Every time you go fishing, whether offshore, inshore
or from the shore, you should consider it borrowed time. There
are always overt and hidden dangers associated with our loved
sport. Knowing that they exist and understanding preventative
measures to prevent them can minimize many dangers. Regrettably,
not all problems are prevented in time; so knowing how to recognize
problems and what you should do about them is always a major issue.
Damage caused by the
sun is one of the factors you should always address in any
outdoor activity. Nowhere is this more important than in
fishing. If you are old enough to read this, it is likely
that there has been enough significant, yet unapparent,
sun damage to cause skin cancer. My goal is to outline for
you how to recognize several types of skin cancer and preventative
measures that can keep you alive to fish another day. Please
keep in mind that self-diagnosis is never a good idea, especially
to the untrained eye. In fact, in my practice I never rely
on the visual presentation of any "suspicious"
skin lesion for diagnosis but rather on microscopic evaluation
of a small biopsy. It is important that you see your physician
for this guidance. Please don't bring a chunk of your
flesh to your doctor in a zip lock. We have more humane
and aesthetically pleasing ways of doing this for you (that
last bit was added because of a true incident).
As a physician, father and fisherman, the one
type of skin cancer that I fear most is melanoma. It has a very
high rate of malignancy and therefore death. It is believed that
1 in 90 persons will develop melanoma and some studies show that
50% of the time it is incurable by excision surgery alone. Personally,
I also find it the most difficult to diagnose because it looks
like so many other pigmented lesions (colored). Many individuals
have skin lesions that look potentially like melanoma from common
freckles to flat seborrheic keratosis (liver spots). There are
several characteristics of the most common types of melanoma that
should give you concern. First, change in color (black, brown,
speckled) of normal skin, lumps, bumps or moles. Second, irregular
borders or poorly defined borders of any color on a lesion. Third,
any changing skin lesion that you may find. Often many melanomas
are missed because they can occur anywhere on the body and go
undiscovered because it is not in typically in a sun-exposed area.
A good general rule is: there is nowhere the sun doesn't
shine, despite popular opinion.
type of skin cancer caused by sun damage is squamous cell carcinoma.
About 12 out of every 100,000 white males alone will develop this
disease. All races are at risk, but Caucasian males are the highest
risk group. It tends to grow slowly and spreads less aggressively
than melanoma. It can be any color shape or size and can form
crust, scales or ulcerations. Areas that I see most often involved
are the tips of the ears and the outer lower lip but keep in mind
that this can occur anywhere that you could imagine. Again, all
suspicious areas should be biopsied.
cell carcinoma can look much like squamous cell cancer,
but is much less dangerous on average. It can be incredibly
disfiguring if left untreated. Thankfully, it is the most
common type of skin cancer as opposed to the previous two
types mentioned. Basal cell cancers often looks like a smooth
mole or lump and usually has very fine blood vessels called
telangectasias on its surface although this is not always
the case. On several cases my patients' only complaint
to me has been concerning a lump that they always cut themselves
on while shaving. The ensuing biopsy showed basal cell carcinoma
on most of the cases. Although this type of skin cancer
is rarely metastatic compared to melanoma and squamous cell
cancer, it can be very invasive. This can mean relatively
extensive surgery to remove the entire tumor. The rule here
is to catch it early and report all concerning lumps, bumps
or moles to your physician and request a small biopsy to
be sure that it's okay.
Actinic keratosis also called solar keratosis
is though to be pre-cancerous and can turn into squamous cell
carcinoma. It is that red, scaly rash that is on your favorite
'old salts' head, nose ears or arms. Basically, it
is anywhere on the body that the sun typically shines or everywhere
if you reside in a nudist colony. A simple cream prescribed by
your doctor can help you here. Don't be shy -- no biopsy
is usually needed for this diagnosis or treatment.
Prevention of sun related skin damage is generally
easy. However, we (I include myself here) are often so busy having
fun, we forget the basics. The first line of defense is sunscreen.
I prefer a waterproof, quick drying type that is at least SPF
36. Bullfrog gel is my favorite. Often one application a day of
any type of sunscreen is not nearly enough. This is especially
true if you are swimming or sweating profusely. Take the time
to apply sunscreen before you get out in the sun and it is a good
idea to have help applying it to areas that are hard to reach.
Reapply sunscreen throughout the day. Try to wear a broad brimmed
hat that applies shade to your face and your ears. Please put
liberal amounts of sunscreen on your children! Most of the skin
cancer found in adults is the result of sun damage that occurred
decades earlier! Wearing long sleeve shirts and pants whenever
possible provides the best protection aside from fishing at night
or staying indoors, but who wants to do that?
To wrap it
up, protect yourself and your loved ones from future grief caused
by the sun. If you are like me, and most people I know who didn't
know that sunscreen existed when you were a tike or a know-it-all
teen, have your skin inspected by a professional or at the very
least someone else who has an idea what to look for. Follow up
on any "suspicious" findings with a doctor. Please,
pass the word along.