Skin Cancer

Skin cancer is an increasingly common occurrence that can affect anyone regardless of age, sex, or skin tone. Exposure to the sun’s ultraviolet rays cause more than 90% of skin cancers, and the sad fact is that many cases of skin cancer can be prevented by taking proper precautions. Exposing unprotected skin to UV rays, including using tanning beds, multiply your risk for developing a skin cancer.

Early diagnosis is the one the best ways to ensure a cure for skin cancer. We recommend yearly skin checks for all of our patients and even more frequently if you have had a skin cancer before or have a higher risk of developing skin cancer.

Some common factors for increased risk are:

  • light colored skin, hair, and eyes
  • many moles or freckles
  • personal or family history of skin cancer
  • history of many sunburns or extended unprotected exposure to the sun for long periods of time, such as working outdoors for many years
  • use of tanning beds
  • decreased immune system function due to disease or medical treatments

One of the best ways to protect your skin when you are going to be exposed to prolonged sunlight is to use a broad spectrum sunscreen, SPF 30 or higher, and reapply frequently, especially if you are swimming or heavily sweating. We also recommend wearing protective clothing such as hats and UV blocking sunglasses. Staying out of the sun during peak hours is another great way to help prevent skin cancer.

Our goal is to detect and treat skin cancers at their earliest stages and to prevent them by treating precancers before they can develop into cancer.

Common skin precancers are Actinic Keratoses (AKs) and atypical moles.

Actinic Keratoses are caused by UV light exposure and appear as scaly, crusted growths. They are often easier to feel than to see. A common treatment for AKs are cryosurgery, where liquid nitrogen is used to freeze the lesion, which later may blister and crust before falling off. Other common treatments include topical medications, and curettage and electrodesiccation. Sometimes these therapies are used in conjunction with one another.

Atypical moles, also known as dysplastic nevi, are generally benign or noncancerous moles that have an increased risk of developing into melanoma if left untreated. People with a history of atypical moles have a higher risk of developing melanoma than those with no history of atypical moles. There is also a genetic link between the propensity of development of melanoma in people who have close relatives who have had melanoma.

Basal Cell Carcinoma(BCC), Squamous Cell Carcinoma(SCC), and Malignant Melamona(MM) account for the vast majority of skin cancers.

While melanoma is the most deadly and well known of skin cancers, all skin cancers are serious and can lead to further problems if left untreated.

Basal Cell Carcinoma

BCCs are the most common type of skin cancer with over 2.5 million people in the United States diagnosed every year. These cancers tend to develop in areas with the most exposure to direct sunlight such as the ears, scalp, neck, and face.

Most BCCs are curable if detected and treated in the early stages. If left untreated BCCs can continue to grow larger and get deeper increasing the risk for problems such as nerve damage, disfigurement, and potentially even death.

Most BCCs can be treated in our office with excision, cautery and electrodesiccation, or topical treatments for the most superficial types of cancer. Some BCCs may require Mohs surgery to treat deep tumors and ensure the entire cancer is removed. We work with closely with several local Mohs surgeons to ensure our patients get the best care possible.

Things to watch for to detect a potential BCC:

  • Pearly or shiny bump or nodule
  • Persistent or non-healing sore that may be crusty or bleeding for more than 3 weeks
  • Areas that look scar-like with poorly defined borders that may be white, yellow, or waxy appearing.
  • Reddish or pink growth that may be elevated with an indentation in that is crusted in the center

These lesions may  not itch or hurt, but that is not always an indicator of disease. Your best bet is to come for yearly skin checks and monitor your skin monthly for changes or new lesions. Hyper-vigilance should be exercised during your self exams. If anything appears to have changed or seems off, have it checked by your physician.

Squamous Cell Carcinoma

SCCs are the second most common type of skin cancer. In the United States around 700,000 cases are diagnosed every year. These skin cancers come from abnormal squamous cells in the epidermis.

Chronic UV radiation from the sun, and artificial sources of UV light such as tanning beds, is a strong promoter of SCC. Most of these cancers are curable when identified and treated in the earliest stages. The number of these cancers has risen due to the increased use of tanning beds, especially in young women.

Treatments for these lesions include surgical excision, curettage and electrodesiccation, and Mohs surgery. Early detection and treatment is the best way to ensure a cure for these cancers.

Things to watch for to detect a potential SCC:

  • Thick, wart-like growths that crust or occasionally bleeds
  • Persistent sores that don’t heal and bleed
  • Growths that are elevated with a central depression that may increase rapidly in size and bleeds on occasion
  • Scaly, red patches with irregular borders that may be crusted or bleed

Yearly skin checks with your dermatologist and monthly skin self-exams are vital to the early detection and treatment of these skin cancers. If you feel you see any new or persistent growths, make an appointment with your provider to have it checked.

Malignant Melanoma

Melanoma is the least common of these skin cancers, but is considered the most deadly. Over 10,000 people in the United States die from melanoma every year. These cancer arise from the skin cells that produce melanin, which are the cells that give our skin color.

There are many factors that lead to increased risk of melanoma occurrence, including having fair hair and skin, history of multiple sunburns, indoor tanning bed use, family history of melanoma, and a personal history of dysplastic moles. Studies also suggest that people with 50 or more benign moles may be at increased risk as well.

When detected early many melanomas are curable using surgical excision, which may include removing the margins around the melanoma to ensure the entire tumor is gone. Depending on the depth and severity of the melanoma, lymph node biopsies may also be done to determine if the melanoma has spread to other parts of the body.

The “ABCDE” signs are an easy way to remember what to watch for when doing self-exams.

  • Asymmetry-If you drew a line through the center of the mole the two halves would not match. Most normal moles are round and symmetrical.
  • Border-Melanoma borders are often uneven and may appear scalloped at the edges. Normal moles have smooth, even edges.
  • Color-Moles that have varying colors in pink, brown, tan, and black shades may be the first signs of melanoma. As they progress they may develop shades of red, white, or blue. Benign moles are generally a single shade of brown.
  • Diameter-Many melanomas tend to grow. Moles that appear larger than a pencil eraser should be checked.
  • Evolving-Any change in shape, size, color, or other traits can be important. Don’t wait for pain or bleeding as potential signs of danger.

Moles displaying any of the above symptoms should be checked by your doctor as soon as possible. The best treatment for melanoma is early detection and treatment. The majority of melanomas we find are curable. Skin self-exams are vital to identifying these potentially deadly cancers in their earliest stage. The patient’s job is not to diagnose, but to be suspicious and see your doctor.

For more information visit the Skin Cancer Foundation website.

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