Questions About Skin Cancer?
Skin cancer is the most common form of human cancers, affecting more than two million Americans every year. One in five Americans will develop skin cancer at some point in their lives. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.
The three different types of sun related skin cancers are basal cell carcinoma, squamous cell carcinoma and melanoma. These result from exposure to ultraviolet light (UVA and UVB) either from the sun or artificial sources such as tanning beds.
Basal Cell Carcinoma
This is the most common form of skin cancer. Basal cell carcinomas tend to be slow-growing tumors which rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:
- raised pink or pearly white bump with a pearly edge and small, visible blood vessels
- pigmented bumps that look like moles with a pearly edge
- a sore that continuously heals and re-opens
- flat scaly scar with a waxy appearance and blurred edges
Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck because these are areas that are most exposed to the sun.
Risk factors for basal cell carcinoma include having fair skin, sun exposure, exposure to ultraviolet radiation (as in tanning beds), a family history of basal cell carcinoma and therapeutic radiation given to treat an unrelated health issue.
Diagnosing basal cell carcinoma requires a biopsy.
Treatments for basal cell carcinoma include:
- Curettage and Desiccation — The preferred method of dermatologists, this treatment involves using a small metal instrument (called a curette) to surgically remove the tumor along with an application of an electric current to destroy any remaining cancer cells.
- Mohs Micrographic Surgery — This method is preferred when basal cell carcinomas are recurrent or located over areas of skin covering cartilage such as the nose or earlobe.
- Prescription Medicated Creams — These creams can be applied at home. They stimulate the body's natural immune system over the course of weeks to destroy the cancerous lesions.
- Radiation Therapy — Radiation therapy is used when a patient is not a good surgical candidate.
- Surgical Excision — This method may be required for aggressive cancers.
Squamous Cell Carcinoma
Squamous cells are found in the upper layer (the surface) of the epidermis. They may present as a crusted or scaly patch of skin with an inflamed, red base or as red bumps. They are often tender to the touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.
Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, they evolve from precancerous lesions called actinic keratoses.
Diagnosing squamous cell carcinoma requires a biopsy.
Treatments for squamous cell carcinoma are identical to those of basal cell carcinoma listed above.
While melanoma is the least common type of skin cancer, it is by far the most virulent. It is the most common form of cancer among young adults age 25 to 29. Melanomas may suddenly appear without warning or evolve from an existing benign mole. Melanomas can occur anyplace on the body but are most commonly found on the upper back, torso, lower legs and neck. Melanomas can spread rapidly to internal organs and lymph nodes if not detected and treated in its early stages. A new rapidly growing mole or a mole that itches, burns hurts or bleeds or becomes darker in color may be exhibiting changes indicative of a melanoma and should be brought to the attention of Dr. Oshman.
It is important for people to conduct regular self-examinations of your skin in order to detect any potential skin cancer early, when it is treatable and curable.
Melanoma is diagnosed via a biopsy. Treatments include surgical removal and/or chemotherapy.
What to Look For
The key to detecting skin cancers is to notice changes in your skin. Look for:
- Dark lesions on the palms of the hands and soles of the feet, fingertips toes, mouth, nose or genitalia.
- Translucent pearly or red dome-shaped growths.
- Existing moles that begin to grow, become darker in color, itch, burn or bleed.
- Brown or black vertical streaks under the nails.
- A sore that repeatedly heals and re-opens.
- Scaly lesions that are pink or red.
The American Academy of Dermatology has developed the following ABCDE guide for assessing whether or not a mole or other lesion may be becoming cancerous.
- Asymmetry: Half the mole does not match the other half in size, shape or color.
- Border: The edges of moles are irregular, scalloped, or poorly defined.
- Color: The mole is a variety of colors such as brown, black, tan and red.
- Diameter: The mole is greater than 6 millimeters in diameter. Smaller black lesions always need to be evaluated.
- Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.
If any of these conditions occur, please make an appointment to see Dr. Oshman right away. The doctor may do a biopsy of the mole to determine if it is cancerous.
Roughly 90% of nonmelanoma cancers are attributable to ultraviolet radiation from the sun or artificial sources such as tanning beds. In order to prevent sun related skin cancers the following precautions should be taken:
- Stay out of the sun during peak hours (between 10 a.m. and 4 p.m.).
- Cover the arms and legs with protective clothing.
- Wearing a wide-brimmed hat and sunglasses.
- Use sunscreens year round with an SPF of 30 and the ability to screen out both UVA and UVB rays. Look for products that use the term "broad spectrum".
- Use extra caution near water, snow and sand. These are reflective surfaces which increase your chances of sunburn.
- Avoid tanning beds,
- Check your skin monthly and contact Dr. Oshman if you notice any changes.
- Get regular skin examinations. It is advised that adults over 40 schedule a body check annually.
Call Dr. Oshman immediately to evaluate any skin lesions which you find suspect.
Interested in a Skin Cancer check up? Call Robin Gail Oshman MD, PhD in
Westport and New Canaan, CT to schedule an appointment!