As we begin to enjoy long summer days, spending any chance we get outside, even more important than remembering that sunscreen is regularly examining your skin.

One in five Americans will develop some form of skin cancer. As a practicing licensed massage therapist, I may see someone’s back more than they ever will. Sixty-four percent of the population never examines their back or seek out an examination by their physician or schedule an appointment with a dermatologist. Because I am not a doctor or a dermatologist, I would never want to wrongly alarm someone about a mole on their back when they are coming to me for relaxation and therapeutic pain relief. However, I am aware of the importance of our unique role as massage therapists to encourage our clients to get regular skin examinations. I have recently taken an online continuing education course offered by American Massage Therapy Association, “Talking to Your Clients About Skin Cancer” to help improve my education on identifying questionable skin lesions because I realize I may be the one seeing my client’s back the most. All the information mentioned in this article comes from this course and a presentation by dermatologist Dr. Amanda Friedrichs from Illinois.

Studies over the past two decades show that UVA damages skin cells called keratinocytes in the basal layer of the epidermis, where most skin cancers occur. Although they are less intense than UVB, UVA rays are 30 to 50 times more prevalent. They are present with relatively equal intensity during all daylight hours throughout the year, and can penetrate clouds and glass. UVA rays are responsible for aging the skin and UVB rays are the ones that we are familiar with for burning the skin. Dermatologists recommend that you wear sunscreen every day, year round. Most people in our town have a vitamin D deficiency because of using sun protection and it is important to take a vitamin D supplement daily, as well.

The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell carcinoma is the most common, affecting 800,000 Americans and often appears as a pimple, but if left untreated it will continue to eat away at the skin around it. It looks a bit like a wart and will sometimes bleed if trauma occurs. Often it will be a rashy looking patch. They are often asymptomatic and can go unnoticed. They are extremely easy to treat and no one should die from this type of skin cancer.

Squamous cell carcinoma (SCC) often looks like scaly red patches, open sores, elevated growths with a central depression or warts; they may crust or bleed. SCC can become disfiguring and sometimes deadly if allowed to grow. As many as 8,800 people die from the disease annually in the U.S. Incidence of the disease has increased up to 200 percent in the past three decades. SCCs are most common in areas frequently exposed to the sun. This includes the rim of the ear, lower lip, face, balding scalp, neck, hands, arms and legs. Often the skin in these areas reveals telltale signs of sun damage, including wrinkles, pigment changes, freckles, “age spots,” loss of elasticity and broken blood vessels. SCC on the scalp, ear and mouth can metastasize quickly. SCC is the most common form of skin cancer found in African Americans, usually as a result of trauma or scarring.

Seventy-five percent of skin cancer deaths are caused by melanomas. Melanoma is the deadliest form of skin cancer. These cancerous growths develop when unrepaired DNA damage to skin cells triggers mutations that lead the skin cells to multiply rapidly and form malignant tumors. Melanomas often resemble moles. Some develop from moles. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white. Melanomas appear most commonly on the back. Melanoma is caused mainly by intense, occasional UV exposure (frequently leading to sunburn), especially in those who are genetically predisposed to the disease. Melanoma kills an estimated 10,130 people in the U.S. annually.

Sun protection is the best way to avoid skin cancer. Besides applying sunscreen, there is now clothing available with a Ultraviolet Protective Factor (UPF) of 50-plus. This means one-fiftieth of the sun’s rays penetrate the clothing. Shirts with long sleeves are best. Wide brim hats are also a necessary protection. Sunglasses are needed to protect the eyes, as melanomas can appear on the back of the eye. It should be remembered, reflections off sand, sidewalks and snow can increase exposure.

Diagnosing is outside the scope of my practice as a massage therapist. Regularly examining your own back, urging your friends and family to make it part of your annual examination, finding a local dermatologist, and free cancer screening events are all going to help in early detection of skin cancer, which is the key to recovery and survival. Visit the American Academy of Dermatology online at aad.org to become familiar in identifying suspicious moles and lesions. You may also visit skincancer.org for brochures, additional information or membership.

To schedule a therapeutic massage, contact Ambrosia Brown at the Telluride Wellness Center at 435-260-1122, ambrosiabrown@gmail.com, ambrosiabrownmassage.com or telluridethaimassage.com.