Skin Cancer

Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases are reported each yearand the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.

Q. Who gets skin cancer and why?

The primary cause of skin cancer is ultraviolet radiationmost often from the sun, but also from artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities, and perhaps the thinning of the earths protective ozone layer are behind the alarming rise were now seeing in skin cancers.

Anyone can get skin cancerno matter what your skin type, race or age, no matter where you live or what you do. But your risk is greater if

• Your skin is fair and freckles easily.
• You have light-colored hair and eyes.
• You have a large number of moles, or moles of unusual size or shape.
• You have a family history of skin cancer or a personal history of blistering sunburn.
• You spend a lot of time working or playing outdoors.
• You live closer to the equator, at a higher altitude, or in any place that gets intense, year-round sunshine.
• You received therapeutic radiation treatments for adolescent acne.

Q. What are the types of skin cancer?

By far the most common type of skin cancer is basal cell carcinoma. Fortunately, its also the least dangerous kindit tends to grow slowly and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life threatening, if left untreated it can grow deep beneath the skin and into the underlying tissue and bone, causing serious damage (particularly if its located near the eye).

Squamous cell carcinoma is the next most common kind of skin cancer, frequently appearing on the lips, face, or ears. It sometimes spreads to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if its not treated.

A third form of skin cancer, malignant melanoma, is the least common, but its incidence is increasing rapidly, especially in the Sunbelt states. Malignant melanoma is also the most dangerous type of skin cancer. If discovered early enough, it can be completely cured. If its not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly.

Q. Are there are other types of skin growths?

Two other common types of skin growths are moles and keratoses.

Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. While most pose no danger, someparticularly large moles present at birthor those with mottled colors and poorly defined bordersmay develop into malignant melanoma. Moles are frequently removed for cosmetic reasons, or because theyre constantly irritated by clothing or jewelry (which can sometimes cause pre-cancerous changes).

Solar or actinic keratoses are rough, red or brown, scaly patches on the skin. They are usually found on areas exposed to the sun, and sometimes develop into squamous cell cancer.

Q. How can I identify skin cancer?

Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps; it can be smooth and shiny, waxy, or pitted on the surface. Or it might appear as a red spot thats rough, dry, or scaly; a firm, red lump that may form a crust; a crusted group of nodules; a sore that bleeds or doesnt heal after two to four weeks; or a white patch that looks like scar tissue.

Malignant melanoma is usually signaled by a change in the size, shape, or color of an existing mole, or as a new growth on normal skin. Watch for the ABCD warning signs of melanoma:

• Asymmetrya growth with unmatched halves
• Border irregularityragged or blurred edges
• Colora mottled appearance, with shades of tan, brown, and black, sometimes mixed with red, white, or blue
• Diametera growth more than 6 millimeters across (about the size of a pencil eraser), or any unusual increase in size.

If all these variables sound confusing, the most important thing to remember is this: Get to know your skin and examine it regularly, from the top of your head to the soles of your feet. (Dont forget your back.) If you notice any unusual changes on any part of your body, have a doctor check it out.

Q. How is skin cancer diagnosed and treated?

Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body. Small skin cancers can often be excised quickly and easily in our office.

Most skin cancers are removed surgically, by a plastic surgeon or a dermatologist. If the cancer is small, the procedure can be done quickly and easily, in an outpatient facility or the physicians office, using local anesthesia. The procedure may be a simple excision, which usually leaves a thin, barely visible scar. Or curettage and desiccation may be performed. In this procedure the cancer is scraped out with an electric current to control bleeding and kill any remaining cancer cells. This leaves a slightly larger, white scar. In either case, the risks accompanying surgery are low.

If the cancer is large, however, or if it has spread to the lymph glands or elsewhere in the body, major surgery may be required. Other possible treatments for skin cancer include cryosurgery (freezing the cancer cells), radiation therapy (using x-rays), topical chemotherapy (anti-cancer drugs applied to the skin), and Mohs surgery, a special procedure in which the cancer is shaved off one layer at a time. Mohs surgery is performed only by specially trained physicians and often requires a reconstructive procedure as follow-up.