stage I melanoma surgery consists of the simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.
The removal of stage II and III melanomas are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes, and possibly to other organs. Where the cancer is will dictate your treatment.
After surgery, the removed tissue and lymph nodes will go to a specialist called a pathologist, who will measure the melanoma and find out if it has clear margins. Having clear margins means the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.
Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.
Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is recurrent disease.
Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022. The combination of two immunotherapies is called Opdualag.
For those with the BRAF mutation, targeted drugs which shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:
- Zelboraf (vemurafenib) and Cotellic (cobimetinib)
- Braftovi (encorafenib) and Mektovi (binimetinib)
- Tafinlar (dabrafenib) and Mekinist (trametinib)
- Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.
“Every patient is different and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.
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Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”
So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.
Questions to Ask Your Doctor
If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests some of the following to help you on your cancer journey.
- What type of skin cancer do I have?
- What treatment options exist for my type of melanoma?
- Will insurance cover this treatment?
- Would treatment through a clinical trial make sense for me?
- What resources exist to help manage my anxiety because of this diagnosis?
Leading Experts Urge Us to Be Proactive
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview, “because finding a doctor who is up to the latest of information is important.”
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
RELATED: Be Pushy, Be Your Own Advocate, Says Leading Expert
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
