The number of cases of skin cancer is rising each year in the United States.
According to the American Cancer Society (ACS), exposure to ultraviolet (UV)
rays is believed to be the biggest culprit. That's why it's so important to
protect your skin from excessive sun exposure. It's also important to check your
skin regularly for warning signs of skin cancer. If caught and treated early,
skin cancer CAN be successfully treated.
Types of Skin Cancer
Although skin cancer
can develop on any part of the body, it's most commonly found on areas that are
often exposed to the sun. The National Cancer Institute (NCI) and ACS say there
are different types of skin cancer:
- Basal cell cancer, the most common, is relatively slow-growing in many
cases. It begins in the lowest layer of the epidermis, called the basal cell
layer. It can first appear as a waxy bump or a flat lesion.
- Squamous cell cancer is also slow-growing but it can metastasize or spread
to other body parts. It begins in the middle portion of the epidermis. This type
of cancer can also start as a pearly bump or a flat lesion. It may be crusted as
well.
- Malignant melanoma is the most dangerous type. It originates in the
melanocytes, or pigment producing cells of the skin. It starts as a pearly or
dark bump or as a small lesion with irregular borders. About a third of the
cases start in moles that suddenly change appearance or start to bleed.
- Other nonmelanoma skin cancers account for less than one percent of
nonmelanoma skin cancers, according to ACS. These less common skin cancers
include:
- Kaposi's sarcoma, which usually starts within the dermis but can also form
in internal organs. The tumors consist of bluish-red or purple lesions. This
cancer occurs in people with compromised immune systems , such as those with HIV infection or
AIDS, as well as transplant
recipients who are on immune-suppressing drugs.
- cutaneous lymphoma, a type of lymphoma that begins in the skin.
- skin adnexal tumors, rare tumors that start in the hair follicles or sweat
glands, and are usually benign.
- sarcomas, which usually start in tissues deep beneath the skin, but can
develop in the skin as well.
- Merkel cell carcinoma, a rare cancer that develops on or just beneath the
skin and in hair follicles, and usually appears as firm, shiny skin lumps.
There is another condition, actinic keratosis (AK), which appears as rough,
red or brown scaly patches on the skin. AK is known as a precancerous condition
because it sometimes develops into cancer. Like skin cancer, it usually appears
on sun-exposed areas but can be found elsewhere. The National Institutes of
Health say AK's may start as small, red, flat spots then grow larger and become
scaly or thick, like a wart. Most AKs form on the face or back of the hands, but
can appear elsewhere.
When examining your skin for changes or growths, the American Academy of
Dermatology says there are "ABCD" warning signs to be aware of:
- Asymmetry - one half of a growth does not match the other half.
- Border irregularity - the edges are ragged, notched or blurred.
- Color - the pigmentation is mottled or not uniform.
- Diameter - the width is greater than six millimeters (about the size
of a pencil eraser).
In general, any unusual change in the skin,
especially a new growth or sore that doesn't heal, can be a warning sign of skin
cancer, and should be checked promptly by your physician. Any growth of a mole
should be of concern too. When caught early, your chances for successful
treatment are much higher.
Who's at risk
Since sun exposure is most commonly linked to skin cancer, people who have a
history of frequent sun exposure as well as sunburns are at a higher risk of the
disease. NCI says fair skinned individuals, especially if they have blond or red
hair and blue eyes are more at risk, as are people with a family history of skin cancer.
Since the effects of sun exposure add up, the National Institute on Aging
says our risk of developing skin cancer also increases as we get older. And people with a large number of
moles can have a higher risk of developing skin cancer. Anyone in a high-risk
group should take extra precautions against skin cancer and talk with their
doctor about regular screenings.
Treatment options
Treatment for skin cancer usually involves some type of surgery, according to
NCI. In some cases, doctors suggest radiation therapy or chemotherapy. Sometimes
a combination of methods is used. Options include:
- Surgery - NCI says many skin cancers can be cut from the skin. In fact, the
cancer is sometimes completely removed at the time of the biopsy, and no further
treatment is needed.
- Curettage and Electrodesiccation - In this procedure, the cancer is scooped
out with a curette, an instrument with a sharp, spoon-shaped end. The area is
also treated with an electric current from a special machine is used to control
bleeding and kill any cancer cells remaining around the edge of the wound.
- Mohs' Surgery - The purpose of this technique is to remove all of the
cancerous tissue and as little of the healthy tissue as possible. In addition,
this method is used to remove large tumors, those in hard-to-treat places, and
cancers that have recurred. The cancer is shaved off one thin layer at a time.
Each layer is checked under a microscope until the entire tumor is removed. NCI
says this method should be used only by doctors who are specially trained in
this type of surgery.
- Cryosurgery - Extreme cold may be used to treat precancerous skin
conditions, such as actinic keratosis, as well as certain small skin cancers. In
cryosurgery, liquid nitrogen is applied to the growth to freeze and kill the
abnormal cells.
- Laser Therapy - Laser therapy uses a narrow beam of light to remove or
destroy cancer cells.
- Radiation - NCI says skin cancer responds well to radiation therapy (also
called radiotherapy), which uses high-energy rays to damage cancer cells and
stop them from growing. Doctors often use this treatment for cancers that occur
in areas that are hard to treat with surgery.
- Topical therapy - Anticancer drugs in a cream or lotion can also be applied
to the skin.
Prevention
The American College of Preventive Medicine (ACPM) says the key way to help
avoid skin cancer is to avoid excessive sun exposure, especially during the peak
burning hours between 10AM and 3PM. If you have to be outdoors, use hats and
protective clothing, and ask your pharmacist to recommend a waterproof sunscreen
with an SPF of at least 15. Some people are allergic to certain sunscreen ingredients, so ask a
healthcare professional for advice if this could be a problem for you or your
family.
Children need sun protection as well. According to ACPM, roughly 80 percent
of a person's sun exposure occurs before age 21. Sunscreens are usually
recommended for children older than six months. Ask your pediatrician for
specific advice about protective measures best suited for your infant or
toddler.
Another issue to be aware of is certain medications - for example, some
antibiotics or diuretics -
and even some herbal supplements like St. John's Wort can make skin more sensitive to the
sun's rays. Ask your doctor about this potential side effect of your
medications, and take extra precautions.