Before You Soak Up the Sun, Read This


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By Joseph M. Pepek, MD

With spring upon us and summer approaching, many people are excited to get outdoors and soak up the sun.

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However, it’s important to remember that exposure to the sun’s harmful UV (ultraviolet) rays can increase the risk of developing skin cancer.

Skin cancer is the most common cancer in the United States, affecting millions of people each year, according to the Skin Cancer Foundation.

While prevention is key, there are several effective treatment options available for skin cancer, especially if the disease is detected early.

Types of Skin Cancer

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma.

Basal cell carcinoma is the most common type of skin cancer, with approximately 3.6 million cases diagnosed each year, according to the Skin Cancer Foundation.

These cancers arise from basal cells in the outermost area of the skin and are usually caused by a combination of intermittent, intense exposure and cumulative, long-term exposure to UV radiation from the sun.

Squamous cell carcinoma is the second most common type of skin cancer, affecting more than 1.8 million people each year, and arises from the squamous cells in the skin’s outer layer.

These cancers are typically caused by long-term exposure to UV radiation from the sun and from tanning beds, according to the Skin Cancer Foundation.

Melanoma develops from melanocytes, the skin cells that produce melanin pigment, which gives skin its color.

While melanoma is the least common form of skin cancer, it is the most dangerous because it can spread rapidly. As the Skin Cancer Foundation notes, melanoma is typically caused by intense sun exposure, the kind that leads to sunburns, or exposure to UV radiation from tanning beds.

More than one in five people will develop some type of skin cancer by the age of 70, according to the Skin Cancer Foundation, and more people are diagnosed with skin cancer
each year in the U.S. than all other cancers combined.

Warning Signs

The warning signs of skin cancer aren’t always clear and vary depending on the type. However, there are some common potential indicators of the disease, which include:

  • New, changing, or unusual skin growths.
  • Redness or swelling beyond the border of a mole.
  • Any sore that does not heal.
  • Itching, pain, or tenderness in an area that doesn’t go away or goes away then comes
  • Changes in the surface of a mole: oozing, scaliness, bleeding, or the appearance of a lump or bump.

If you are concerned about changes in your skin or your risk for skin cancer, see a dermatologist for an evaluation. The earlier skin cancer is detected, the easier it is to treat.


If you are diagnosed with skin cancer, there are several treatment options available depending on the type of cancer and its severity.

Surgery is the most common treatment for skin cancer. In most cases, the cancerous tissue is removed, and the area is then stitched closed. In some cases, a skin graft may be necessary to cover the wound.

For large cancers or cancers that have spread to other parts of the body, chemotherapy and radiation may also be recommended.

In addition, for nonmelanoma-type skin cancers, radiation may be used as an alternative to surgery with similar cure rates. Radiation is helpful for difficult surgical areas such as the nose, ear, and eye regions.

At the Cancer Center at Penn Medicine Princeton Medical Center (PMC), radiation oncologists are using high-dose rate (HDR) brachytherapy to treat basal cell and squamous cell carcinomas.

This approach delivers a highly concentrated dose of radiation to the tumor with specialized applicators that allow for precise delivery to protect and spare healthy tissues.

Research indicates that HDR brachytherapy can be an effective alternative to surgery, especially to areas like the face where scarring may be concern and for patients who may not be candidates for surgery.


While most people equate summertime with sunshine, exposure to the sun’s harmful rays can happen year-round, even when you’re simply out walking the dog or running errands.

The Skin Cancer Foundation recommends taking these steps to guard against skin cancer, no matter the season:

  • Seek the shade, especially between 10 a.m. and 4 p.m. when the sun’s rays are the
  •  Don’t get sunburned.
  • Avoid tanning and never use UV tanning beds.
  •  Cover up with clothing, UV-blocking sunglasses, and a broad brimmed hat.
  • Use a broad-spectrum (UVA/UVB) sunscreen with an SPF (sun protection factor) of 15 or higher every day.
  • For extended outdoor activity use a water-resistant, broad-spectrum (UVA/UVB)
    sunscreen with an SPF of 30 or higher. Apply at least one ounce of sunscreen to your
    entire body 30 minutes before going outside. Reapply every two hours or after
    swimming or excessive sweating.
  • Keep newborns out of the sun. Use sunscreen on babies over six months old.
  • Examine your skin head to toe each month.
  • See a dermatologist at least once a year for an annual skin exam.

To find a physician with Penn Medicine Princeton Health call (888) 742-7496 or visit

Joseph M. Pepek, MD, specializes in radiation oncology and is Chief of Radiation Oncology at Penn Medicine Princeton Health.

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