More patients protect themselves from the sun after skin cancer surgery

CHICAGO – Patients who have had skin cancers surgically removed report little change in quality of life, but are more likely to use sun screen, wear hats, and avoid the sun after their surgeries than they were before, according to an article in the February issue of The Archives of Otolaryngology, one of the JAMA/Archives journals.

According to background information in the article, skin cancer is the most common type of cancer, and is estimated to affect one in five Americans at some time in their lives. Studies suggest that there are 1.3 million new cases of nonmelanoma skin cancer (NMSC, a type of skin cancer) each year in the United States, and this number is expected to double in the next 30 years. The article states that patients with cancer often experience a diminished quality of life and experience depression, anxiety and feelings of vulnerability.

John S. Rhee, M.D., M.P.H., of the Medical College of Wisconsin, Milwaukee, and colleagues investigated whether the quality of life of skin cancer patients changed after undergoing surgery to remove NMSC. The researchers also studied whether patients' sun-protective behavior (wearing hats and sunscreen, avoiding the sun) and other risky behavior like smoking, changed after surgery.

The researchers assessed the quality of life and smoking habits of 121 patients referred to a dermatology clinic for NMSC of the head and neck. Patients were surveyed again about their quality of life, sun-protective behavior and smoking habits at one month (n=105) and four months (n=101) after their surgeries.

Overall, patients' general quality of life showed little change after surgery, the researchers write, but mental and emotional health improved significantly. The researchers also found that many patients started using sunscreen, wearing hats and adopted other sun-protective behaviors after their surgeries, but smoking habits did not change.

The percentage of patients who practiced various sun-protective behaviors before, and one month after their surgeries was as follows:

sunscreen use – 49 percent before, 72 percent after

wearing hats when outside – 67 percent before, 74 percent after

avoiding the sun – 20 percent before, 44 percent after "Use of sun-protective behaviors increases after treatment," write the authors. "General quality of life instruments demonstrate little change following treatment of NMSC. Although the associations are modest, improvements in emotional and mental health well-being following treatment of NMSC were demonstrated, especially for those younger than 65 years and employed."

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(Arch Otolaryngol Head Neck Surg. 2004;130:141-146. Available post-embargo at archoto.com)

Editor's Note: This study was supported in part by an educational grant from the Tobacco Prevention Research Education Project, American Cancer Society; and by the Medical College of Wisconsin Cancer Center, Milwaukee.

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org .

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Journal

Archives of Otolaryngology - Head and Neck Surgery