Skin cancers

[Frank Persson]

Dr Frank Harry Bonfils Persson
Clinical radiation Oncologist
MBBCH FC Rad (Onc) Mmed Rad (Onc) B.sc
Netcare Vaalpark Hospital Suite 5
40 Karas Avenue
Roodia
Sasolburg
0824144183

Today I want to discuss SKIN CANCER

South Africa has one of the highest rates of skin cancer in the world, second only to Australia. It is the MOST COMMON cancer in South Africa with approximately 20 000 new cases being reported annually and 700 skin related deaths reported.

The main cause of skin cancer is exposure to the sun’s ultraviolet (UV) rays which damages the skin cells DNA and can cause abnormal growth (cancer)

Artificial beds used for TANNING can also induce skin cancer

The most common type of skin cancer is the BASAL CELL CARCINOMA (BCC). This typically originates from the BASAL layer of the skin. It typically accounts for 80 % of all skin cancer. It is our more benign (kinder) skin cancers as it does not spread to the lymphatic nodes nor in the blood to our vital organs. It is however LOCALLY AGGRESSIVE and is often referred to as a “RODENT ULCER” i.e. giving the impression of a rat having eaten the skin
It is absolutely sun damage related.
Generally, fully curable with good surgery i.e. full excision or possibly even using radiation therapy.

The second most common skin cancer is SQUAMOUS CELL CARCINOMA. This skin cancer originates from the squamous cell component of our skin. It accounts for 14% of all skin cancer. It is a more aggressive cancer than the BCC as it can spread, typically through the lymphatics, to regional lymph nodes
It too absolutely sun damage related.
Generally, fully curable with good surgery i.e. full excision or possibly even using radiation therapy.


The third most common cancer is the Malignant Melanoma. Malignant melanomas originate from the pigments cells in our skin.
This accounts for approximately 6% of all our skin cancer. It is typically NOT skin damage related although early severe SUN BURN may induce DNA damage with DNA MUTATION…typically B-RAF mutation.
Malignant melanomas are extremely unpredictable in their behavior and spread both lymphatically as well as through blood to all our vital organs.
Treatment involved full excision with a wide margin and regular follow up.

Living in our harsh sun climate in South Africa ,protection against the sun’s UV radiation is important.

Sun protection creams should be applied before exiting the house. Important to buy a SPF (sun protection factor) cream approved by SAPHRA (South Africa Health Products Regulatory Authority). A minimum of 50 SPF should be used

Everybody is at risk of getting skin cancer and hence ACTIVE BODY SURVEILLANCE is IMPERATIVE

Any skin sore that has not healed fully after a full 2 weeks of treatment/observation must be referred to the general practitioner for inspection and possibly biopsy.

Any mole ( benign pigment spot) that behaves abnormally must be addressed by the general practitioner for being a possible malignant melanoma.
When assessing a benign mole against a possible malignant melanoma these are the 5 things to consider
A Aymmetry.. mole is always symmetrical…malignant melanoma NOT
B Border...mole’s border is always regular/sharp… malignant melanoma NOT
C Colour... moles are typically one pigment colour only…. malignant melanoma NOT (they can have multiple stains)
D Diameter... moles are typically not larger than 6 mm in diameter…Malignant melanoma can be many centimeters in diameter.
U Ulceration....any mole that spontaneously BLEEDS i.e. ULCERATES must be inspected for possible malignant melanoma transformation.

To AVOID skin cancer, stay out of the sun between 10.00 and 15.00 when the sun is at its most dangerous.
Cover up by wearing full fitting clothing and wide brim HATS
Always wear SUNCREEN with the appropriate SPF (minimum 50)
Protect your eyes by wearing sunglasses with the appropriate UV protection rating of UV400
Avoid SUNLAMPS and TANNING PARLOURS
Take special care to protect children
Check your skin regularly.

[Kangaroo]

Thank you for taking the time to post this. Looking forward to further interesting posts...

[Flybynite]

Thanks Doc.

It is so important to bring it to the pilot’s attention. We spend a lot of time outdoors and are at high risk.

I had a melenoma removed from my temple and had to excise it 3 times and do the deep and wide excision to get rid of it. I am now on the SACAA protocol for the past 4 years and I have to do multiple tests and X-rays every 12 months to keep my license.

I now wear my hat, sunglasses and decent sunblock when I fly.

[Fransw]

Thank you Doc@Frank Persson !