Skin Cancer

What You Need To Know About Skin Cancer

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Skin cancer is the most common of all human cancers.  Some form of skin cancer is diagnosed in more than 1 million people in the United States each year.

Cancer occurs when normal cells undergo a transformation during which they grow and multiply without normal controls.

  • As the cells multiply, they form a mass called a tumor.  Tumors of the skin are often referred as lesions.
  • Tumors are cancerous only if they are malignant.  This means that they encroach on and invade neighboring tissues because of their uncontrolled growth.
  • Tumors may also travel to remote organs via the bloodstream or lymphatic system.
  • The process of invading and spreading to other organs is called metastasis.
  • Tumors overwhelm surrounding tissues by invading their space and taking the oxygen and nutrients they need to survive and function.

 

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Known Causes of Skin Cancer

Ultraviolet (UV) light exposure, most commonly from sunlight, is overwhelmingly the most frequent cause of skin cancer.

Other important causes of skin cancer include the following:

  • Use of tanning booths.
  • Immunosuppression-impairment of the immune system, which protects the body from foreign entities, such as germs or substances than cause an allergic reaction.  This may occur as a consequence of some diseases or can be due to medications prescribed to combat autoimmune diseases or prevent organ transplant rejection.
  • Exposure to unusually high levels of x-rays.
  • Contact with certain chemicals-arsenic (miners, sheep shearers, and farmers), hydrocarbons in tar, oils and soot.

The following people are at the greatest risk:

  • People with fair skin, especially types that freckle, sunburn easily, or become painful in the sun.
  • People with light (blond or red) hair and blue or green eyes.
  • Those with certain genetic disorders that deplete skin pigment such as albinism, xeroderma pigmentosum.
  • People who have already been treated for skin cancer.
  • People with numerous moles, unusual moles, or large moles that were present at birth.
  • People with close family members who have developed skin cancer.
  • People who have had at least one severe sunburn early in life.

Basal cell carcinomas are more common in older people.  Melanomas are more common in younger people.  For example, melanoma is the most common cancer in people 25-29 years of age.

3 Types of Skin Cancers:

Basal cell, squamous cell carcinoma and melanoma.

  • The vast majority of skin cancers are squamous cell and basal cell.  While malignant, these are unlikely to spread to other parts of the body.  These cancers may be fatal if not treated early.
  • A small but significant number of skin cancers are malignant melanomas.  Malignant melanoma is a highly aggressive cancer that tends to spread to other parts of the body.  They may be disfiguring if not treated early.

Like many cancers, skin cancers start as precancerous lesions.  These precancerous lesions are changes in the skin that are not cancer but could become cancer over time.  Medical professionals often refer to these changes as dysplasia.  Some specific dysplasiac changes that occur in skin are:

  • Actinic keratosis is a patch of red or brown, scaly, rough skin, which can develop into squamous cell carcinoma.
  • A nevus is a mole and dysplastic nevi are abnormal moles.  These can develop into melanoma over time.

Moles (nevi) are simply growths on the skin.  They are very common.  Very few moles become cancer.

  • Most people have 10-40 moles on their body.
  • Moles can be flat or raised; some begin as flat and become raised over time.
  • The surface is usually smooth.
  • Moles are usually pink, tan, brown, or the same color as the skin.
  • Moles are round or oval and no larger than 1/4 inch across.
  • An individual’s moles usually look pretty much alike.  A mole that looks different from the others should be examined by your health care provider.

Prevention

You can reduce your risk of getting skin cancer.

  • Limit sun exposure.  Attempt to avoid the sun’s intense rays between 10 a.m. and 2 p.m.
  • Apply sunscreen frequently.  Use a sunscreen with sun protection factor (SPF) of at least 15 both before and during sun exposure.  Select products that block both UVA and UVB light.
  • If you are likely to sunburn, wear long sleeves and a wide brimmed hat.
  • Avoid artificial tanning booths.
  • Conduct periodic skin self-examinations.

Skin self-examination

Monthly self-examination improves your chances of finding skin cancer early, when it has done a minimum of damage to your skin and can be treated easily.  Regular self-exam helps you recognize any new or changing features.

  • The best time to do a self-exam is right after a shower or bath.
  • Do the self-exam in a well-lighted room; use a full length mirror and a handheld mirror.
  • Learn where your moles, birthmarks and blemishes are, and what they look like.
  • Each time you do a self-exam, check these areas for changes in size, texture, and color, and for ulceration.  If you notice any changes, call your primary care provider or dermatologist.

Check all areas of your body, including “hard to reach” areas.  Ask a loved one to help you if there areas you can’t see.

  • Look in the full length mirror at your front and back (use the handheld mirror to do this).  Raise your arms and look at your left and right sides.
  • Bend your elbows and look carefully at your palms, your forearms (front and back) and upper arms.
  • Examine the backs and fronts of your legs.  Look at your buttocks and your genitals (use handheld mirror to make sure you see all areas).
  • Sit down and examine your feet carefully, including the soles and between the toes.
  • Look at your scalp, face and neck.  You may use a comb or blow dryer to move your hair while examining your scalp.

Skin Cancer Treatment

Treatment for basal cell carcinoma and squamous cell carcinoma is straightforward.  Usually, surgical removal of the lesion is adequate.

Malignant melanoma, however, may require several treatment methods, including surgery, radiation therapy, and chemotherapy.  Because of the complexity of treatment decisions, people with malignant melanoma may benefit from the combined expertise of the dermatologist, a cancer surgeon and an oncologist.

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