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    What Everyone Should Know About Skin Cancer

    Clay Davis MD 05/11/2021

    According to the American Academy of Dermatology, it is estimated that one in five Americans will develop skin cancer in their lifetime.

    People of all races can develop skin cancer. However, certain people are more likely to develop skin cancer. Some skin cancer risk factors include:

    • Sunburns—especially repeated ones at a young age
    • Skin types: Caucasians are 20x more likely to develop melanoma (a type of skin cancer) than     African Americans.
    • Over 50 moles on your skin
    • Family history of skin cancer, especially melanoma
    • Using indoor tanning devices (sunbeds, tanning beds)
    • Exposure to x-rays/radiation
    • Exposure to cancer-causing compounds, such as arsenic

    Pre-Cancerous Lesions
    Pre-cancerous lesions, called actinic keratosis (AK), are scaly, raised macules that are considered precancerous. They’re usually found on sun-exposed skin, such as the face, scalp, ears, hands, arms, etc.  People who develop AK's often have fair skin/light hair/light eyes; they are often seen in redheads and natural blondes.  About 3%-10% of the time, an AK can progress into a certain type of skin cancer called a squamous cell carcinoma.

    If you have a lesion that concerns you, and have some of the risk factors listed above, bring it to the attention of your dermatologist for further evaluation and treatment.

    Types of Skin Cancer

    Basal Cell Carcinoma
    The most common type of skin cancer is basal cell carcinoma (BCC). It can appear as a pearl-like bump, or a pinkish patch of skin. Like AKs, BCCs develop in areas of frequent sun exposure, such as the head, neck and arms. BCCs can also be found on the trunk and extremities. They often become like a pimple that won't heal, either bleeding, crusting or becoming an open wound.

    A good rule of thumb is any lesion that is nonhealing over 4 weeks should be evaluated by a physician. A physician will usually perform a biopsy to determine how best the lesion should be treated. 

    Squamous Cell Carcinoma
    A squamous cell carcinoma (SCC) is the second most common type of skin cancer. It can present as a firm bump, scaly patch, or ulcer/sore that will not heal. Like other skin cancers, it tends to occur in places that get lots of sun. The rims of the ear, neck, arms and trunk are common sites. Those with light skin are the most likely to develop a squamous cell.

    Most SCCs are easily treatable with no complications; however, it can occasionally be recurrent or even metastasize (spread to other sites in the body), so they should be taken seriously. Treatment includes surgical and non-surgical procedures/therapies. Radiation is sometimes used, and if it has metastasized, chemo/radiation is needed.

    The third most-common--but most dangerous-- skin cancer is melanoma. A change in a mole is often the first sign of a melanoma. These changes follow an ABCDE pattern.

    • A: Asymmetry – One half doesn’t look like the other. If you were to outline it and fold it in half, the edges would not line up.
    • B: Border – The edges are irregular, “scalloped” or poorly defined.
    • C: Color – A normal mole normally has one color, but a melanoma has varied color from one area to another. It can be from shades of tan or brown, to black, to even red, blue or white.
    • D: Diameter – A size greater than 6 mm (a pencil eraser diameter) is concerning.
    • E: Evolving - Meaning, that it’s been changing. Also, that it looks different than other moles you may have.

    Treatment for melanoma varies from patient to patient, mostly depending on what stage the cancer has been detected. Most are treated with a wide excision of the lesion (to remove all cancer cells), and sometimes nearby lymph node biopsy. New treatments for metastatic melanoma have revolutionized the treatment of these dangerous cancers. 

    A Note on Tanning Beds
    Some tanning beds produce radiation of UVA and UVB rays that are ten times stronger than the rays from the natural sun. There is no safe amount of exposure. Tanning before vacations, for prom or social situations is very dangerous. Additionally, tanning beds may lead to premature wrinkles and age spots on skin, and damage to the eyes, resulting in early cataracts and even blindness.

    Preventing Skin Cancer

    •  Reduce your exposure to ultraviolet light—whether it’s from the sun or from tanning beds. Never seek the sun in your outdoor activities.
    •  Wear protective clothing, such as long sleeved shirts and long pants, a wide-brimmed hat, and sunglasses.
    • You want to use a broad-spectrum, water-resistant sunscreen even on cloudy days. Reapplication after swimming or sweating is important. An SPF of 30 is recommended, but higher numbers may be helpful for those with very light skin or will be outdoors for long periods. Also, be sure to apply enough sunscreen. Don’t skimp!
    •  Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m.
    •  Get vitamin D safely through a healthy diet and/or supplements as opposed to getting it from the sun.
    •  If you have light skin, lots of moles and a family history, you’re at a much greater risk of developing skin cancer. 
    •  If one or more of your first degree relatives (parent, sibling or child) has had a melanoma, it increases your risk.
    •  Protect your children from sunburns. Burns from infancy through the teen years are particularly dangerous.


    Learn more about the author

    J. Clay Davis, MD
    Specialty: Dermatology
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