Skin Cancer

Mar 1, 2010
2010 / March 2010

Skin cancer is the most common of all types of cancer. In fact, each year there are more new cases of skin cancer than the combined occurrence of cancers of the breast, prostate, lung and colon. More than 1 million Americans are diagnosed with skin cancer every year; one in five will develop skin cancer in the course of a lifetime.

Skin cancer most commonly develops on skin that has been exposed to sunlight, but it can develop on unexposed skin. There are three major types: basal cell carcinoma, squamous cell carcinoma and melanoma, the most deadly form. All three are on the rise, with dramatic increases over the past two decades, mainly because of cumulative exposure to ultraviolet rays.

Skin cancers affect people of all skin tones, including darker complexions. A cancerous skin lesion can appear suddenly or develop slowly. Its appearance depends on the type of cancer. Actinic keratosis, the earliest stage of certain skin cancers, appears as a small, scaly spot, most commonly on the face, ears, neck, forearms, the scalp of bald men and the backs and hands of fair-skinned people who have had significant sun exposure.

Basal cell carcinoma, the most common type of skin cancer, occurs most frequently on the head and neck, but the trunk and lower limbs can also be involved. It often looks like a fleshy bump, nodule or red patch, and is frequently found in fair-skinned people, rarely in dark-skinned individuals. It usually does not grow quickly, but treatment should occur as soon as possible.

Squamous cell carcinoma is the second-most common skin cancer. It is found in fair-skinned individuals and rarely in dark-skinned people. It is typically located on the rim of the ear, face, near the mouth or on the trunk. It first appears as a firm bump or a red, scaly patch, which can develop into large masses and become invasive, leading to local tissue destruction. Early treatment is important.

Malignant melanoma is the most deadly of all skin cancers. More than 100,000 Americans develop melanoma annually, with more than 8,000 dying from it. Melanoma begins in the melanocytes, skin cells that produce the pigment melanin. Clusters of melanocytes make up the moles on our skin. Melanoma may appear suddenly or begin in or near a mole or other dark spot. Melanoma usually appears in mixed shades of tan, brown or black, although it can be red or white.

Fair-skinned individuals who sunburn easily are at particularly high risk for skin cancer. Other risk factors include tanning devices, especially tanning beds; a family history of skin cancer; and repeated medical or industrial X-ray exposure. Immunosuppression, scarring from diseases or burns and occupational exposure to compounds such as coal tar and arsenic are also significant factors.

If a skin biopsy reveals cancer, a variety of treatments are available, depending on the type of cancer, its location and size. Treatments include surgical incision, microscopic surgery, electrodessication and curettage (burning and scraping), cryosurgery (freezing with liquid nitrogen), laser surgery, radiation therapy, photodynamic therapy (a chemical applied to the skin is exposed to light) or topical application of chemotherapy products.

Early detection is key. Develop a routine to inspect your body for any skin changes. If a growth, mole, sore or skin discoloration suddenly appears or begins to change, see a board-certified dermatologist. Schedule an annual skin examination by your dermatologist, especially if you have a history of sun exposure, previous skin cancer or other risk factors.

Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun and still decrease your risk. Liberally apply a water-resistant, broad-spectrum (UVA and UVB protection) sunscreen with SPF 15 or higher; reapply every two hours. Whenever possible, wear protective clothing such as long-sleeved shirt, pants, wide-brimmed hat and large sunglasses.

The sun’s rays are strongest between 10 a.m. and 4 p.m., so if your shadow is shorter than you are, get into the shade. Protect children by playing in the shade, using protective clothing and frequently applying sunscreen. Use extra caution near water, sand or snow, which reflect the damaging rays of the sun and increase chances of sunburn. Get vitamin D safely through a healthy diet that may include supplements. If you want to look like you have been in the sun, use a sunless self-tanning product and continue to use sunscreen with it.

Most skin cancer can be prevented by limiting exposure to ultraviolet radiation and by paying attention to suspicious changes in your skin. With early detection, you can receive treatment for most skin cancers, even the most aggressive forms. For information visit www.nlm.nih.gov.
The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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