Colon and Rectum Cancer – What you should know and How to reduce your risks

Introduction – The incidence is rising!

Colorectal cancer is the number one cancer diagnosed for males in Singapore and number two cancer diagnosed for females in Singapore (Singapore Cancer Registry, Interim Annual Registry Report, Trends in Cancer Incidence in Singapore, 2006-2010). Colorectal cancer cases have increased because of the aging population (chance of getting colorectal cancer increases with age) and also more people are going for screening.

Screening for colorectal cancer is effective because it almost always starts as a small benign growth, known as polyp, in the wall of the colon or rectum and, over a few years grows bigger to become a cancer. (Fig.1)

Fig. 1

Who is at risk?

The risk factors for colorectal cancer are:
• Age over 50 years (but can occur at any age)
• Personal history of colorectal polyps or colorectal cancer
• Personal history of ulcerative colitis or Crohn's disease
• Family history of colorectal cancer
• Genetic syndrome, Hereditary Non-Polyposis Colorectal Cancer (HPNCC) and Familial Adenomatous Polyposis (FAP)
• Physical inactivity
• Low-fibre and high-fat diet
• Obesity
• Excessive alcohol drinking
• Smoking

What are the signs and symptoms of colorectal cancer?

Usually, people with early stages of colorectal cancer may not experience any symptoms. Thus it is important to go for screening even if there are no symptoms. The common symptoms of colorectal cancer are:
• Blood in the stool
• Unexplained weight loss
• Change in bowel habits (diarrhoea or constipation)
• Bloating and feeling of fullness
• Stools that are narrower than normal
• Nausea and vomiting
• Persistent abdominal pain

How is the diagnosis made?

The diagnosis is usually confirmed with a colonoscopy and biopsy of the cancer. 

Fig. 2

Colonoscopy is an outpatient procedure using a flexible endoscope to examine the inner walls of the colon and rectum. The procedure takes about 20 to 30 minutes under sedation and should be done in a hospital by

a trained doctor. If a polyp or growth is seen during colonoscopy, the some tissues are taken out and send to the laboratory to check if it is benign or cancerous. Fig. 2 shows colon cancer as seen during colonoscopy.

Once diagnosis is confirmed, special scans such as CT or PET scans may be ordered by the doctor to study the extent of the disease.

Stage and Prognosis (Fig. 3)

Stage I (5 year survival rate more than 90%)
Cancer cells are found in the mucosa (innermost layer) and submucosa of the colon wall and may also be found to have spread up to the muscle layer of the colon wall.

Stage II (5 year survival rate 60-75%)
Cancer cells are found to have spread through the muscle layer to the serosa (outermost layer) of the colon wall or nearby organs.

Stage III (5 year survival rate 40%)
Cancer cells have spread nearby lymph nodes

Stage IV (5 year survival rate very low))
Cancer cells have spread to organs like lungs, liver and ovary or a distant lymph node.

Fig. 3

How is colorectal cancer treated?

Treatment for colorectal cancer includes surgery, chemotherapy and radiotherapy which may be used alone or in combination.

In surgery, part of the colon or rectum where the cancer is noted will be removed.(Fig.4) After surgery, most patients can lead an active lifestyle and defecate through their anus like normal individuals.

Fig. 4

In chemotherapy, a drug is used to kill the cancer cells before or after surgery. Possible side effects of chemotherapy are nausea and vomiting, loss of appetite, fatigue, hair loss and diarrhoea.

In radiotherapy, x-rays are used to kill the cancer cells before or after surgery. Possible side effects of radiotherapy are diarrhoea, bleeding and fatigue.

How do I reduce my risk of colorectal cancer?

Family history risks, genetic predisposition and risk associated with age cannot be modified except by going for screening. (see screening recommendations below). 

There are however some modifiable factors we can control:

• Avoid or stop smoking

• Exercise regularly

• Maintain a normal body weight (body mass index <25)

• Eat a high fibre, low fat diet

• Avoid excessive alcohol

• Go for screening 

Screening recommendations

Colorectal cancer is curable if detected early. 

Go for colorectal screening if you are 50 years and above even with no symptoms. If you have a history of colorectal polyp or colorectal cancer do not forget to have regular follow-up with your doctor. If you have a family history of colorectal cancer, you should go for screening at least 10 years earlier than the age when your relative was diagnosed with colorectal cancer. 

The recommended screening tests for colorectal cancer are fecal occult blood test and colonoscopy which should begin at the age of 50 years for people with no symptoms and no family history. If you have symptoms described above, consult your doctor early. 

Fecal occult blood test screens for blood in stool that cannot be detected by the naked eye. It is easy and painless as the person just need to submit a stool sample to the laboratory.

The best method is colonoscopy. It is an outpatient procedure using a flexible endoscope to examine the inner walls of the colon and rectum.

This article was contributed to Tab A Doctor by,

By Dr Kum Cheng Kiong, General Surgeon, Center of Screening and Surgery

 

Providing Support to a Family or Friend Diagnosed with Breast Cancer

There will always be an initial state of shock for most patients. Some may feel a sense of anger of what has happened. The most worrying state to be in is to be in the state of denial, where patients may refuse treatment. But generally, most will come to an acceptance of the illness and accept appropriate treatment.

After diagnosis, a comprehensive discussion of the treatment plan needs to be discussed with the patient. First of all, we need to stage the patient, that is, we need to do some imaging to ascertain if the disease has spread to other parts of the body. Following this, we need to decide if the patient should go for upfront surgery to remove the breast, or if the patient need some treatment, such as chemotherapy and targeted therapy to optimise the condition prior to surgery. 

With modern surgical techniques, surgery is not disfiguring as one would imagine. Depending on the type of surgery, there may also be an option for breast reconstruction which can produce good results. When a patient is undergoing chemotherapy, there may be a possibility of hair loss but this is only temporary.

The diagnosis of cancer and the treatment that one has to undergo is often a daunting experience for many. As a family or friend, it is important to provide emotional and moral support for the patient. I would try to avoid offering medical advice as this may confuse the patients. If the relative or friend is keen to know more, it is best to accompany patient to the treating physician and discuss. With the availability the internet, patients and relatives have easy access to information about medical conditions but often these information are misinterpretated or misconstrued. Hence, my advice is just to be sensitive to the patient’s feelings and needs, lend them a shoulder to cry on, and offer a listening ear if necessary.

The diagnosis and treatment of breast cancer have evolved to offer treatment with lesser side effects and minimal disruption to patients’ lifestyle. When the patient undergoes surgery or chemotherapy, they may feel slightly more lethargic than usual, limiting their activities but this is a temporary problem. One’s appetite may be affected during chemotherapy and therefore we encourage food with more nutritional value. We advise everyone, not only breast cancer patients to maintain a healthy lifestyle of exercise, food consisting of more fruits and vegetables and abstain from alcohol and smoking.

Common Myths about Breast Cancer

Myth 1: All breast lumps are cancerous.

This is not true. About 80% of breast lumps are usually benign (non-cancerous). The important thing is to get it evaluated, and catch it early if it is truly something serious. It is also important to note that sometimes breast cancer may manifest as skin changes such as skin irritation, redness or dimpling, breast pain, nipple retraction (turning inward) and nipple discharge

Myth 2: Annual mammogram exposes one to too much radiation.

The radiation used in mammogram is very small. Any associated risks are minimal compared to the potential benefits that it can offer to detect breast cancer. Mammograms can detect lumps before they can be felt or noticed and the earlier cancer is detected, the better the chance of survival. All women should undergo a screening mammogram every year, starting from age 40.

This article was contributed to Tab A Doctor by,
By Dr Wong Chiung Ing, Medical Oncologist, The Cancer Centre, a subsidiary of the Singapore Medical Group

 

Prostate Cancer

"Prostate cancer is the 3rd most common cancer among Singaporean men. Prostate specific tumor antigen (PSA) blood testing can be done in men with symptoms suggestive of prostate cancer or in men at high risk of developing prostate cancer."

Causes

The cause prostate cancer is not clear.
A combination of factors may play a role in prostate cancer such as family history, ethnicity, hormones, diet and the environment.

Risk factors

The main risk factors include:

• Age. The risk of prostate cancer increases after the age of 50 years.
• Race or ethnicity. Dark skinned men have a higher risk of developing and dying of prostate cancer.
• Family history of prostate cancer increases the risk of prostate cancer.
• Diet. A high-fat diet and obesity may increase your risk of prostate cancer.
• High testosterone levels in men who use testosterone therapy.

Symptoms

In the early stages of prostate cancer, there may be no symptoms.
In the later stages, symptoms of prostate cancer may include urinary symptoms such as:

• Difficulty passing urine or slowing of the flow of urine to a trickle
• Decreased force in the stream of urine
• Blood in your urine or semen

Advanced prostate cancer which has spread to:

• Bones may cause bone pain, fractures and compression of the spine.
• Lymph nodes may cause swelling of the leg or discomfort.

Diagnosis

These include:

• Digital rectal examination (DRE) to detect any abnormalities in the texture, shape or size of the prostate gland.
• Prostate-specific antigen (PSA) test involves taking a blood sample from a vein and testing for PSA, a substance that is naturally produced by the prostate gland to help liquefy semen. High levels will warrant further investigation.
• Tran rectal ultrasound to detect any abnormalities in the prostate gland.
• Prostate biopsy involves taking thin sections of tissue from the prostate gland.

Additional tests include:

• Bone scan
• Ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Lymph node biopsy

Complications

The typical complications of prostate cancer and its treatments include:

• Spread of cancer to nearby organs or travel through the bloodstream or lymphatic system affecting the bones or other organs.
• Pain when the cancer spreads to bones it can cause excruciating pain.
• Difficulty urinating (urinary incontinence).
• Erectile dysfunction (ED) or impotence.
• Depression after a diagnosis of prostate cancer or after trying to cope with the side effects of treatment.

Treatment

The most common treatments for prostate cancer include the following:

• External beam radiation therapy: uses high-powered X-rays to kill cancer cells.
• Radioactive seed implant: also known as brachytherapy, deliver a higher dose of radiation than do external beams.
• Hormone therapy: using drugs to stop the body from producing the male sex hormones testosterone, which can stimulate the growth of cancer cells.
• Radical prostatectomy: surgical removal of prostate gland is used to treat cancer that is confined to the prostate gland.
• Chemotherapy: uses drugs to destroy rapidly growing cancer cells.

Prevention

Prostate cancer cannot be prevented. In general, men are advised to make choices that benefit their overall health such as regular exercise, avoiding high-fat diets, and consuming fruits and vegetables rich in antioxidants.

The established risk factors are increasing age (>50 years), family history and ethnicity (African). So, men aged over 50 years with a normal risk of prostate cancer should discuss with their doctors the risks and benefits of prostate cancer screening. Men who have a strong family history, for example, a brother or father with prostate cancer should be aware of the symptoms of prostate cancer, and discuss management options with their doctor.

This article was originally published on http://www.hpb.gov.sg

What is Ovarian Cancer?

Ovarian cancer refers to malignant growth arising from different parts of the ovaries. (Diagram of anatomy). The ovaries are part of a woman’s reproductive system, where the eggs are developed. Most ovarian cancers are classified as "epithelial" and arise from the surface (epithelium) of the ovary. Other types arise from the egg cells (germ cell tumor) or supporting cells (sex cord/stromal).

How common is Ovarian Cancer?

Ovarian cancer is the 5th commonest cancer in Singapore. There are 280 cases diagnosed yearly based on the Singapore Cancer Registry 2005-2009. It is the second most common female genital tract cancer.

Age of Onset

Epithelial ovarian cancer usually affects older women although it can also happen to younger women. Germ cell cancers of the ovary occur more frequently in younger women.

Causes and Risks

Risk factors associated with ovarian cancer include:-

• late pregnancy
• early onset of menstruation
• late menopause
• never had children-history of breast cancer
• genetic predisposition
• endometriosis

Ovarian cancer is known to run in some families where family members may have increased risk of getting ovarian, breast and endometrial cancer(eg BRCA gene abnormalities) or increased risk of getting endometrial cancer, colorectal cancer in addition to ovarian cancer (Lynch syndrome). In women who have a sister or mother with this disease, the risk of developing ovarian cancer is increased twenty-fold. Ovarian cancer also runs in certain families with a history of breast and colon cancers. There is now evidence to suggest that certain genes are involved in causing these diseases.

Symptoms

Among female genital tract cancers, epithelial ovarian cancers are the most difficult to prevent or cure because they rarely have early symptoms or signs. Symptoms tend to develop only when the cancer is advanced. These symptoms include abdominal swelling and discomfort, bloating or wind, pain, change in bowel habits.

Diagnosis

Although a marker in the blood, called CA-125, is raised in about 80% of patients with epithelial ovarian cancers, it is not always accurate and not adequate for diagnosis of ovarian cancer. It is also raised in non-cancerous conditions, such as endometriosis and appendicitis. The result of elevated CA-125 must therefore be interpreted in the light of other clinical findings. Pelvic ultrasound can help to detect abnormal ovarian cysts. CT scans of the abdomen and pelvis and chest x-rays are also useful in detecting whether are areas of the body is affected. Ultimately an operation or biopsy is required to prove that the cells affected are cancerous and originated from the ovaries.

Treatment of Ovarian Cancer

To determine the actual extent of the cancer, surgical exploration or staging is required. During the procedure, the doctor will examine the peritoneum, which is the inner lining of the abdomen. Fluid within the abdomen is sent for assessment which involves analysis under a microscope. Besides determining the stage of the cancer, the aim of surgery is to remove as much of the cancer as possible. Often this includes removing ovaries, the uterus and its surrounding lymphatics.

Additional treatment following surgery will be determined by the stage of the disease, the grade of the disease (aggressiveness) and the type of cancer.

For very early stage disease and non-aggressive types, further treatment may not be required. For the more advanced and aggressive types of cancers, chemotherapy is the treatment of choice.

Prognosis of Ovarian Cancer

Ovarian cancer in the early stage can potentially be cured while those in the late stage of the cancer, permanent cure maybe difficult.

Frequently Asked Questions

Is there a screening test for ovarian cancer?

There is currently no widely accepted and effective screening test for ovarian cancer. However, if there is a strong family of history of breast or ovarian cancer, it may be appropriate for that woman to go for genetic counseling and testing.

This article was originally published in nccs.com.sg

What Is A Tumor?

A tumor, also known as a neoplasm, is an abnormal mass of tissue which may be solid or fluid-filled. A tumor does not mean cancer - tumors can be benign (not cancerous), pre-malignant (pre-cancerous), or malignant (cancerous). There are many different types of tumors and a variety of names for them - their names usually reflect their shape and the kind of tissue they appear in. Put simply, a tumor is a kind of lump or swelling, it does not necessarily pose a health threat.

When doctors use the term tumor they are talking generically and not about the size of the lesion. A mass usually refers to a lump which is at least 20 mm (0.787 inches) in diameter at its widest point, while a nodule is less than 20 mm at its widest point.

Tumor sizes may vary enormously. In January 2012, Nguyen Duy Hai, a 32-year-old Vietnamese man underwent a 12-hour operation to remove a 200-pound tumor from his leg. Dr. McKay McKinnon, lead surgeon, had rated the success of the operation at just 50%. The surgery was a success.

Cancer stem cells may play a major role in tumor growth, three studies published in the journals Nature and Science revealed in August 2012. Scientists believe cancer might have its own stem cells that impact on the regrowth of tumors. They added that if further studies confirm their findings, the way we treat cancerous tumors may change dramatically.

According to Medilexicon's medical dictionary, a Tumor is:

1. Any swelling or tumefaction.

2. One of the four signs of inflammation (t., calor, dolor, rubor) enunciated by Celsus.


What is a benign tumor?

A benign tumor (benign neoplasm) cannot metastasize - it cannot spread. Examples include uterine fibroids and moles. "Benign" means it is non-progressive, it remains as it is.

Most benign tumors are not harmful to human health. Even though they are not cancerous, some may press against nerves or blood vessels and cause pain or other negative effects. Benign tumors of endocrine tissues may result in the excessive production of some hormones.

Examples of benign tumors include:

Adenomas - tumors that arise from glandular epithelial tissue - epithelial tissue is the thin membrane that covers glands, organs and other structures in the body. A polyp in the colon is a type of adenoma. Other examples include pituitary adenoma, adrenocortical adenoma, basal cell adenoma, bile duct adenoma, chromophobe adenoma, follicular adenoma, hepatocellular adenoma, and nipple adenoma (there are many more).

Although adenomas are not cancerous, they can change and become so; then they are called adenocarcinomas.

Fibroids (fibromas) - benign tumors that grow on fibrous or connective tissue of any organ in the body. Uterine fibroids are common. Uterine fibroids can cause vaginal bleeding, pelvic pain or discomfort, and urinary incontinence.

The fibroma durum (hard fibroma) is made up of many fibers and few cells. The fibroma molle (soft fibroma) is made up of several loosely connected cells and less fibroid tissue. Soft fibroma is usually found in the armpits, groin, neck and eyelids.

There are many types of fibromas, such as angiofibroma, cystic fibroma (fibroma cysticum), myxofibroma (fibroma myxomatodes), nonossifying fibroma, ossifying fibroma, cemento-ossifying fibroma, pleomorphic fibroma, fibroma of tendon sheath nuchal fibroma, chondromyxoid fibroma, desmoplasmic fibroma, collagenous fibroma, and perifollicular fibroma.

Some fibromas can cause symptoms and may require surgical removal. Rarely, fibroids can change and eventually become cancerous, they are then called fibrosarcomas.


Hemangiomas - benign tumors which consists of a collection of too many blood cells. They can sometimes be seen on the surface of the skin and are colloquially called strawberry marks. The majority of hemangiomas appear at birth and gradually go away after some months or years.

Hemangiomas do not usually require any treatment. If they affect the patient's ability to eat, hear or see, the doctor may recommend treatment with corticosteroids. If the patient is over 10 years of age, they are more commonly removed today using laser surgery.


Lipomas - the most common form of soft-tissue tumor. Lipomas consist of adipose tissue (fat cells). Most of them are very small, painless, soft to the touch, and generally movable. They are more common among people aged 40+ years. Experts disagree on whether lipomas can change and become cancerous (malignant).

There are many kinds of lipomas, such as angiolipoleiomyoma, angiolipoma, chondroid lipoma, corpus callosum lipoma, hibernoma, intradermal spindle cell lipoma, neural fibrolipoma, pleomorphic lipomas, and superficial subcutaneous lipoma (the most common type, found just below the skin's surface).


What is a premalignant tumor?

A premalignant or precancerous tumor is one that is not yet malignant, but is about to become so.

Examples of premalignant growths include:

Actinic keratosis - also known as senile keratosis or solar keratosis is a premalignant growth consisting of crusty, scaly and thick patches of skin. Fair-skinned people are more susceptible to these types of growths, especially those who are exposed to sunlight (it is linked to solar damage).

Actinic keratoses are seen as potentially premalignant because a number of them progress to squamous cell carcinoma. Doctors usually recommend treating them because of this. There is a 20% risk that untreated lesions eventually become cancerous. Continuous sun exposure increases the risk of malignancy.

Dysplasia of the cervix - the normal cells lining the cervix of the uterus change. The growth can be premalignant, a prelude to cervical cancer. Cervical dysplasia is diagnosed with a PAP smear. According to the National Institutes of Health, USA, about 5% of PAP smears detect the presence of cervical dysplasia. They are more common in women aged 25 to 35. They may be removed with Cryotherapy (freezing), or conization (the cone of tissue from the cervix is removed).

Metaplasia of the lung - the growths occur in the bronchi, tubes that carry air from the windpipe into the lung. The bronchi are lined with glandular cells, which can change and become squamous cells. Metaplasia of the lung is most commonly caused by smoking.

Leukoplakia - thick, white patches form on the gums, bottom of the mouth, insides of the cheeks, and less commonly on the tongue. They cannot be scraped off easily. Experts believe tobacco smoking and/or chewing is the main cause. Although Leukoplakia is rarely dangerous, a small percentage are premalignant and can eventually become cancerous. Many mouth cancers occur next to areas of leukoplakia.

If smokers quit, the condition usually clears up. Quitting both alcohol and tobacco together has better results. The patches can be removed using laser, a scalpel or a cold probe that freezes the cancer cells (cryoprobe).


What is a malignant tumor?

Malignant tumors are cancerous tumors, they tend to become progressively worse, and can potentially result in death. Unlike benign tumors, malignant ones grow fast, they are ambitious, they seek out new territory, and they spread (metastasize).

The abnormal cells that form a malignant tumor multiply at a faster rate. Experts say that there is no clear dividing line between cancerous, precancerous and non-cancerous tumors - sometimes determining which is which may be arbitrary, especially if the tumor is in the middle of the spectrum. Some benign tumors eventually become premalignant, and then malignant.

Metastasis - malignant tumors invade nearby cells, and then the cells near those, and spread. Some cells can break off from the tumor and spread to various parts of the body through the bloodstream or the lymphatic system, and establish themselves anywhere in the body, and form new malignant tumors. Metastasis is the process by which cancer cells spread from their primary site to distant locations in the human body. For example, a patient may have started off with melanoma (skin cancer) which metastasized in their brain.

The cancer cells that metastasize are the same as the original ones. If a lung cancer spreads to the liver, those cancer cells that grow in the liver are lung cancer cells which have acquired the ability to invade other organs.

There are different types of tumors, which are made up of specific types of cancer cells:

Carcinoma - these tumors are derived from the skin or tissues that line body organs (epithelial cells). Carcinomas can be, for example, of the stomach, prostate, pancreas, lung, liver, colon or breast. Many of the most common tumors are of this type, especially among older patients.

Sarcoma - these are tumors that start off in connective tissue, such as cartilage, bones, fat and nerves. They originate in the mesenchymal cells outside the bone marrow. The majority of sarcoma tumors are malignant. They are called after the cell, tissue or structure they arise from, for example fibrosarcoma, liposarcoma, angiosarcoma, chondrosarcoma, and osteosarcoma.

Lymphoma/Leukemia - cancer arises from the blood forming (hematopoietic) cells that originate in the marrow and generally mature in the blood or lymph nodes. Leukemia accounts for 30% of childhood cancers. Leukemia is thought to be the only cancer where tumors are not formed.

Germ cell tumor - these are tumors that arise from a germ cell, pluripotent cells (cells than can turn into any kind of cell). Germ cell tumors most commonly present in the ovary (dysgerminoma) or testicle (seminoma). The majority of testicular tumors are germ cell ones. Less commonly, germ cell tumors may also appear in the brain, abdomen or chest.

Blastoma - tumors derived from embryonic tissue or immature "precursor" cells. These types of tumors are more common in children than adults. "Blastoma" is often the root word used in longer ones that describe tumors, for example, medulloblastoma and glioblastoma are kinds of brain tumors, retinoblastoma is a tumor in the retina of the eye, osteoblastoma is a type of bone tumor, while a neuroblastoma is a tumor found in children of neural origin.


What is a biopsy?

To decide whether a tumor is malignant or not, a sample must be taken by a surgeon or an interventional radiologist and sent to the laboratory and examined under a microscope by a pathologist - the sample is called a biopsy. There are three different types of biopsies:

1. Excisional biopsy - the entire lump or suspicious area is surgically removed.
2. Incisional (core) biopsy - a sample is surgically removed from the tumor
3. Needle aspiration biopsy - fluid or a sample of tissue is removed with a needle

This article was written by Christian Nordqvist for Medical News Today

Why You Should Wear Sunscreen

For anyone who's ever wondered why you should wear sunscreen, the answers to this question are straightforward and beneficial to your health.

Reasons Why You Should Wear Sunscreen 

There is a huge variety of sunscreen options available today. Even people who don't wear sunscreen every day on exposed body parts usually invest in a bottle or more during summer, when outdoor activities call. There are a number of smart reasons to wear sunscreen daily. These include:

Avoiding sunburn: 

Besides being painful, sunburns are associated with an increased risk for melanoma, the most serious form of skin cancer. Anyone who has ever suffered a severe sunburn knows how debilitating it can be, but the temporary physical effects you see and feel may have consequences far into the future that aren't apparent at the time. 

Children are especially at higher risk for sunburns, and protecting their delicate skin now will cut down on their risk of skin cancer later in life; multiple blistering sunburns during childhood increases the cancer risk as a person ages. 

Cuts down on skin cancer risk: 

With more awareness about skin cancer and skin cancer risks, the sunscreen industry has seen a boom. The earlier and more often people are protected from the harmful rays of the sun, the more they cut down on their risks of getting this disease, which range from mild to life-threatening. 

It's worth investing in sunscreen and the small amount of time it takes to apply to avoid serious cancer down the road. Parents and caregivers, of course, will have to be diligent in applying sunscreen to children, and there are plenty of formulas made just for young and sensitive skin.

Keep skin wrinkle-free: 

Besides the health benefits of slathering on sunscreen every day, there's also a vanity reason, for those who want to maintain their youthful looks. Some of the damaging physical effects of too much sun include premature aging, or wrinkles, and age spots. 

If the skin cancer facts don't sway you, perhaps the idea that you can delay wrinkles will. You can easily wear a general sunscreen all over the body, while using a product made specifically for the face on that area. 

In addition, many cosmetic companies manufacture makeup with built-in sunscreen, so you can enjoy the convenience of multi-tasking products that will also protect you.

Prescription worries: 

Certain medications make the skin ultra sensitive to the sun's rays, making a sunburn or allergic reaction a more likely possibility, even if you don't spend a lot of time outdoors. 

Always check with your doctor or pharmacist when taking medications. Some over-the-counter meds also increase your sun sensitivity, such as those containing ingredients to fight serious acne. It's important to wear a sunscreen if you know you'll be outside while taking phototoxic or photoallergic drugs, but to be on the safest side, stay indoors as much as possible. 

Sunscreen Is for Everyone

Although some people, due to genetics and their physical makeup, are more at risk for developing skin cancer, anyone of any ethnicity can get the disease. Some people with darker complexions mistakenly believe that the additional melanin in their skin protects them from skin cancer, but this is not true. Everyone should be aware of why you should wear sunscreen, whether they're fair-skinned or not.

Smart Sunscreen Use

Young or old, dark or fair, sunscreen benefits everyone. The next time your child complains about having to endure being covered head-to-toe in sunscreen before you head to the beach or pool, you can explain why sunscreen is necessary. Besides the physical effects you may see now or sometime in the future, the serious health risks that may arise from never using sunscreen should be enough to convince anyone.



This article was originally published in lovetoknow.com