Getting men to visit the doctor for annual screenings is akin to pulling teeth. But as many men come to the realization that taking care of themselves is essential to living longer, healthier and happier lives, they grudgingly do their screenings for diseases like diabetes, cholesterol and hypertension. And although they may have to be dragged fighting tooth and nail, many of them now even have their prostate, testicles and colon checked. But for many, the thought of having their skin checked for cancer is ludicrous -- even though they may be the very ones that spend hours on end in the sun without protection.
Being screened for skin cancer is the last thing on 42-year-old Darville Demeritte's mind. Just like most men, Demeritte's job entails that he spends hours in the sun, and he often finds himself engaging in recreational outdoor sports, but he never thought once about applying anything to his skin to protect it from the ultraviolet (UV) sun rays he exposes his skin to daily.
"I have heard about [skin cancer] but I know absolutely nothing about it," said Demeritte. "I never really thought it was that important to get screened for skin cancer before, but I do think I should look it up."
Demeritte said he would consider being screened for skin cancer because it is recommended that men take more precautions for it, much like they do with other diseases and other forms of cancers.
Skin cancer, the form of cancer that famous men like Bob Marley, Ronald Reagan, Regis Philbin and Clint Eastwood developed is one that medical professionals say should be taken seriously. Despite the fact that a large percentage of the population in The Bahamas is dark-skinned and as a result may feel they are not prone to skin cancer, this is only a myth, according to Dr. Rashmi Unwala, a dermatologist who has a sessional clinic at Doctors Hospital.
"Contrary to belief, dark-skinned people do have a susceptibility to skin cancer. Their chances may not be as high compared to persons with a lighter hue due to having an abundance of melanin (a natural pigment in the skin that protects against the sun's dangerous UV rays) in their skin, but the risk is still there, especially for those within this population who are fairer in complexion," said the doctor.

What is skin cancer?
Skin cancer is a broad term that encompasses several different cancers of the skin. The three most common forms are basal cell carcinoma, squamous cell carcinoma and melanoma. All are associated with sunlight or the use of tanning beds.
Of all the forms of skin cancer, basal cell carcinoma is the most common. It shows up as a pink or light-looking spot that may look like a pimple but will bleed very easily and can become very tender, according to Dr. Unwala. She said it slowly grows and destroys the surrounding tissue.
The next most common skin cancer is the squamous cell carcinoma. It is found in sun-exposed areas and is described as a red scaly, hard growth that can grow and destroy the skin but that also grows deep and involves the nerves and even gets inside the body if left untreated.
The third most common form of skin cancer is melanoma. This is considered the most serious form due to it having the highest possibility of being terminal. It can spread in the body and cause significant damage to other organs and promote other illnesses that can lead to death if the cancer is not detected and treated early.
Although skin cancers can happen to members of both sexes, the dermatologist said it most commonly occurs in males, due to the majority of men consistently not protecting themselves from the sun while doing the many outdoor activities they are prone to do -- playing sports like basketball, softball or football or if it's a work-related outdoor activity like construction, fishing or landscaping.
"Men in general should be concerned about their skin health and not ignore the signs of problems like uncommon moles or patches of skin that look irregular," said Dr. Unwala. "But before it even gets that far I would want men to just take the simple precautionary measures to protect their skin. There is no reason to get skin cancer if you do what you need to. Some cancers are genetically linked which means that some people are prone to developing it naturally, but it doesn't mean one shouldnt be doing what can be done to prevent it from occurring."

Protect yourself
The dermatologist said the simplest way to protect against everyday skin damage that can potentially lead to cancer is to use a sunscreen lotion that at least has a sun protection factor (SPF) of 30. She said it is also advisable for men to make an effort to wear long sleeved light weight clothing and a hat with at least a three-inch brim when they know they will be outside in direct sunlight for long periods of time. If their job or hobby requires them to work outside she said they should try to do as much work as they can in a shaded area.
In general, she said if people can avoid being in the sun between the hours of 10 a.m. and 4 p.m. when the sun's rays are at their most powerful, that it would be an even better preventative measure.
And when protecting yourself, Dr. Unwala said the protection should be done properly.
"Many people do take protective measures against the sun, but it is not always done correctly because they are misinformed. For instance people think that if it is cloudy or overcast there is no need for sunscreen," said the physician. "This is not so because the sun's rays can still get through the clouds and cause skin damage. You can get a sunburn on a cloudy day. This means people should always wear sunscreen. Also many people believe their sunscreen is waterproof and they don't need to reapply after they come out of the water or sweat profusely. This is not true as there is no such thing as waterproof sunscreen. It will still need to be reapplied," she said.
"It is recommended that it be put on every two hours -- no matter the situation. It is also incorrect to feel that the higher the SPF on the label the better the protection."
The doctor said as long as a sunscreen is at least 30 SPF and has broad spectrum coverage it will protect just as well as sunscreens with higher SPFs.
"There isn't a significant difference between using an SPF 50 over an SPF 100. They both will cover more than 98 percent UVB. The protection doesn't go up the higher the number," according to Dr. Unwala.
How the sunscreen is applied is just as important. If you use too little sunscreen you won't get the protection you should. Dr. Unwala said the rule of thumb is that you need a full two-ounce shot glass amount for full body protection. And that the sunscreen should be applied at least a half an hour before going into the sun because it takes time for it to work.
"In the United States about one million people are diagnosed with squamous cell carcinoma and about 50,000 are found to have melanoma. These numbers are likely to be much lower in The Bahamas due to the much smaller population size and the fact that most people have darker complexions in the region," she said. "But this is no reason for people not to be wary of skin cancer and screen annually -- particularly men," said the doctor.
And even if it is outside their alloted time to do a physical if there is anything unusual happening with their skin, Dr. Unwala said men should be concerned enough to see their normal physician or dermatologist as soon as possible. She said the sooner something is detected and treated, the better the chances. And that even if it is a false alarm, in this day and age, she said it is better to be safe than sorry.
A skin exam by a dermatologist or other health professional should be part of a routine cancer checkup.
Men's Health Week is celebrated June 11-17 globally to heighten the awareness about preventable health problems, and to encourage the early detection and treatment of disease among men and boys. In The Bahamas, the awareness takes place over a month, to remind men that taking care of themselves is essential to living longer, healthier and happier lives. And for them to take the necessary steps to balance work, home and play.

Myths About sunscreen
Myth: People with dark complexions aren't susceptible to skin cancer and therefore don't need to worry about putting on sunscreens.

Truth: All people are susceptible to skin cancer although darker skinned individuals generally have a lower likelihood of developing skin cancer. Even so all people should wear sunscreen and protect themselves adequately since skin cancer can be genetically linked in some cases. Also in the average dark-skinned person, skin cancers can develop on the hands and soles of the feet where skin is lighter and constantly exposed to the sun.

Dispelling the myths about sunscreen
Myth: If it's overcast you don't need sunscreen.
Truth: You need sunscreen whether the sun is out or not. The UV rays can still penetrate the cloud cover and cause skin damage if you are out all day and skin is unprotected.

Myth: The higher the sun protection factor (SPF) number the greater the protection.
Truth: Once the sunscreen is at least 30 SPF and has a wide spectrum coverage the protection given is adequate. There is little difference between a sunscreen that says it has a 50 SPF or another one with 100 SPF.

Myth: If waterproof sunscreen is applied, it doesn't need reapplication after a person comes out of the water.
Truth: There is no sunscreen that is really waterproof. All need to be reapplied after heavy sweating or being submerged in water.

Myth: If sunscreen is applied at the beginning of the day, it doesn't need to be reapplied.
Truth: For sunscreen to properly work it has to be reapplied every two hours and in the proper amounts (two ounces for full body coverage). It should also be applied at least half an hour before being exposed to the sun.

How to protect oneself from the sun
Wear a sunscreen with an SPF of 30 or above daily and reapply in a timely fashion.
If you work outside ensure to do so in a shaded area.
If you are outside for long periods of time wear light weight long sleeved clothing and a hat with a three-inch brim.
Avoid being outside unnecessarily between 10 a.m. and 4 p.m. which are the peak hours of ultraviolet (UV) ray exposure.

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