By: Gary Pettus, UMMC

For the dozens of people screened recently for skin cancer at a University of Mississippi Medical Center clinic, the checkups were free — and priceless.

At UMMC Grants Ferry in Flowood, around 115 people were evaluated one day in May, during Skin Cancer Awareness Month; among them, screeners found 69 cases of skin cancer or pre-cancerous conditions.

The very first person examined showed signs of the deadliest skin cancer of all: melanoma.

That, and the fact that another 68 cases were discovered, underlines the value of early detection, said Dr. Stephen Helms, professor of dermatology at UMMC.

“When we find a case of cancer or pre-cancer, we give the person a list of dermatologists to see in the area, if they don’t already have one.

“We do recommend that they make an appointment for a biopsy pretty soon, especially for melanoma; you don’t want to put it off.”

A biopsy is a procedure to remove a portion of a suspicious area for closer examination or to completely remove the abnormal mass, or tumor, as a potential cure for certain types of skin cancer.

Laura Beth Puhr, LPN, supervisor of clinic operations for dermatology at UMMC, said the nearly six dozen cases detected last month break down this way:

• Actinic keratoses: 50 – Untreated, this pre-cancerous condition can turn into a type of skin cancer called squamous cell carcinoma.
• Non-melanoma skin cancers: 17 – These include squamous cell carcinoma, “which can metastasize and can be very aggressive,” Helms said, and basal cell carcinoma, which accounts for about 75-80% of skin cancer cases and which can also be destructive and disfiguring if left untreated.
• Dysplastic (or atypical) nevi: 1 – A type of mole that looks different from a common mole, including in size, shape and color, a dysplastic nevus rarely turns into melanoma, but the greater the number and size of nevi, the greater the risk.
• Melanoma: 1 – It causes most skin cancer deaths, Helms said. More than 100,000 cases of this disease will be diagnosed in the U.S. this year, and more than 8,000 people are expected to die from it, reports the American Cancer Society. Melanoma can be harder to cure than other forms, but if caught early and treated, the task becomes easier and death is less likely to follow.

Held every year, the Grants Ferry screening event is sponsored by the Department of Dermatology at UMMC in partnership with the American Academy of Dermatology and the Women’s Dermatologic Society.

“Our department is very appreciative for all of the people who help us with this every year and who volunteer,” Helms said.

Some 50 or so UMMC nurses, physicians, staff members, students and other volunteers pitched in at Grants Ferry for this year’s screenings, organized by Helms, Dr. Amy Flischel, associate professor of dermatology; Dr. Thy Huynh, assistant professor of dermatology; Dr. Hannah McCowan, a preliminary medicine resident at UMMC; Walton Mallette, director of ambulatory operations for UPA Dermatology Administration; and Puhr.

“We’ve always had a great turnout for the screening event,” Puhr said.

“Usually, detection is early enough that we can get treatment for the patient so they don’t have to worry about it. Some people who come in may have a family history of skin cancer. Others come in with spots on their skin that they are concerned about.”

One in five people in the U.S. will develop skin cancer, the most common cancer in the U.S., the American Academy of Dermatology reports.

“Usually, if you find a basal cell or squamous cell carcinoma early, it’s not going to spread the way melanoma will,” Puhr said. “Which is why these screenings are so important.”

For patients with these non-melanoma cancers, physicians recommend that they get them removed within a month or so, she said. “But we don’t wait on melanoma. It’s done as soon as possible.”

Melanoma may even show up on unexposed areas of the body – such as the bottom of a foot, Helms said. “And it’s more likely to spread to other parts of the body compared to other forms of skin cancer.

“Clearly, one of the causes related to skin cancer is exposure to sunlight, which is more intense from 10 a.m. to around 3 or 4 p.m.,” Helms said. “It’s more likely to damage lighter skin, but cancer is found in darker skin as well.

“People should try to avoid overexposure. Outdoors, they should wear a hat and light-colored clothing and cover up.”

And use sunscreen, Helms said. “It should be applied about half an hour before exposure to the sun. There are chemical sunscreens that absorb the bad UV rays and release them from the body. The others are physical sun blockers with ingredients like zinc oxide or titanium dioxide.

“It’s best to use a SPF [Sun Protection Factor] of 30 or greater.”

People who come by Grants Ferry for a screening receive samples of sunscreen and instructions on protecting skin from sunlight, Puhr said. “We also ask them to avoid tanning beds.”

UMMC offers skin cancer screenings and/or dermatologic services elsewhere, including those for underserved patients. Among them is the monthly Mississippi Delta Rolling Fork High School Dermatology Clinic for rural patients. The Jackson Free Clinic, 925 Martin Luther King Jr. Drive, Jackson, run by student volunteers, schedules free dermatologic services for patients once every three months.

Even if you’ve never had skin cancer, a yearly screening is prudent, Puhr said. For those who have been treated for skin cancer, the recommendation is a screening every three months afterward for the first year. If no cancer is discovered, the checkups come less frequently, but at least once a year.

In the meantime, you should also check yourself, Helms said. “Look for bleeding lesions or pigmented lesions or moles that are growing or changing color.” For guidance, use the ABCDE test when scrutinizing a mole, he said:

Asymmetry – If the shape isn’t symmetrical, or uniform, this is a warning sign.

Border – Look for a mole with an irregular border – jagged, uneven, etc.

Color – If the mole has more than one color or shade, it may be cancerous.

Diameter – A span of more than a quarter of an inch – about the size of a pencil eraser – is another red flag.

Evolution – When a spot is changing in size, shape or color, or bleeds or becomes itchy or painful, it’s time to see a dermatologist.

In fact, if any of these signs appear, Helms said, see a dermatologist soon.

To schedule an appointment with a dermatology provider at UMMC, call 601-815-3374 or go online here.