By Maureen Stott

One of the classes at this year’s National Convention was, Talking to Your Client About Skin Cancer with Dermatologist Dr. Amanda Friedrichs.

She started by saying that many people think that getting a tan is a sign of a healthy body, when in fact it is a sign that they are killing their cells, damaging their tissues, and greatly increasing their chances of getting skin cancer. A tan is not healthy at all.

She also explained that you want to have the name of a Dermatologist so you can refer clients if necessary.  Unlike other doctors, Dermatologists are trained to recognize skin cancer.

Here are some facts she shared about skin cancer:

• According to current estimates 1 in 5 Americans will develop skin cancer in their lifetime.
• Only 36% of our population examine their back (at least once a year) for signs of skin cancer.
• There are three major types of skin cancer:
  Basal cell carcinoma
  Squamous cell carcinoma
  Melanoma – the deadliest of the three.
• Basal cell and squamous cell carcinomas are the two most common forms of skin cancer, but if they are detected early they are easily treated and have cure rates approaching 95%.
• Transplant patients are more susceptible to skin cancer.

Here are some facts about Melanoma:

• One American dies from melanoma almost every hour.
• The most common place for a melanoma is on the back.
• Melanoma incidence rates have been increasing for at least 30 years.
• It is the most common form of cancer for young adults 25 – 29 years old and second most common form of cancer for adolescents 15 – 24 years old.
• The major risk factor for melanoma of the skin is exposure to ultraviolet light – either from the sun or tanning beds. We are also exposed to UV light when we ride in the car because UV rays come through glass. So wear sunscreen daily!

We are the only profession that spends an hour or more looking at our client’s skin. With our repeat clients we are better than any other healthcare provider to detect changes to a bump, a sore that doesn’t go away, or unusual skin growth – especially those on the client’s back, but also on their legs, upper chest, neck and face. All of the areas exposed to the UV rays of the sun.

Dr. Friedrichs emphasized that it is NOT our job to diagnose whether the area of concern is cancer or not.

She showed photos of various skin cancers. One photo showed what looked like an age spot and did not have the characteristics of a skin cancer. But, she said, it had changed size and her patient was concerned so they did a biopsy and she admitted that when the diagnosis came back as a melanoma, even she was surprised.

She spoke of what she calls, “Ugly Ducklings.” This is when there are a group of moles, let’s say, and one of them looks different. They may all be the same color but one doesn’t look like the others. It is better to err on the side of caution.

Talking to your clients…

So, what do say when you notice that the area just doesn’t look right or has changed over time?

• Remember that you are not diagnosing, just sharing your observations.
• Wait until after the massage to talk to the client about your observation so that they can relax and enjoy the session. Either make a mental note that you need to talk to them, or, if possible, write down a word or two to remind yourself to talk to them after their massage.
• DO NOT use the word Cancer at all when speaking to the client.
• When the session ends, let the client know that you noticed a spot/area on their body. Ask them if they were aware of this spot/area/bump. If they did not know it was there, assure them that you are not suggesting that it is serious, that you do not diagnose, but they may want to have a dermatologist look at it just to make sure.
• If they are aware of the spot you could ask them, “How long have you had it?” “Does it ever hurt or bleed?” It is my personal experience that if they know that it is there, they have already asked a Dermatologist to look at it. If is hurts or is bleeding, strongly urge them to have a Dermatologist look at it as these may indicate a more serious condition.
• Ask, “Would it be okay if I took a picture of the area so you can show it to the Dermatologist?” and then, making sure that there is good light, use their phone to take the picture so they have it to show the Dr. She said that doctors really appreciate it when they have a photo so they can see if the spot changed and also so they can see where on the body to look. Often, patients have a hard time explaining where it is when they cannot see the area, especially on their back.

She also noted that what the client does with this information is totally up to them. We should not follow-up to see if they took our advice. These are adults who are responsible for their own health and well-being.

Her advice is that anytime you are outside to apply sun-screen. Do this all year long and find one that has at least 4% zinc oxide. I

I find it rewarding to know that by being aware and looking for changes in our client’s skin our observation could save someone’s life.