Scratching the surface on skin cancers

Skin cancer is the most common form of the disease — and it’s preventable . . .

Cancer of the skin is the most common of all cancers. There are two main categories of skin cancer. Melanomas start in the pigment-making cells. These are rare and very serious skin cancers. I will focus on the second category, which includes the majority of skin cancers — basal-cell and squamous-cell carcinomas that start in the keratinocytes cells in the skin.

About 3.5 million basal- and squamous-cell cancers are found each year. About 80% of these are basal-cell and about 20% are squamouscell carcinomas. While very common, people rarely die from these two types of cancer. There are only about 3,000 deaths per year.

Risk factors

The risk factors for basal-cell carcinoma and squamous-cell carcinoma are similar:

• UV light: The amount of UV exposure depends upon the strength of the light, the length of exposure and whether the skin was covered with clothing and sunscreen.
• Smoking, fair skin, older age, genetics, weakened immune system
• Gender: Males are twice as likely as females to have basal-cell and three times as likely to have squamous cell cancers
• Radiation: There is a higher risk of developing skin cancer in areas that were previously radiated
• Skin damaged by certain diseases or scars from bad burns is more likely to develop skin cancer
• Human Papilloma Virus (HPV) infection may increase risk of skin cancer in genital areas

Signs and symptoms

As a general rule, any sore, lump, marking or change in the way an area of skin looks may be a sign of skin cancer and should be examined by a physician. Pay attention to a new growth, a spot or bump that is increasing in size or any sore that does not heal within two months.

Look for flat, firm, pale areas or small raised, pink or red shiny areas that may bleed after minor injury. You may see abnormal blood vessels. They are most often found in sun-exposed areas like the head and neck. Also watch for growing lumps often with a rough, scaly or crusted surface. They may also appear as flat, reddish patches that grow slowly.

Treatment

• Surgery: Surgical removal of the cancer is usually the first step. There are many different kinds of surgery. The type depends upon how large the cancer is, where the cancer is located and the exact type of skin cancer. Often minor surgery is curative. For certain types of squamous cell cancers that have a higher risk of spreading, surgery might be followed by radiation or chemotherapy.
• Skin grafting and reconstructive surgery: If a large skin cancer is removed, skin grafting may be necessary.
• Cryosurgery: Liquid nitrogen is used to freeze and kill cancer cells.
• Photodynamic therapy (PDT): A drug is injected either into the skin or into the blood. The drug makes the cancer cells sensitive to light. A light source is focused on the cancer to “turn on” the drug.
• Topical chemotherapy: These drugs are placed directly on the skin surface. • Immune response modifiers: These are drugs which boost the body’s immune system response to the cancer.
• Radiation therapy: This may be used in cases where the tumor is large or in an area where surgery would be difficult. It is also used in older people who may be poor surgical candidates. In some cases it is used as an adjuvant (additional) therapy after surgery. • Chemotherapy: The use of systemic chemotherapy is uncommon.

Prevention

The best way to lower your risk of developing skin cancer is to limit your exposure to strong sunlight. Here are a few suggestions:

• Wear clothing to protect your skin.
• Wear sunglasses and a wide-brimmed hat. Baseball caps do not cover your neck and ears.
• Use sunscreen with SPF 30 or more. Apply liberally and often.
• Avoid tanning beds and sunlamps.
• Protect children from the sun.

If you have a suspicious skin condition, call our office the numbers below.

Susan Locke, MD, is Healthnetwork Foundation’s Medical Director.

Healthnework is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: [email protected]