Check Your Birthday Suit on Your Birthday: Skin Cancer Awareness

By Elaine S. DeMeyer, RN, MSN, AOCN®, BMTCN® - May 9, 2023

May is National Nurses Month, and National Nurses Week starts each year on May 6, ending on May 12, Florence Nightingale’s birthday. In harmony with Oncology Nursing Month, May is also melanoma and skin cancer awareness month. Perhaps one of the greatest gifts to celebrate this month is to commit to:

Check Your Birthday Suit on Your Birthday

This saying reminds everyone to schedule a head-to-toe skin screening with a dermatologist to help with early detection of skin cancer. In addition to monthly skin self-screening, schedule an annual visit to the dermatologist during your birthday month.

Skin Cancer Facts

Although some people (light skin, blue eyes, red hair) are more prone to sunburn, anyone of any skin tone or race can develop skin cancer. According to the Skin Cancer Foundation, here are a few facts:

More people are diagnosed with skin cancer each year than all other cancers combined
Every hour, more than 2 people die of skin cancer
1 in 5 Americans will develop skin cancer by the age of 70
Approximately 3.6 million Americans develop basal cell carcinoma each year
5 or more lifetime sunburns double the risk of melanoma
Daily use of sunscreen reduces melanoma risk by 50%

The 3 most common types of skin cancer are keratinocyte carcinomas or non-melanoma skin cancers—basal cell and squamous cell carcinomas—and melanoma.

The ABCDEF Rule

The ABCDEF rule is an easy acronym to remember to look for signs of melanoma. In addition, the American Academy of Dermatology provides pictures and a downloadable body mole map to document any spots during monthly skin self-examination.

A—Asymmetry: spot halves do not match

B—Border: spot has an irregular, scalloped, or poorly defined border

C—Color: spot has various colors or shades

D—Diameter: spot can be any size, but > 6 mm (or pencil eraser size) is concerning

E—Evolving: spot is changing in size, shape, or color

F—Feel: spot itches or feels strange

Any new spots, different spots, or changing spots need to be evaluated by a dermatologist.

Slip, Slop, Slap, Seek, Slide

The slip, slop, slap, seek, slide campaign originated in Australia more than 40 years ago as a call to action to prevent skin cancer. Unfortunately, Australia and New Zealand have some of the highest melanoma rates globally. Nevertheless, they remain a global leader in skin cancer prevention, especially with their education efforts for young children.

Many cancer centers in the US use this slogan to help prevent skin cancer. It can be for personal use or educating the community about prevention or sun safety after cancer treatment.

Slip on Protective Clothing. Look for protective clothing with long sleeves, pants, or UV protective apparel with built-in SPF. Clothing with ratings of UPF 50 or higher can block 98% of UVA/UVB rays. Continue to use sunscreen under UV-protective clothing as an extra layer of protection.
Slop on Sunscreen. Most dermatologists recommend using sunscreen with an SPF of at least 30. For cancer survivors, like those receiving a stem cell transplant, encourage sunscreen with SPF 50 or higher. The key to using sunscreen is to apply enough and reapply often. Experts recommend at least a shot glass for the entire body and 2 finger lengths of sunscreen for the face. Be sure to apply sunscreen 15-30 minutes before going outside and reapply every 2 hours.
Slap on a Hat. Choose a broad-brim hat (not a baseball cap) to shield the face and ears—the more intense the hue, the better the protection. Although white hats may be the coolest, darker colors (black and navy) are more effective at protection from UV rays. Of course, the best hat is one that someone will wear.
Seek Shade. Always avoid direct sunlight. Seek shade from UV under structures, umbrellas, trees, or tents. The sun’s rays are significantly damaging between 10 am and 2 pm. Although shade can help, it must be in combination with other sun protection measures.
Slide on the Sunglasses. Find 100% UV protective eyewear—blocking both UVA and UVB radiation. Consider oversized or wraparound-style glasses for the best protection. Everyone aged 6 months or older should wear eye protection all year long. Starting the habit early, like brushing your teeth, can help establish eye safety. Remember that sunglasses reduce the risk of ocular melanoma and growths on or near the eyes and can prevent early cataracts, macular degeneration, and other eye conditions.

Consult a Dermatologist Each Year

Most primary care providers (PCP) examine the skin during an annual physical, so why make a separate appointment with a dermatologist? A dermatologist’s skin screening differs from a PCP visit, who may briefly look at the arms, legs, or behind the gown. In addition, patients may be wearing makeup or nail polish that can interfere with a skin screening.

Dermatologists look at every inch of the skin, even between the toes and under the nails. They carefully examine the palms, soles, scalp, and genital areas. During the initial visit, they assess, measure, and document every mole, birthmark, or suspicious lesion. Often, digital photography helps them monitor any area. It’s best to not wear nail polish or makeup during a dermatologist’s screening.

If an area could become precancerous, dermatologists will freeze it with liquid nitrogen or use local anesthesia to remove it. Any suspicious spot will have an immediate biopsy, with results back in approximately 1 week. The frequency of future visits depends on family history, findings, and risk. Typically, screening is annual for average risk and biannual or more frequently for high-risk patients.

Oncology nurses can be role models for healthy behaviors. Just as monthly breast and testicular self-examination can help people know their own bodies, monthly skin assessment can help people report early changes. To take care of others (patients, partner, family, or friends), you must first take care of yourself. Commit to practicing sun safety, monthly skin exams, and annual dermatology skin assessments this month.