May 26, 2023 - 9:07 am
Updated May 27, 2023 - 10:55 am
For most Americans, Memorial Day marks the unofficial start of summer. For Southern Nevadans, the arrival of warmer weather is pretty much been-there-done-that, thanks to our nearly yearlong acquaintance with sunshine.
Still, the return of summer can serve as a reminder of what Southern Nevadans need to do to protect themselves from the potentially harmful effects of spending longer days in the sun. And, as with just about everything else, the COVID-19 pandemic hasn’t made that easier.
A number of studies suggest that skin cancer screenings and treatments may have suffered delays during the pandemic. That may have allowed some skin cancers to progress further than would have been the case without the COVID- related delays, according to some research.
Particularly during the early phase of the COVID shutdown, “it was just hard to get an appointment — period — across the board,” said Dr. Russell P. Gollard, a medical oncologist and hematologist and medical director of Optum Care Cancer Care. “For a while, people could not get in to see their primary care providers or specialists.”
Also, “there was a period of time early in the pandemic when all elective surgeries were canceled or delayed. So skin cancer surgeries got pushed out,” said Dr. Wolfram Samlowski, a medical oncologist at Comprehensive Cancer Centers of Nevada.
But patient care never stopped. In fact, Samlowski noted, the pandemic by necessity helped spur other treatment methods — involving, for example, a combination of surgery and drugs that act on the immune system — that have proven effective enough to be incorporated into standard treatment approaches.
Some patients may have been leery of visiting doctors’ offices even when they were again able to. Dr. Darlina Manthei, a family practice physician with Touro University Nevada College of Osteopathic Medicine, who also practiced general and cosmetic dermatology for 10 years, said that “a lot of people put off going to see even their regular doctor.”
The obstacles to access caused by COVID may have helped to compound what, Manthei said, already has been a rise in skin cancer rates over the past few decades.
Samlowski said the effect of the pandemic right now is “hard to say, because there is a group of patients who seem to put off managing things for a lot of reasons.”
Among that group of patients, Samlowski said, pandemic restrictions “might have given an excuse to put things off.”
“When we (saw) people with more advanced cancers,” he added, “whether it’s because of the pandemic is not clear to me. We worked steadily through the pandemic, and dermatologists certainly funneled a lot of patients.”
In some cases, the effect of pandemic delays may even have been blunted because some skin cancers are relatively slow-growing.
There can be a certain amount of “lag time,” measured in years, sometimes, between sun exposure and development of skin cancers, Gollard said, even as doctors also see more aggressive cancers that require prompt treatment.
Squamous cell carcinoma and basal cell carcinoma, two common forms of skin cancer, tend to grow over a period of time, Samlowski said, while melanoma — a more serious form of skin cancer that can metastasize to other parts of the body — generally is more aggressive.
“For some cancers, a three-month delay doesn’t matter as much,” Samlowski said, but for a more aggressive cancer “a lot can change in three or four months.”
Exposure and UV damage
The complete effect of the pandemic on skin cancer diagnosis and outcomes may take years to determine. But skin cancer remains the most common type of cancer, according to the American Cancer Society, and one of its most common risk factors remains exposure to the sun’s harmful ultraviolet rays.
“The problem is skin cancer can develop 30 or 40 years after sun damage,” Samlowski said.
“When I was a kid, we’d all go to the beach and get a really deep tan that ‘gets you ready for summer,’ ” Gollard said. “That’s the worst thing you can do. All of those commercials we saw — ‘Get a Coppertone tan’ and you used to see kids putting baby oil on — are really not healthy and can come back and haunt you years later.”
People who participate in outdoor activities tend to have greater exposure, Gollard said, but “most sun exposure is not deliberate. It’s just taking the dog for a walk or going to the grocery store.”
Nor does skin damage occur only on sunny days. “Even if it’s a cloudy day you can be at risk,” Manthei said.
Skin cancer can appear in the form of moles, discolorations or atypical markings. During a screening, a doctor or health care provider will evaluate such skin markings.
Gollard adds that skin cancer can develop at any age. “People in their 20s and 30s do get skin cancer, and can get the most lethal form of skin cancer,” he said.
Protecting your skin
Preventing skin cancer requires protecting the skin from UV sun damage.
“Don’t get a deep sunburn, particularly one that peels,” Gollard said. Cover up exposed skin, and use a sunblock of at least SPF 30.
Use a broad spectrum sunblock, Manthei added. “That means it prevents UVA and UVB exposure.”
“I always tell my patients that they have to wear their sunscreen every day,” said Manthei, who recommends using about a shot glass worth of sunscreen per application.
“I tell them they have to reapply sunscreen every two hours. Put it on all exposed areas of the body,” she said, and reapply after swimming.
Limit time in the sun — particularly between 10 a.m. and 2 p.m. — and wear light-colored clothing, Manthei said. “And I think a hat is very appropriate.”
Also make sure that your kids are protected.
It may take years for the full effect of the pandemic on skin cancer cases to be determined, Gollard said.
“I do think that when you reduce access to any type of screening you’re going to have more disease at the other end,” he said. “The key thing is, if people have any questions, to set up a visit, even a virtual visit, with their provider.”
More summer safety tips
Avoiding the harmful effects of the sun is just one thing to keep in mind in summertime. Here are a few more tips for staying safe and healthy as temperatures soar.
It’s easy to become dehydrated, particularly in Southern Nevada’s low humidity. Community Ambulance recommends drinking at least 2.5 liters of water on average each day and avoiding alcohol and caffeine, which can cause dehydration.
Keep foods safe
Mishandling foods can result in a nasty case of salmonella, E. coli and other foodborne illnesses, according to Dr. Neil Gokal of Southwest Medical, part of Optum Care.
Symptoms of food poisoning can include vomiting, stomach cramps, diarrhea and a fever that can last from a few hours to several days. At particular risk are pregnant women, older adults, young children and those with weakened immune systems.
Gokal suggests taking care when working with raw meats, summer salads, dairy products and vegetables. Cook foods to proper temperatures — use a food thermometer to be sure — and refrigerate perishable foods within two hours (or if it’s over 90 degrees, within one hour).
Don’t forget to wash your hands, keep utensils clean and prevent cross-contamination of foods.
Extreme heat can be dangerous, Community Ambulance notes, and heatstroke, heat exhaustion and heat-related illness can strike anyone of any age.
Dizziness, nausea or a headache can be signs of heat-related illness. Move to a cooler location and drink water.
Stay hydrated and stay indoors or in the shade when the days are hottest, and never leave pets or children in a parked car.