Skin Cancer

Of all the cancers that humans can get, skin cancer is the most common.  In the United States, skin cancer is increasing in all races.

Who gets skin cancer?
People of all colors and races get skin cancer.  Those with light skin who sunburn easily have a higher risk.  Risk factors include: sunburns, family history of skin cancer, exposure to x-rays, weakened immune system, scarring caused by a disease or burn, and exposure to cancer-causing compounds such as arsenic.  Using indoor tanning devices such as tanning beds and sunlamps also increases the risk of developing skin cancer.

What does skin cancer look like?
There are different types of skin cancer, and each tends to look a bit different.

These dry, scaly patches or spots are considered the earliest stage in the development of skin cancer.  In rare cases, an AK can progress to a type of skin cancer called squamous cell carcinoma (SCC). People who get AKs usually have fair skin.  Most people see their first AKs after 40 years of age because AKs tend to develop after years of sun exposure.  But even teens can have AKs when they live in sunny areas or use indoor tanning.  AKs form on skin that gets lots of sun exposure, such as the head, neck, hands, and forearms.  Because AKs increase the risk of getting SCC, AKs are usually treated. Proper use of sunscreens can help prevent AKs.

This is the most common type of skin cancer.  It frequently looks like a flesh-colored, pearl-like bump.  It also can appear as a pinkish patch of skin.  Like AKs, BCC develops on skin that gets frequent sun exposure, such as the head, neck, and arms.  Many BCCs also form on the trunk and lower limbs.  While BCC frequently develops in people who have fair skin, it can occur in people with dark skin.  BCC usually does not grow quickly, and it rarely spreads to other parts of the body.  But it should be treated promptly.  This cancer can invade the surrounding tissue and grow into the nerves and bones, causing damage and disfigurement.

SCC is the second most common type of skin cancer.  This skin cancer often looks like a firm bump, scaly patch, or an ulcer that heals and then re-opens. SCC is usually reddish in color.  It tends to form on skin that gets frequent sun exposure, such as the rim of the ear, face, neck, arms, and trunk.  People who have light skin are most likely to develop SCC, but it can also develop in dark-skinned people, especially those who have scarring.  Because SCC can grow deep, it can cause damage and disfigurement.  Early treatment can prevent this and stop SCC from spreading to other areas of the body.

This skin cancer frequently develops in a mole or appears suddenly as a new dark spot on the skin.  Either way, melanoma can be deadly.  Every year, more than 8,500 Americans (nearly one person per hour) die from melanoma, making melanoma the deadliest form of skin cancer.

Are there warning signs?
It is estimated that more than 120,000 Americans will develop melanoma this year.  A change is often the first sign of melanoma; therefore, it is important to know where moles appear and what they look like.  When detected and properly treated before it spreads, melanoma has a high cure rate.  The ABCDE warning signs of melanoma can help people detect change:

A  stands for ASYMMETRY; one half unlike the other half.
B stands for BORDER; irregular, scalloped or poorly defined border.
C stands for COLOR; varied from one area to another; shades of tan and brown, black; sometimes white, red or blue.
D stands for DIAMETER; while melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, they can be smaller.
E stands for EVOLVING; a mole or skin lesion that looks different from the rest or is changing in size, shape, or color.

Other changes that could indicate melanoma are pain, itch, or bleeding in a mole or new spot on the skin.

What are the risk factors?
Several risk factors increase a person’s likelihood of getting melanoma.  One risk factor is sun exposure.  It is important to protect the skin with sunscreen and clothing and never sunburn.

Another risk factor is light skin.  However, people with skin of color do get melanoma.  In skin of color, melanoma usually appears on the palms, sales, under the nails, in the mouth, or on the genitals.

A few risk factors significantly increase a person’s risk of getting melanoma.  If one or more first-degree relatives (parent, sibling, or child) has had melanoma, the risk significantly increases.  Having many moles (50-100 or more) or several atypical moles also increases the risk.  An atypical mole is not cancerous, but because of its different appearance, these moles need to be closely monitored for any changes.  Having had melanoma also increases your chances of having additional melanomas.  Most skin cancer can be found early.

Are skin exams important?
With early detection and proper treatment, the cure rate for BCC and SCC is about 95%.  When melanoma is detected before it spreads, it also has a high cure rate.  Regular skin exams help people find early skin cancers.

One type of skin exam is the skin self-exam.  During a self-exam, people examine their own skin for signs of change.  If a growth, mole, sore, or skin discoloration appears suddenly, or begins to change, see a dermatologist.

People who have spent time in the sun, have a family history of skin cancer (especially melanoma), have many moles or atypical moles or have other risk factors for skin cancer should see a dermatologist for regular skin exams.  Some people should have this exam once a year.  Others need more frequent exams.  A dermatologist will recommend the frequency that is best for each patient.

If during the skin exam, a dermatologist sees a potential skin cancer, the dermatologist will remove the growth (or part of it) so that it can be examined under a microscope.  This is called a biopsy.  A dermatologist can safely and quickly perform this procedure during an office visit.

If the biopsy report confirms that the suspicious growth  is skin cancer, more treatment may be needed.  When caught early and the entire growth is removed, sometimes further treatment is not needed.  If further treatment is needed, the dermatologist will choose from an array of medical and surgical treatments for skin cancer.  Treatment varies with the type of skin cancer, the size and location of the skin cancer, and the needs of the patient. 

How can I protect myself?
Sun exposure is the most preventable risk factor for all skin cancers, including melanoma.  You can have fun in the sun and decrease 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 30 or more 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 a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where 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, wearing protective clothing, and applying sunscreen.
  • Use extra caution near water, snow and sand as they reflect the damaging rays of the sun which can increase your chance 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’ve nee 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.