Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases are reported each year and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.
The primary cause of skin cancer is ultraviolet radiation, most often from the sun, but also from artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities and perhaps the thinning of the earth’s protective ozone layer are behind the alarming rise we are now seeing in skin cancers.
Anyone can get skin cancer, no matter what your skin type, race or age, no matter where you live or what you do. But your risk is at greater if your skin is fair and freckles easily, you have light colored hair and eyes, you have a large number of moles or moles of unusual size or shape. Also if you have a family history of skin cancer or a personal history of blistering sunburns, if you spend a lot of time working or playing outdoors, if you live closer to the equator or at a higher altitude or in any place that gets intense, year-round sunshine or if you received therapeutic radiation treatments for adolescent acne.
TYPES OF SKIN CANCER
By far, the most common type of skin cancer is basal cell carcinoma. Fortunately, it is also the least dangerous kind. It tends to grow slowly and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life threatening, if left untreated it can grow deep beneath the skin and into the underlying tissue and bone causing serious damage, particularly if it is located near the eye.
Squamous cell carcinoma is the next most common kind of skin cancer, frequently appearing on the lips, face or ears. It sometimes spreads to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if it is not treated.
A third form of skin cancer, malignant melanoma is the least common, but its incidence is increasing rapidly, especially in the Sunbelt states. Malignant melanoma is also the most dangerous type of skin cancer. If discovered early enough it can be completely cured. If it is not treated quickly malignant melanoma may spread throughout the body and is often deadly.
OTHER SKIN GROWTHS YOU SHOULD KNOW ABOUT
Two other common types of skin growths are moles and keratoses.
Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. While most pose no danger, some particularly large moles present at birth or those with mottled colors and poorly defined borders may develop into malignant melanoma. Moles are frequently removed for cosmetic reasons or because they are constantly irritated by clothing or jewelry which can sometimes cause pre-cancerous changes.
Solar or actinic keratoses are rough, red or brown scaly patches on the skin. They are usually found on areas exposed to the sun and sometimes develop into squamous cell cancer.
RECOGNIZING SKIN CANCER
Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps, it can be smooth and shiny, waxy or pitted on the surface. It may appear as a red spot that is rough, dry or scaly or a firm red lump that may form a crust or a crusted group of nodules. Another symptom can be a sore that bleeds or does not heal after two to four weeks or a white patch that looks like scar tissue.
Malignant melanoma is usually signaled by a change in the size, shape or color of an existing mole or as a new growth on normal skin. Watch for the “ABCD” warning signs of melanoma:
Asymmetry – a growth with unmatched halves.
Border irregularity – ragged or blurred edges.
Color – a mottled appearance with shades of tan, brown and black, sometimes mixed with red, white or blue.
Diameter – a growth more than 6 millimeters across (about the size of a pencil eraser) or any unusual increase in size.
If all of these variables sound confusing, the most important thing to remember is to get to know your skin and examine it regularly, from the top of your head to the soles of your feet and also check your back. If you notice any unusual changes on any part of your body, consult a physician.
DIAGNOSIS AND TREATMENT
Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth and its location on your body.
Most skin cancers are removed surgically, by a plastic surgeon or a dermatologist. If the cancer is small, the procedure can be done quickly and easily at our surgical center using local anesthesia. The procedure may be a simple excision which usually leaves a thin, barely visible scar, or curettage and desiccation may be performed. In this procedure the cancer is scraped out with an electric current to control bleeding and kill any remaining cancer cells. This leaves a slightly larger, white scar. In either case, the risks of the surgery are low.
If the cancer is large, however, or if it has spread to the lymph glands or elsewhere in the body, major surgery may be required. Other possible treatments for skin cancer include cryosurgery (freezing the cancer cells), radiation therapy (using x-rays), topical chemotherapy (anti-cancer drugs applied to the skin) and Mohs surgery, a special procedure in which the cancer is shaved off one layer at a time. (Mohs surgery is performed only by specially trained physicians and often requires a reconstructive procedure as follow-up).
OPTIONS AND CONCERNS
All of the treatments mentioned above, when chosen carefully and appropriately, have good cure rates for most basal cell and squamous cell cancers and even for malignant melanoma, if it is caught very early, before it has a chance to spread.