Preventive Care for Skin Cancer

Pharmacists can provide guidance on preventing sun-related skin conditions.

Community pharmacists play a substantial role in reducing the risk of skin cancer in the United States. Pharmacists are often the front line of defense against skin cancer since they are frequently consulted first about potentially concerning skin conditions or lesions. For example, pharmacists may be asked whether a certain mole looks suspicious, what sunscreen they recommend, and what they would recommend as the best over-the-counter remedy for skin concerns. Pharmacists also counsel on prescribed topical medications and review application techniques with patients. It is important for pharmacists to be aware of skin disorders and cancer risks so they are able to help patients by providing preventive and early-stage care.

Brown bag sessions are a nice opportunity not only to review patient medications, but also to review the risks for developing conditions such as skin cancer. The pharmacy serves as both a chronic and preventive hub of care within the community. Pharmacists are ideally positioned to counsel patients about the importance of sun protection. Whether it is sunny or cloudy or whether that patient is young or old, protection from the sun should be a precaution for everyone.

For example, when a patient requests advice about treating sunburn, this is an opportunity for the pharmacist to stress the importance of sunburn prevention and recommend appropriate sunscreens. This is especially imperative for fair-skinned patients or patients taking on medications that make them more sensitive to the sun.

Because the development of skin cancer is commonly related to UV radiation exposure, limiting exposure to sunlight is one of the most important preventive measures. To limit sun exposure, patients should be advised to avoid the strong midday sun. When sun exposure is unavoidable, the pharmacist should recommend wearing a hat and protective clothing and make certain the patient has the proper sunscreen. When patients purchase or seek advice about sunscreens, pharmacists can educate them about the appropriate use of those products. Some general counseling points include:

• Use a sunscreen with a sun protection factor of at least 30
• Use a sunscreen that protects against both UVA and UVB light
• Apply to dry skin 15 to 30 minutes before sun exposure
• Reapply every 2 to 3 hours and after sweating or swimming

Pharmacists can also assist in educating patients about self-monitoring for skin cancer. Counseling patients to keep an eye on the symmetry, border, color, and diameter of moles or growths can be done at any new or refill prescription pickup. This allows for any suspicious lesions to be detected and treated at the earliest possible stage.

SC is a 45-year-old female who is a relatively new customer to your pharmacy. Through a prior counseling session, you learned she is employed as a tour guide and spends the majority of her day outside. SC is very aware of her health and prescription medications. Today, SC stops in the pharmacy to pick up her new prescription for levofloxacin. You counsel her on levofloxacin and explain the concept behind a brown bag session. You tell her that since she is health conscious and on a few prescription medications, you think she would be a great candidate to participate in a review. SC is curious and appreciates your attention.

To prepare for tomorrow’s session, you pull up SC’s pharmacy profile so you are able to compare it with what is in her brown bag:

• Furosemide 40 mg once daily every morning
• Atorvastatin 20 mg once daily every evening
• Levofloxacin 500 mg one daily for 7 days
• Levothyroxine 25 mcg once daily every morning
• Esomeprazole 40 mg once daily

SC arrives the next day for your appointment with pen and paper ready to create a list. She empties her brown bag and you notice these additional medications:

• Aspirin 325 mg once daily
• Calcium carbonate 1000 mg once daily
• Adult multivitamin once daily
• Over-the-counter omeprazole 20 mg once daily
• Over-the-counter topical retinoid

As you review the medications for accuracy, SC tells you in confidence that her limited budget and travel schedule sometimes prevent her from being compliant with therapy. She also has been monitoring her blood pressure more frequently and has questions about goals and diet. She is very interested in participating in the medication therapy management session you offered as follow up. How would you properly review CG’ s medication profile and what advice could you offer her during the brown-bag checkup, specifically related to her job, current medication list, and skin cancer prevention?

Dr. Drury works as a clinical pharmacy specialist in Chicago, Illinois, and Milwaukee, Wisconsin. She earned her doctor of pharmacy from Midwestern University College of Pharmacy. Her blog, Compounding in the Kitchen, appears on www.PharmacyTimes.com.