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Skin Cancer

One way to help prevent skin cancer is limit your exposure to UV rays.

Individuals who frequently expose themselves to UV rays have a higher risk of developing skin cancer. [©Shutterstock, 2010]
©Shutterstock, 2010
Individuals who frequently expose themselves to UV rays have a higher risk of developing skin cancer.

Skin Cancer

Skin cancer, in its many forms, accounts for about half of all cancers and is the most common type of cancer. According to the American Cancer Society, more than 1 million cases of unreported, non-melanoma skin cancer occur annually. In 2008, it is estimated that 62,480 people will be diagnosed with melanoma, the most dangerous and life-threatening form of skin cancer. There are likely to be 11,200 deaths due to melanoma in 2008, with an additional 2,780 deaths attributable to other non-epithelial skin cancers.

Types of Skin Cancer

The National Cancer Institute cites three major categories of skin cancer: basal cell carcinoma, sqaumous cell carcinoma and melanoma. Additional types of skin cancer, which are less common, include Karposi sarcoma, merkel cell carcinoma and sebaceous gland carcinoma.

According to the Stanford Cancer Center, 90 percent of all skin cancers are basal cell carcinoma, also known as non-melanoma skin cancer. However, it is rarely diagnosed in people with dark skin. Typically, basal cell carcinoma starts as a tiny nodule or raised area on the back of the hand, neck or head. Less often, a flat nodule appears on the torso.

Squamous cell carcinoma is also a non-melanoma type of skin cancer. It is the second most commonly found skin cancer in Caucasians. Generally, it starts as a nodule or it may appear as a red and scaly segment of skin. Most cases of squamous cell carcinoma begin on the ears, lips or face.

Melanoma, the most serious type of skin cancer, is also the rarest form of skin cancer. It typically occurs in adults and accounts for 75 percent of all skin cancer related deaths. While melanoma normally appears on the skin, it can appear on other organs, such as the eyes, mouth and vagina. Melanoma commonly starts as a mole. Moles that start to itch, ooze or show changes in size, shape or color are suspect.

Risk Factors

People with a genetic history of skin cancer in the family are at an increased risk for developing skin cancer. In addition, the risk for developing skin cancer increases if a person has certain genetic diseases, such as albinism, xeroderma pigmentosum and basal cell nevus syndrome. Finally, genetics determine the degree of pigment in a person's skin. People with less pigment, such as fair-skinned red-heads, have greater chances for developing skin cancer than people with more pigment. It is important to note, however, that dark-skinned people can and do get skin cancer.

Another important risk factor to consider is lifetime exposure to UV rays. The more UV radiation a person receives in his or her lifetime, the greater the risk for developing skin cancer. Exposure to UV radiation varies depending on lifestyle and geographic location. Lifestyle factors include daily outdoor activities, clothing choices and exposure to UV radiation in tanning booths, tanning beds or under sunlamps. Geographic location affects the intensity of UV radiation received. The closer a person lives to the equator, the more intense UV radiation they'll receive when outside. In addition, people living in higher altitudes receive more UV radiation because the air is thinner and cleaner. Other risk factors for skin cancer include advanced age, scars or burns on the skin, chronic skin inflammation, ulcers, arsenic exposure, radiation therapy, certain immune-suppressing drugs or medical conditions, actinic keratosis (premalignant crusty patches of skin), and Bowen's disease (characterized by enlarging, irregular regions of crusty skin).

Skin Cancer Diagnoses

Early diagnosis is important, especially since skin cancer has a 95 percent cure rate when identified in its earliest stages. This is especially true for basal cell carcinoma and squamous cell carcinoma. Frequently, diagnosis begins at home when a person notices a slight change in a mole or a persistent sore that doesn't heal. The next step is a visit to the dermatologist. If the dermatologist suspects skin cancer after a visual inspection, a biopsy is necessary. The biopsy procedure commences with the injection of a local anesthetic near the location of the biopsy. Once the area is numb, the dermatologist completes a punch biopsy or an excisional biopsy. Doctors use the punch biopsy when the lesion is small and excisional biopsies when the lesion is larger. After completing the biopsy, the doctor typically closes the site with one or more stitches. When the doctor suspects melanoma, removal of the entire lesion is likely.

Skin Cancer Treatment

Treatment may be as simple as removing the lesion; however, in some cases, additional treatments are recommended. The Mayo Clinic identifies various additional treatment options, including cryosurgery, excisional surgery, laser therapy, Mohs surgery, curettage and electrodecessation, radiation therapy and chemotherapy. When deciding which type of therapy to use, medical professionals consider several factors such as the stage of the cancer, the patient's preference and ability to handle certain treatments, and the patient's age and overall health. The newest treatment options involve biological therapy and photodynamic therapy (PDT).

Prevention of Skin Cancer

The first step in preventing skin cancer is to limit exposure to UV radiation. The best way to limit UV exposure is to stay out of the sun, especially during the mid-day hours when the UV radiation is most intense. When heading outside, cover the skin to the greatest extent possible, with tightly woven clothing. Use sunscreen on exposed areas of the skin, such as the face, hands and neck. Doctors recommend daily application of sunscreen, even when clouds obscure the sun.

In addition to protecting the skin from UV radiation, the American Academy of Dermatology (AAD) suggests regularly completing a self-examination that starts by standing in front of a mirror, without clothing, and looking over the entire body. Use a handheld mirror to aid in the examination of the back, buttocks and scalp. Don't overlook the palms of the hands and soles of the feet, as well as behind the arms and legs. While doing the examination, the AAD recommends following the ABCDs of Melanoma Detection. The acronym ABCD stands for Asymmetry, Border, Color and Diameter. To follow the ABCDs of Melanoma Detection, the person should first examine spots for irregular or jagged edges. Secondly, it is important to examine the symmetry of the spot. If one half of the spot differs from the other half, then there is cause for concern. Next, it is necessary to examine the color of the spot. A spot is suspicious if the color is inconsistent throughout or the spot has certain colors, such as dark tan, black, red, white or blue. Lastly use a ruler to measure the diameter of the spot and monitor changes in the size. The larger the spot gets, the greater the concern.

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