Skin Cancer is the most prevalent of all types of cancers. More than one million cases of skin cancer are diagnosed in the United States every year.
Fair-skinned individuals who sunburn easily are at a particularly high risk of developing skin cancer. Other important risk factors include the use of tanning devices, family history, repeated medical and industrial x-ray exposure, immunosuppression, scarring from diseases or burns, and occupational exposure to compounds such as coal, tar, and arsenic.
Actinic Keratoses (AK)
AKs (or solar keratoses) are considered the earliest stage in the development of skin cancers. They are small, scaly spots most commonly found on the face, ears, neck, forearm, the scalp of men, and backs of the hands in fair-skinned individuals who have had significant sun exposure. AKs can be treated by cryosurgery (freezing using liquid nitrogen), topical chemotherapy (applying a cream or lotion), chemical peeling, dermabrasion, laser surgery, electrodesiccation and curettage (ED&C- alternately scraping and burning the lesion), photodynamic therapy, or other dermatologic surgical procedures.
Some AKs may progress to advanced stages that require more extensive treatment. Proper use of sunscreens can help prevent AKs even after extensive sun damage has already occurred.
Basal Cell Carcinoma (BCC)
BCC is the most common type of skin cancer; it occurs most frequently in the head and neck, with the rest mainly on the trunk and lower limbs, and often appears as a fleshy bump, nodule, or red patch. BCCs are frequently found in fair-skinned individuals. BCCs usually do not grow quickly, but this does not mean treatment should be delayed. While BCCs rarely metastasize (spread) to other organs, if untreated, cancer often will begin to repeatedly bleed and crust over and can extend below the skin to the bone and nerves causing considerable damage.
Squamous Cell Carcinoma (SCC)
SCC is the second most common skin cancer. It is primarily found in fair-skinned individuals and rarely dark-skinned individuals. Typically located on the rim of the ear, face, near the mouth, or the trunk, this cancer may appear as a firm bump, or as a red, scaly patch. SCCs can develop into large masses and become invasive, leading to extensive tissue destruction and possible risk of metastasis. Therefore, it is important to have early treatment.
When detected and treated early, the cure rate for both SCC and BCC approaches 95 percent.
Malignant Melanoma is the most deadly of all skin cancers. Every year, more than 8,000 Americans will die from Melanoma. It is projected that 100,000 Americans will develop melanoma annually.
Melanoma begins in the melanocyte, the cells throughout the skin which produce the pigment Melanin which makes the skin tan; clusters of melanocytes make up moles. Melanoma may appear suddenly or begin in or near a mole, or another dark spot on the skin. It is important to know the location and appearance of the moles on the body to detect the changes early. Since melanoma cells can continue to produce melanin, this skin cancer often appears in the mixed shades of tan, brown and black, although it can also appear red or white.
Any changing mole must be examined by a dermatologist. Early melanoma can be removed while still in the curable stage. Melanoma readily metastasizes, making early detection and treatment essential to increase survival rates.
Excessive sun exposure, especially sunburn, is the most important preventable risk factor for melanoma. Fair-skinned individuals are at particular risk, but heredity also plays a part. A person has an increased chance of developing melanoma if a relative or close family member had had melanoma. Atypical moles, which may also run in families, and have a large number of moles, can also serve as markers for individuals at increased risk of developing melanoma.
Dark skin is not a guarantee against melanoma. People with skin of color can develop melanoma, especially on the palms, soles, under the nails, in the mouth, or on the genitalia.
Early Detection is Key
Develop a regular routine to inspect your body for skin changes. If a growth, mole, sore, or skin discoloration spears suddenly, or begins to change, see a dermatologist. It is wise to have an annual skin examination by a dermatologist especially for adults with significant past sun exposure, a family history of skin cancer, or other known risk factors.
Early Detection and treatment is key to surviving melanoma. It is beneficial to get assistance from a partner in performing skin self-exams. Get familiar with your skin and your own pattern moles, freckles, and “beauty marks”. Make sure to look at your entire body every month. Consult a dermatologist promptly if any changes are noticed.
The ABCDE’s of Melanoma
Asymmetry- one-half of the lesion is unlike the other half
Border- irregular, scalloped or poorly defined border
Color- Varied from one area to another; shades of brown and tan, black; sometimes white, red, or blue.
Diameter- While melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, they can be smaller
Evolving- A mole or skin lesion that looks different from the rest or is changing in size, shape, or color.
Warning signs of Melanoma Include:
- Changes in the surface of a mole
- Scaliness, oozing or bleeding from an existing mole or the appearance of a new mole that looks different than others.
- Spread of pigment from the border of the mole to the surrounding skin
- Change in sensation including itchiness, tenderness, and pain.
Treatment of Skin Cancer
If a skin biopsy reveals skin cancer, the dermatologist may choose from an array of medical and surgical treatment procedures depending upon the type of cancer, its size and location, and the needs of the individual.
Dermatologic surgical treatments include:
- Surgical Excision
- Mohs Micrographic surgery- a procedure that removes the tumor while sparing as much normal skin as possible
- Electrodesiccation and Curettage (ED&C)- alternately scraping and burning the tumor
- Cryosurgery- freezing using liquid nitrogen
- Laser Surgery
Other dermatologic treatments include radiation therapy and photodynamic therapy. Topical chemotherapy products may also be used
How to Protect Yourself from Ultraviolet Light
Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun while also decreasing your risk of skin cancer. Here’s how to be “Sun Smart”:
- Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 30 to all exposed skin. “Broad Spectrum” provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply approximately every two hours, even on cloudy days and after swimming or sweating.
- Wear Protective Clothing such as long-sleeved shirts, pants, a wide-brimmed hat and sunglasses when possible
- Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
- Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.
- Use extra caution near water, snow, and sand as they reflect damaging rays of the sun which can increase your risk of sunburn.
- Get Vitamin D safely through a healthy diet that may include vitamin supplements. Don’t seek the sun.
- Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you have been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
- Check your birthday suit on your birthday. If you notice anything changing, growing or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.