House Calls / Dr. Michael Schwartz
Skin cancer is the most common form of cancer in America. More than 2 million new cases are diagnosed yearly and it accounts for almost half of all cancers which are diagnosed in the country annually. The most common forms of skin cancers are basal cell, squamous cell and melanoma.
Skin cancers are thought to be caused by excessive exposure to ultraviolet rays from the sun. They are more commonly found in fair-skinned patients and patients who have received multiple sunburns throughout their lives. It is believed that ultraviolet radiation from the sun causes mutations in our genes. Once this occurs, abnormal cells may be created, which can lead to the development of cancer.
Basal cell is the slowest growing skin cancer. Although it rarely spreads throughout the body, it will spread locally, destroying and damaging tissue. The most common area where basal cell cancers are found is on the face.
Squamous cell cancer is a more serious form of the disease. Although it, too, grows rather slowly, it does have the potential to metastasize throughout the body damaging tissues and organs. It most commonly involves sun-exposed areas.
Melanoma is the most serious form of skin cancer. It can be difficult to detect and spreads rather quickly. If not identified and treated in its earliest stages, the rate of mortality can be as high as 90 percent. It can occur anywhere on the body and therefore can be difficult to diagnose.
Skin cancers are diagnosed by biopsy. If a skin lesion is changing in any way, appearing irregularly shaped, turning black, becoming crusty, bleeding all the time, getting larger than a pencil eraser or becoming raised, you should visit your dermatologist for an evaluation. Most lesions are benign, but only a biopsy can determine the makeup of the lesion.
Once a cancer is detected, treatment is determined by type and location. This may include local excision, laser therapy, freezing techniques, creams or in the case of melanoma -- radical excision with biopsies of the surrounding lymph nodes. In severe cases, treatment may also include chemotherapy and/or radiation.
The following factors are believed to increase your risk of developing skin cancer:
Family history of skin cancer;
Multiple freckles or moles;
Fair complexion, light eyes and light hair color;
Previous burns or skin damage;
Chemical exposures (e.g. arsenic);
Previous skin infections (e.g. human papilloma virus);
Sensitizing medications (e.g. antibiotics);
Previous exposure to radiation;
Compromised immune system.
Recommendations to help detect and prevent skin cancer:
Skin cancer screening. Many hospitals and clinics offer free screening. If you are unable to make one of these visits, make a yearly appointment with a dermatologist.
Wear sunscreen and reapply after swimming and every two hours. "Sun protective factor" refers to the amount of protection of suntan lotions. Use a minimum of SPF 15 and SPF 30 for fairer-skinned individuals.
Avoid the sun between the hours of 10 a.m. and 4 p.m. This is when the UV rays are at their strongest and the risk of sunburns is the greatest.
Wear a hat to protect your head. This is especially crucial for people who have thinning hair or are bald.
Wear long pants and long sleeves to cover other sun-exposed areas. They afford extra protection against sun burn.
Melanoma can occur in the eye. Wear sunglasses to block out the UV rays. It is also important to visit your eye doctor for yearly examinations.
Skin cancers are very common. If detected early, they can be successfully treated. Identifying risk factors and minimizing them is the first step towards prevention. If you are in any of the high risk groups, visit your doctor yearly. If you notice an abnormal skin lesion, visit your dermatologist immediately. He or she can perform a complete examination and biopsy if necessary. Remember to have fun in the sun, but always remember to look out for No. 1.