Ask the Expert

We polled the pros on sun burns and the link between birth control pills and breast cancer

expert_article Q: A friend of mine has cancer. What can I say or do?
A: “Finding out that a friend or a relative has cancer can be quite shocking. In such circumstances, being a good listener and a good helper can be challenging,” says Guy Pelletier, clinical psychologist in the Department of Psychosocial Resources at the Tom Baker Cancer Centre in Calgary.

He gives these helpful pointers as you help your friend navigate his or her treatment and care: “First, don’t assume that your friend feels and thinks the way you do,” Pelletier says. “As best as possible, express the feelings that you feel and make offers you can manage.” In terms of what to say, he says it’s OK to be honest about not knowing the best next steps to take. “It is OK to say something like, ‘I don’t know what to say right now, but I care for you and I want to help you.’” Pelletier explains. “Other acceptable responses may include ‘I am sorry this is happening to you’ or ‘What are you feeling at this time?’” he says, noting these are more direct and clear than a blanket “How are you feeling?”

If your friend opens up the conversation about cancer, it is safe to assume he/she wants to talk about it, Pelletier says. “Try to help the conversation by encouraging the person to talk freely and tell his or her story. Avoid shutting the person down by saying something like: ‘I know how you feel’ (because you don’t), ‘my aunt had that kind of cancer too and it was horrible,’ or ‘I know you will be all right.’” Sometimes a person may not feel like talking much, so in such case it’s OK to just touch or hug, or be good company. Finally, it’s a good time to be practical. “Make direct and specific offers of help such as driving, cooking, cleaning, rather than saying “tell me how I can help?” Pelletier concludes.

Q: I’ve heard that there is some connection between birth control and breast cancer. What do I need to know?
A: “Taking the birth control pill may slightly increase your risk of developing breast cancer, but the good news is that the risk is small and tends to return to normal after you’ve stopped taking it for 10 years or more,” says Dr. Huiming Yang, Medical Director, Screening Programs, for Alberta Health Services. Yang notes that most women taking hormonal birth control are younger, and generally at an age when breast cancer is rare. But, he says, “For women who have had a past breast cancer, hormones in the pill might have an effect on the cancer. If you’re worried about your risk of breast cancer, you can consider switching to a non-hormonal form of birth control and finding out whether screening is right for you.”

Yang says that screening mammography is still the best method for detecting cancer early. For more information about breast cancer and screening mammograms, he suggests talking to your healthcare provider or visiting this website. Other good resources on the subject include the National Cancer Institute’s (2014) Genetics of Breast and Ovarian Cancer, Yang advises.

Q: I have heard skin cancer is relatively rare these days. Is this true?
A: “Skin cancer is one of the most frequently diagnosed cancers,” says Allison Fyfe, nurse practitioner in surgical oncology with Alberta Health Services. “The most common types of skin cancers include basal cell carcinoma, squamous cell carcinomas and melanoma. In 2012, an estimated 81, 300 Canadians were diagnosed with non-melanoma skin cancer such as basal or squamous cell carcinoma,” Fyfe adds, noting melanoma is one of the most devastating types of cancer, and its incidence is on the rise.

“In 2012, an estimated 5,800 Canadians were diagnosed with melanoma, resulting in an estimated 970 deaths.” Fyfe says the good news amidst the staggering statistics is most skin cancers are preventable – essentially by avoiding excessive Ultraviolet (UV) radiation exposure from the sun and artificial sources. And for those who are facing a skin cancer diagnosis, the earlier a diagnosis is made, the better overall outcome for patients, she says.

Having worked for many years in the Cutaneous Clinic at the Tom Baker Centre in Calgary, when it comes to skin cancer, Fyfe has nearly seen it all. “New patients often come to the clinic after having a concerning skin lesion or changing mole. This lesion is usually detected by themselves, a family member or friend, doctor, hair dresser or massage therapist,” she explains. “They often describe a new mole or long term mole that has changed in size, shape, colour or has become raised, oozing, bleeding, not healing or itchy. They will go on to have a biopsy of this lesion and a diagnosis is made. When it’s a diagnosis of cancer, it is understandably very difficult for patients and their families.”

Melanomas detected early can be lower-risk and have better outcomes, says Fyfe, adding: “A high-risk melanoma has a greater chance of spreading within the body leading to intensive treatments. Unfortunately, in some cases, this is incurable,” she notes. “It is heart breaking to see both younger and older people dying of melanoma.” The Alberta Provincial Cutaneous Tumor Team developed a list of guidelines for skin cancer prevention, which Fyfe stresses following:

  • Limit sun exposure in the midday sun (usually between 10 a.m. and 4 p.m.) as UV rays are reflected on snow, water and concrete.
  • Seek shade whenever possible.
  • Wear protective clothing when in the sun, including a wide-brim hat, sunglasses and tightly woven, loose fitting clothes that cover as much of the body as possible.
  • Use broad spectrum sunscreen with an SPF of at least 30 and protective lip balm even on cloudy days. Apply both liberally to ensure adequate protection. Reapply often, every two hours and immediately after swimming or excessive sweating.
  • Avoid indoor tanning.
  • Protect children and teens with the tips listed above. Use sunscreen on children six months of age or older.
  • Babies younger than six months should be kept out of direct sunlight and protected from the sun using hats and protective clothing.
  • Regularly examine your skin and report to your doctor any skin lesion that looks unusual, is not healing or has changed in size, shape, colour, is itchy or bleeding.

Other resources for more detailed information include:

Ask our experts questions about general health, cancer prevention and treatment. Please submit them via email. Remember, this advice is never a substitute for talking directly to your family doctor.

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