Skin cancer (melanoma & non-melanoma)

Repeated sunburns, especially at a young age, are among the factors that count later. The most effective protection is therefore the one children get — shade, clothing and the right amount of cream.

The treatment plan is not made by one person alone but in a round of surgery, oncology, radiology, pathology and radiotherapy. You may ask what was discussed there and which alternatives came up.

Before a big decision it is planned for in many clinics, and the records belong to you. It costs one to two weeks — acceptable in almost every course, and one asks about that if it is urgent.

It is today part of the treatment and not its opposite: it lessens the exhaustion, keeps muscle and bone and improves how the treatment is tolerated. Begin with guidance, less on bad days, but not nothing at all.

Unintended weight loss worsens how any treatment is tolerated. Restrictive diets do more harm than good here — with loss of appetite, dietary advice helps early, not only once kilos are already gone.

By the clock rather than as needed works better and needs less overall. Fear of dependence is the wrong adviser in this situation — untreated pain costs sleep, appetite and strength.

Psycho-oncological support, social advice for insurance and work, and the question of who takes on what at home. This is no emergency measure but belongs at the start — and the relatives belong in it.

Non-melanoma skin cancer is the most common cancer of all and almost never spreads. Melanoma is rarer, but it is decided by thickness: under one millimetre, five-year survival is above ninety-five percent. That is exactly why this is about weeks, not months.

In melanoma, surgery removes the tumour; everything further follows the thickness. Immunotherapy after surgery lowers the return measurably and is given for a year. With spread it works in about half, and in some of those for many years — that was not the case fifteen years ago. In light-coloured skin cancer, creams and local methods are enough for superficial forms; they need four to six weeks and make the area temporarily red and sore, which is part of the effect.

Asymmetry, blurred edge, several colours, diameter over five millimetres, change over months. The more of these apply, the less waiting is worthwhile.

A small lump that keeps bleeding and crusting, a flat, scaly patch on forehead, nose, ear or back of the hand that has been there for months. That is the most common form and the most treatable one.

Most moles appear in childhood and youth. A truly new, dark mole in later adult life deserves more attention than one that has been there for thirty years.

Soles of the feet, between the toes, under the nails, scalp, genital area. These places are almost always forgotten in self-examination — and that is where findings are picked up latest.

No value detects a skin cancer — the eye and the tissue sample do that. In melanoma the LDH is carried along in the follow-up.

A follow-up value in melanoma, not for detection. A normal value rules nothing out.

Anyone who has to avoid the sun consistently more often has low values. That belongs replaced rather than ignored.

The loss of muscle mass helps decide how well a treatment is tolerated. Enough protein spread across the day, together with movement, is the part one holds oneself.

Skin and lining renew themselves quickly and need zinc for it. With places that heal badly, cracked corners of the mouth and frequent skin infections a lack is a serious possibility.

Low values are common with a longer illness, and correcting them counts for bone and muscle. For high-dose courses against the illness itself there are no studies; they can interfere with treatment.

Without vitamin C no stable collagen forms — the wound closes but holds less well. With a very one-sided diet, smoking and alcohol the intake is often tighter than assumed.

Belong in the workup of an anaemia that is otherwise too quickly put down to the illness or the treatment. Both are easy to measure and easy to supplement.

As nicotinamide, 500 mg twice daily over 12 months lowered the number of new light-skin cancers in high-risk people by about a fifth in an Australian trial. After stopping the effect goes again — and it does not apply to melanoma.

Anyone avoiding the sun regularly has low levels — which is why the value belongs measured with strict light protection. An influence on the skin cancer itself is not shown.

Long advertised as protection. In large skin-cancer prevention trials no benefit showed — and in smokers on high sustained doses, more lung cancer. It is one of the clearest examples that a nutrient from food is not the same as that substance in a capsule.

Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.

Anyone carrying a particular variant of the receptor for this hormone has red hair, fair skin and freckles — and forms barely any protective pigment under UV. That is why this skin type needs a different measure, not more discipline.

Consistent light protection measurably lowers the vitamin D level. That is not an argument against the protection but a reason to measure the value and cover it through food or a supplement.

In people with repeated non-melanoma skin cancer 500 mg nicotinamide twice daily over 12 months reduced new lesions by about a quarter. After stopping, the protection ends.

Carotenoids and polyphenols extend natural protection only by minutes. That belongs said, so no one relies on it.

The claim usually rests on the PET scan: weakly radioactive glucose is injected, and the tumour lights up. That shows tumour cells take up sugar faster than the tissue next to them — not that eaten sugar feeds them. You come to a PET scan fasting, and the tumour lights up anyway; the body keeps blood sugar within narrow limits by itself. It cannot be starved out this way. There is an established link nonetheless, but it runs through body fat: in 2016 the International Agency for Research on Cancer (IARC) reviewed the available studies and found sufficient evidence, for thirteen cancers, that absence of excess weight lowers the risk. That concerns prevention — it is not an answer to where an existing illness came from.

Anyone protecting themselves consistently makes less vitamin D. Making it up through food or a supplement is then more sensible than less protection — sunburn is the established risk factor.

Antioxidants are marketed as “sun protection from inside”. They extend natural protection by minutes — that replaces neither shade nor cream.