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Culturally Speaking: The South Florida Sunday Podcast
Skin Cancer Awareness Month with Dr. Theodore Huss
00:12:33
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- [00:00]
A
So May is skin cancer awareness month. But here in Florida, with our big beautiful sun always shining so bright, this is something that we have to worry about all year round. So I brought in Dr. Harold Huss from Baptist Health to give us some helpful information and tips to keep ourselves safe in the summer sun. Thank you so much for joining the show today.
- [00:17]
B
Oh, thank you very much for having me.
- [00:19]
A
Absolutely. How common is skin cancer today? And why is awareness so important?
- [00:26]
B
So skin cancer is the most common cancer in the United States and the world. One in five Americans will develop skin cancer by the age of 70. Almost 10,000 people in the United States are diagnosed with skin cancer every day. That translates to almost 6 million cases of non melanoma skin cancer treated in the United States every year.
- [00:48]
A
Oh wow.
- [00:49]
B
Most people are diagnosed with skin cancer each year in the United States than all other cancers combined. The majority of skin cancers are non melanoma skin cancers like basal cell cancer and squamous cell cancer. And the rest are melanoma. The reason why awareness is so important is because when skin cancers are detected early, most are treatable and rarely result in death.
- [01:13]
A
And what would you say are the biggest risk factors for developing skin cancer, especially here in South Florida?
- [01:18]
B
It's a very interesting question. Florida averages approximately 237 sunny days each year, which is higher than the United states average of 205 sunny days. Greater than 90% of non melanoma and melanoma skin cancers are due to exposure to ultraviolet radiation from the sun. Ultraviolet radiation is a proven human carcinogen. Actually, according to the International Agency for Research on Cancer, plutonium, cigarettes and solar ultraviolet radiation are all listed in the same group of agents that are cancer causing to humans. There are other risk factors for developing skin cancer, like tanning beds, which can emit ultraviolet radiation 10 to 15 times higher than the sun at its peak intensity. In fact, almost 500,000 cases of skin cancer in the United States each year are linked to indoor tanning. There are also family history. There are genetic syndromes like congenital melanocytic Levi syndrome, personal history of skin cancer, many moles, atypical moles, severe sunburn in your younger years. Also phenotypic features such as fair skin, red blonde hair or light eye color. People use ultraviolet light therapy for psoriasis and also ultraviolet nail lamps, people who take immunosuppressive medications like if you had a transplant. As well as age, there's a higher incidence of melanoma with increasing age.
- [02:49]
A
You pointed out a lot of interesting things there, especially with the tanning beds and the, you know, the nail salons, because a lot of people do that. And I don't really think a lot of people know that they're really putting their theirselves in danger just by doing those things too often.
- [03:02]
B
I agree. And that's why many states have banned tanning beds for people under 18 years old. Of course, they should be banned for people who are older than 18 years as well.
- [03:13]
A
Yeah. And, you know, so many people, they go to the beach, and then they also do the tanning beds, too. So that is insane. We often hear about melanoma being the most dangerous form of skin cancer. What makes melanoma specifically so serious, and how is it treated today?
- [03:29]
B
Well, melanoma is one of the most aggressive form of skin cancer. Over 225,000 cases of melanoma were diagnosed in the United States in 2025. Of those, approximately half were in situ, which means non invasive, meaning that the melanoma was confined to the epidermis, which is the top layer of the skin. And half are called invasive melanoma, meaning the melanoma penetrated the epidermis into the dermis, which is the next layer of the skin. Almost 8,500 deaths last year in the United States were due to melanoma. It is the fifth most common cancer in men and women. And in 2040, melanoma cases will double and will be the most common cancer. There are greater than 10,000 cases of invasive melanoma in Florida last year, which is the most out of any state in the United States per capita. So what is melanoma? So melanoma is a type of cancer that comes from melanocytes. Melanocytes are pigment producing cells. They produce melanin, which gives skin its brown, tan color, and it also protects the deeper layer of skin from ultraviolet radiation. Most melanomas are confined to the epidermis, the top layer, and are curable. However, once melanoma invades the dermis, the next layer, it has the potential to metastasize or spread. Melanoma has the potential to spread to almost any organ in the body, and the lymph nodes being the most common place. It grows rapidly. It can invade deeper skin structures. It evades the immune system better than most other skin cancers and spreads to other organs through multiple avenues, including through the lymphatics, which are the lymph nodes, and hematogenously through the bloodstream. And there are many different types of treatment for melanoma, including surgery, immunotherapy, targeted therapy, radiation, something called oncolytic. Virus therapy called tvec, which is injecting a virus into the melanoma itself. There are kill therapy which are tumor infiltrating lymphocytes where we take cells out of the body and increase them. These are cancer killing cells and then put them back into the, into the body. And there's hyperthermic isolated limb perfusion and limb infusion. This is where we give chemotherapy directly to the affected limb or a combination of, of many of these treatments.
- [06:04]
A
Well, I will say with all that, it's really refreshing to see that you have so many options to treat melanoma, especially since it's so widespread and so many people are expected, especially like you said in 202040 to more than double with the cases. That's insane. You said that males are going to be the most affected by that time.
- [06:23]
B
Males, yes, in, in 2040. That's what the, the experts say.
- [06:29]
A
Do you know why or.
- [06:30]
B
Well, there are a few reasons. First of all, men's skin is generally thicker and has less fat than women and therefore makes it more susceptible to UV or ultraviolet damage. Also, men tend to spend more time outdoors and often without adequate sun protection. Also, men are less likely to know the facts about skin cancer prevention and the dangers of using sun and tanning beds. Men have more skin surface area on average, which means more melanocytes. And lastly, men often delay seeking medical care if they find any skin changes, which of course can allow melanoma to progress before detection.
- [07:17]
A
Okay, now that you explained it to me, it kind of makes a little bit more sense. And there's also a lot of misconceptions around sunscreen and sun protection in general. Even some influencers talking about tau because it has less chemicals than sunscreens too. What are the most effective ways people can reduce their risk?
- [07:35]
B
Well, the most important message is to stay out of the sun or limit sun exposure, especially during the peak hours of the day between 10am and 4pm when the sun rays are the strongest. However, if you do run out into the sun, protect yourself with sun protective clothing and sunscreen. Try to use sunscreen with an SPF of at least 30 to protect against both ultraviolet A and ultraviolet B rays. And try to use daily use of sunscreen with an SPF of 30. We know that it reduces the risk of melanoma by 50% and squamous cell carcinoma by 40%. And also remember to reapply sunscreen every two hours or more or more frequently if you're swimming or sweating. Yes, and there are many misconceptions like you said about sunscreen, including that it causes cancer. However, no sunscreen ingredient has ever been proven to cause cancer in humans. But we do know is that ultraviolet radiation does cause cancer in humans. Another concern is inhalation of spray sunscreens. Everybody uses spray sunscreens these days. Even though there is a safety margin built in spray sunscreens, it is still recommended that you spray the sunscreen onto your hand and then rub it onto your face so that inhalation is kept to a minimum.
- [08:55]
A
Okay. And another misconception is that if you're darker skinned or you can tan without getting a sunburn, that you don't have to take those precautions. Is that true?
- [09:03]
B
So we know that people with darker skin definitely still need sunscreen, while melanin, which is the pigment in the melanocytes in darker skin, provides some natural protection against UV radiation. But it definitely is not a complete shield. So definitely it does not matter what color you are. You also need sunscreen even if you're Hispanic or African American.
- [09:28]
A
And what about on those cloudy or overcast days? Should we still be wearing sun protection?
- [09:32]
B
Yes, believe it or not, up to 80% of UV lights can still penetrate the clouds, even on a cloudy day and reach your skin. So, yes, you definitely should still wear sunscreen on cloudy days.
- [09:45]
A
And we kind of talked about this a little bit earlier, but skin cancer rates have seemed to like, increase in younger adults. So what's contributing to that trend?
- [09:53]
B
Yeah, I've noticed increased rates of melanoma and non melanoma skin cancer in younger adults. And if you look at the literature, there's also a clear trend globally of a rise in melanoma and non melanoma skin cancers in younger adults as well. This could be due to younger adults spending more, more time in the sun as well as tanning beds. Or maybe it could be due to early detection, which is good, I guess. However, most of the melanomas that we find in the younger adults are thinner melanomas, which means more treatable. However, there are countries like Sweden, that the rates of skin cancer in younger adults have continued to decrease. The government of Sweden spend a significant amount of time, money and resources into public health campaigns, raising awareness and educating the public about sunscreen use and early dermatologic visits.
- [10:48]
A
Exactly. And you know what, that is why we always try to do stuff like this. Because awareness really does help to decrease the trend of, you know, people getting sick by things that they can control, you know, or in some cases anyway. What message would you like the listeners to remember? Especially when it comes to prevention and early detection.
- [11:06]
B
So if you remember anything from today's talk on skin cancer prevention, it should be the abcpes of melanoma. So a is asymmetry. That's one half of the lesion does not match the other half of the lesion borders. So B is borders the edge of the lesion. The edges are not smooth. They're irregular or uneven. C is for color. The lesion has different shades of brown or black throughout, or the lesion becomes darker over time. D is diameter. Anything greater than 6 millimeters, which is basically the size of a pencil eraser, should be evaluated by your dermatologist. And E is evolving. So any change in size, shape, color, or elevation or change in condition of the lesion, such as bleeding, crusting, or itching. Although the ABCDs are referring to melanoma, but they're also useful in other cancers. Number two, you should go to a dermatologist at least once a year for a skin check. Number three, daily use of SPF 30 or greater sunscreen. But the importance of the ABCDEs of melanoma cannot be overstated. Remember that most melanomas are found by patients themselves. And also remember that early detection has dramatically improved survival rates with melanoma. If you're concerned, don't push it off and go see your dermatologist right away.