Men over 60 diagnosed with skin cancer at twice the rate
FARGO, N.D. — Drop the stubborn act, men.
Gender differences can affect which cancers are most common to develop, according to Michael Blankinship, a dermatologist at Essentia Health’s South University Clinic in Fargo. But skin pigmentation is a much bigger factor, and Caucasians are at the highest risk.
“For all intents and purposes, men and women have relatively equal risks,” he said.
Still, Yulia Khan, a dermatologist at Sanford Health’s Dermatology and Laser Clinic in Fargo, N.D., said there’s a gender divide when it comes to prevalence as we age.
About one in five Americans will develop skin cancer in their lifetimes, she said, with most getting the more common basal cell or squamous cell varieties.
But it’s estimated that one in 50 will battle melanoma in their lifetime, Khan said. While women are more likely than men to get that potentially deadly diagnosis before age 45, the rate of melanoma is almost twice as high for men older than 60 — and it doesn’t have to be that way.
“Growing up, men tend to go without the shirt,” she said. “They don’t tend to wear makeup or hats like the women do, and women tend to be more vigilant about any spots.”
Getting through The risk of developing skin cancer increases as we age, Blankinship said, because of accumulated exposure we’ve had to ultraviolet rays. For many people, childhood represents the most exposure because kids tend to spend more time outdoors.
But women have been conditioned in recent decades to pay more attention to the risks, and because they’re used to going to a doctor for preventive measures such as Pap smears and mammograms, they typically will do more to lower their chances of developing skin cancer and get examined if they have questions, he said.
“In my experience, guys will usually come in when their wives or significant others make them come in or if something’s causing symptoms,” he said. “By that time, it’s usually unfortunately perhaps a little bit more advanced.”
Advertising and messages in the media have made it clear to women that sunlight exposure can cause aging to their skin and pose a health risk, Blankinship said, so many have responded by using sunscreen and avoiding the rays. But that issue hasn’t been made into a “priority” for males yet, he said, and men often don’t follow these same precautions.
Khan said recent studies have found the majority of sunscreen advertisements are published in magazines explicitly geared toward women.
“If you find a hunting magazine, how many sunscreen ads would you see there?” she said. “Probably very few, so they are definitely missing a large target audience.”
Possibly because of this cultural conditioning, and because women often are more concerned about their appearance than men, Khan said females are more prone to examine their skin and find early signs of skin cancer.
Catching it early is crucial: If detected before spreading to the lymph nodes, the five-year survival rate for melanoma is 98 percent, Khan said. That drops to 62 percent if the melanoma has spread to a nearby lymph node, and only 16 percent will still be alive after five years if it spreads somewhere else.
“A majority of the folks with a very late stage of melanoma will die,” she said.
The other two skin cancers are slower growing and less likely to metastasize, which is why they are less likely to cause death. Still, Blankinship said he’s seen people lose noses, ears or eyes to the slow-growing basal cell skin cancer after ignoring the warning signs for years.
Pay attention Everyone should do a self-skin exam at home once a month, Blankinship said. Males should do it the same day as their self-testicular exam — that way they won’t forget to do either of their cancer screenings — while females can examine their own skin for changes or suspicious spots the same day they check their breasts.
It’s also a good idea to have your skin examined by a doctor at least once a year, he said. Healthy people with lower risks for skin cancer can have their primary care physician look during an annual physical, but he said those with a family history or previous skin cancers should consider a follow-up with a dermatologist.
A pre-existing mole can turn into melanoma, though most cases do not come from such moles, and the other types of skin cancer can appear in several forms ranging from a spot that’s getting larger or changing color to a patch of skin that’s itchy, bleeding or causing pain.
“You should go to a doctor whenever you’re concerned,” he said. “I always tell my patients, ‘If you’re concerned about it, then I’m concerned about it,’ or ‘If your wife’s concerned about it, then I’m concerned about it.’ ”
Protection, prevention There are ways to minimize exposure, Khan said, especially by seeking shade from 10 a.m. to 2 p.m., when sun rays are strongest.
Protective clothing also is important for longer periods of time outdoors — a long-sleeved shirt, pants, sunglasses and wide-brim hat are best, she said.
Sunscreen with a sun exposure factor — or SPF — of at least 30 should be applied to any exposed skin, though Khan said most people don’t use enough. The face and neck alone need about a teaspoon of sunscreen, she said, and it’s important to reapply according to directions after sweating or swimming.
The idea that a tan is a sign of health is slowly changing in our culture, Blankinship said, but everyone should embrace their paleness or natural skin color and realize that there is no such thing as a safe tan, especially through a tanning bed.
“A suntan is just a physical representation that your body has detected DNA mutations caused by ultraviolet light, and it’s tanning in response to try to prevent that,” he said.
The goal, Blankinship said, should be to not have a noticeable difference in skin color from the depths of winter to the sunniest stretch of summer. He tells patients to look at their inside arm — that’s their natural skin color, and all of their skin should ideally match that.
He’s made it a routine in his personal life, and said his skin hasn’t been noticeably tanned in several years. All it takes, he said, is wearing protective clothing that can block out ultraviolet rays, putting on a moisturizer or lotion that contains sunscreen each morning and taking precautions every day, even during car rides when ultraviolet rays can still cause damage through a window.
We might not be able to change how much exposure we had in the past, but Blankinship said it’s never too late to adopt good habits that could prevent getting the most common cancer.
“You can’t do anything about the sun that you had, but you can always do something about the sun that you have going forward.”