Presentation given to non-medical employees at non-medical company about sun safety and skin cancer prevention

1. Sun Safety-
Skin Cancer & Prevention
Brigg Barsness MD
Miller Health & Fitness Center

2. Miller Health & Fitness Center
-Phone 414-931-4444. Please leave a message!!!
-4400 W. State ST, Milwaukee, WI 53208 (right next to Beer Sales)
-Monday, Tuesday, Thursday 8AM to 5PM
-Wednesday, Friday 7AM to 4PM
-Primary care visits (routine care of hypertension, diabetes, high
cholesterol, etc; preventative medicine; annual exams; vaccinations)
-Sick visits (colds & flus, infections, sprains & strains, etc.)
-Mental health care (depression, anxiety)
-Full service lab (almost any lab you can think of)

3. Why should I care about skin cancer?
-ANYONE CAN GET SKIN CANCER, no matter the color of your skin!!!
-an estimated 1 in 5 Americans will develop skin cancer in their lifetime
-Skin cancer is the most common malignancy in the US accounting for
1/3 of all cancers

4. Two Main Types of Skin Cancer
• 1. Nonmelanoma skin cancers (Basal Cell carcinoma & Squamous Cell
carcinoma)
• Actinic Keratosis (not really a cancer, but can turn into Squamous Cell
carcinoma)
•2. Malignant Melanoma

5. Nonmelanoma skin cancer
• Basal Cell carcinoma- Most common skin cancer; Most common in
head/neck region in Whites & People of Color; Can be treated with
cryotherapy or surgery (Mohs)
• Squamous Cell carcinoma- 2nd most common; 20% of all cases; Most
common in sun-exposed areas in Whites; People of Color develop
squamous cell carcinoma most often in less sun-exposed areas like the
legs; Most common tumor in elderly patients; May grow aggressively (2-
6% risk of metastases); best treated with surgery (Mohs)
• Risk Factors: More common with increasing age (cumulative radiation
damage); Chemicals & exposures (tobacco, sun damage, thermal damage,
coal-tar products?); Medical Conditions (chronic infections like HPV,
immunosuppression, ulcers); trauma (scars, burns)

6. Basal Cell carcinoma

7. Squamous Cell carcinoma

8. Actinic Keratosis (pre-cancer)
• The rate of transformation to squamous cell carcinoma is less than one per
1,000 per year
• Cryotherapy (liquid nitrogen) is the primary treatment
• Topical medications are options (5-FU, imiquimod)

9. Malignant Melanoma
• The 8th most common malignancy in the US; 120,000 more Americans
diagnosed every year; 8,500 deaths yearly (1/hr)
• The cancer with the most rapidly increasing incidence; One in 1,500
Americans born in 1935 were likely to develop melanoma, compared with
one in 105 persons born in 1993!
• In contrast to nonmelanoma skin cancer, the frequency of melanoma
peaks between 20 and 45 years of age.
• In Whites, most common in sun-exposed areas; in People of Color, most
common in non-sun-exposed areas like soles of feet, nails, palms, and
mucus membranes
• Melanoma risk is increased in the immunosuppressed (HIV/AIDS, those
being treated for autoimmune conditions)
• Melanoma can recur at ANY TIME, ANYWHERE in the body!!!

10. -Melanin helps protect our DNA from ultraviolet radiation by blocking and dispersing its energy
-Ultraviolet radiation helps fully activate Vitamin D to its active form
-When ultraviolet radiation damages DNA, one of the side-effects is the release of opiates which can lead to addiction!

11. Who can get skin cancer?
ANYONE CAN GET SKIN CANCER!!!

12. February 6th, 1945 - May 11th, 1981
Melanoma
Bruise (Subungual
Hemorrhage)

13. Skin self-examination
1. Examine your body front and back in the mirror, then look at the right
and left sides with your arms raised
2. Bend your elbows and look carefully at forearms, back of upper
underarms, and palms
3. Look at the backs of your legs and feet, between your toes, and the soles
of your feet
4. Examine the back of your neck and scalp with a hand mirror or have your
partner examine those areas
5. Check your back and buttocks with a hand mirror

14. ABCDE’s of skin cancer

15. Prevention of Skin Cancer
• Increase public awareness of the risks of sun exposure. Those who are
aware of skin cancer risk are more likely to bring a malignant lesion to the
attention of a health care provider. ANYONE CAN GET SKIN CANCER!!!
• Niacin (Vitamin B3) 500 mg immediate release (IR) twice daily has been
shown to reduce rates of nonmelanoma skin cancer by vasodilation.
Niacin can also improve cholesterol levels. BUT niacin can irritate the
throat, upset the stomach, raise blood sugar and then crash blood sugar
• Sun Safety

16. Sun Safety
• Minimize sun exposure between 10AM and 4PM (peak ultraviolet-B
hours)
• Sunscreen with a solar protection factor (SPF) of at least 15 should be
applied 30 minutes BEFORE exposure and REAPPLIED every 2 hours at
minimum, even on cloudy days. Reapply after swimming or sweating.
• Be careful near water, snow & sand, which reflect the sun
• Wear wide-brimmed hats, sunglasses and protective clothing (tightly
woven fabrics and long-sleeved shirts)
• Get vitamin D from your diet or from supplements (I recommend vitamin
D3 5,000-10,000 units nightly, absorbs best after a fatty meal)
• Avoid deliberate sun tanning and use of tanning parlors

17. References
• Jerant AF, Johnson JT, Sheridan CD, Caffrey TJ. Early detection and
treatment of skin cancer. Am Fam Physician. 2000 Jul 15;62(2):357-
68, 375-6, 381-2. PMID: 10929700.
• www.thepearldermatology.com
• https://www.drmichellelevy.com/abcdes-of-melanoma
• Nguyen NT and Fisher DE (2019) MITF and UV responses in skin:
From pigmentation to addiction. Pigment Cell Mel Res 32, 224– 236.
• Starr P. Oral Nicotinamide Prevents Common Skin Cancers in High-
Risk Patients, Reduces Costs. Am Health Drug Benefits.
2015;8(Spec Issue):13-14.
• Hwang ES, Song SB. Possible Adverse Effects of High-Dose
Nicotinamide: Mechanisms and Safety Assessment. Biomolecules.
2020;10(5):687. Published 2020 Apr 29. doi:10.3390/biom10050687