About 1 in 5 Americans will develop skin cancer in their lifetime. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. All three are known to be associated with skin damage caused by the sun or tanning beds. These cancers are preventable and treatable with early detection. Knowing the signs and symptoms to look for can help keep you and your family healthy.
Basal Cell Carcinoma and Squamous Cell Carcinoma
Basal cell carcinoma (BCC) is the most common type of skin cancer and the most common cancer overall in humans. BCCs almost never travel elsewhere in body (metastasize) however they continue to grow larger with time. If left untreated they will continue to invade nearby healthy tissue and can spread deeply into nerves and bone. BCCs can appear to be open sores, pink bumps or crusty patches that never seem to heal.
Squamous cell carcinoma (SCC) is the second most common skin cancer. Both SCC and BCC occur primarily in sun-exposed areas but can occur anywhere on the body. SCC is a more aggressive tumor and may metastasize if left untreated. If this tumor spreads in the body it may sometimes be fatal. SCCs often look like rough scaly pink patches or nonhealing areas on the skin and sometimes tender bumps or “boils”.
Melanoma is the most dangerous form of skin cancer. Although it represents only about 1% of all skin cancers, it is responsible for the majority of skin cancer deaths. Melanoma occurs when the pigment producing cells in the skin are damaged and become cancerous. Therefore melanoma most often has the appearance of an abnormal mole. Melanoma can be cured when detected early. However, if the cancer metastasizes it is very difficult to treat and often is fatal. When looking at your own skin it is important to keep in mind the “ABCDEs” of melanoma.
- A = asymmetric
- B = irregular border
- C = multiple colors
- D = diameter larger than a pencil eraser
- E = evolution or change (growing, bleeding, itching)
Treatment of Skin Cancer
The treatment of skin cancer involves the removal or destruction of the cancerous cells. Depending on the type of skin cancer and depth of tumor your doctor may recommend a scrape and burn procedure (electrodessication and curettage), a cream, surgical excision or Mohs surgery.
Mohs surgery is a special tissue sparing technique used for basal cell carcinoma, squamous cell carcinoma and sometimes melanoma. It is indicated when the tumor is on the head, hands, feet or genitals. Mohs surgery is also used for very large or aggressive tumors on the arms, legs and trunk. This highly specialized technique provides a cure rate of 98-99%.
When Mohs surgery is performed your doctor will remove a small piece of skin containing the visible skin cancer. The skin is then processed in our on-site laboratory using a technique that allows mapping of the cancer and examination of 100% of the margins by the Mohs surgeon. Mohs surgery allows for precise removal of only the skin containing the cancer while normal healthy skin is spared. This allows for the highest cure rate with the smallest scar possible.
All of our Mohs surgeons have received additional fellowship training in this specialized procedure. Read more about Mohs surgery and fellowship training here http://www.skincancermohssurgery.org/why-choose
Prevention of Skin Cancer
In the majority of cases skin cancer results from repeated exposure to UV radiation. UVA radiation and UVB radiation are the damaging wavelengths produced by the sun. Tanning beds primarily produce UVA radiation.
When spending time outdoors it is important to take precautions to avoid excessive exposure to the sun’s dangerous UV rays. Seeking shade and avoidance of the sun’s peak hours between 10AM and 2PM is recommended. Sun protective clothing such as hats and clothing with a UPF 50+ rating (can we link Coolibar? http://www.coolibar.com) are easy and effective ways to protect the skin. When choosing a sunblock look for a SPF 50+ rating and broad spectrum (UVA and UVB) coverage.
A sunburn is the body’s response to severe damage caused by UV radiation from the sun or tanning beds. The peeling and redness seen with a sunburn is the result of irreversible damage to cells. A tan also results from cell damage and is the body’s attempt to prevent further harm. There is no such thing as a “safe tan” or the ability of a “base tan” to prevent sun damage. In fact, tanning beds have been recognized by the World Health Organization as a known carcinogen. Read more about the dangers of tanning here (https://www.aad.org/media/stats/prevention-and-care).
People should avoid sunburns at all costs, wear hats and sunscreen and protective clothing and if very compliant in this regard take supplemental Vitamin D usually at 2-4000 units per day. Most patients are not compliant and therefore do not need supplemental Vitamin D.
Recent evidence shows that niacinamide or nicotinamide (the amide version of Vitamin B3) 500 mg bid may help prevent skin cancer. This supplement is benign when taken in these dosages and not terribly expensive thus it would not be unreasonable for people at high risk for skin cancer to take it but it is certainly not required or necessary. (http://solderm.com)
Visit http://www.skincancer.org for more information about skin cancer and how to stay safe in the sun.