Skin Cancer – Patient Education
Who Gets Skin Cancer?
What Does Skin Cancer Look Like?
How Is Skin Cancer Diagnosed and Treated?
What Are the Risk Factors for Developing Skin Cancer?
Are Skin Exams Important?
How Can I Protect Myself?
Of all the cancers that humans can get, skin cancer is the most common. In fact, one in five Americans will develop skin cancer in the course of a lifetime. In the United States, skin cancer is increasing in all races.
Who Gets Skin Cancer?
People of all colors and races get skin cancer. Those with light skin who sunburn easily have a higher risk. Risk factors include: sunburns, family history of skin cancer, exposure to X-rays, weakened immune system, scarring caused by a disease or burn, and exposure to cancer-causing compounds such as arsenic. Using indoor tanning devices such as tanning beds and sunlamps also increases the risk of developing skin cancer.
What Does Skin Cancer Look Like?
There are different types of skin cancer, and each tends to look a bit different.
ACTINIC KERATOSIS
These dry, scaly patches or spots are considered the earliest stage in the development of skin cancer. In rare cases, an actinic keratosis (AK) can progress to a type of skin cancer called squamous cell carcinoma (SCC).
People who get AKs usually have fair skin. Most people see their first AKs after 40 years of age because AKs tend to develop after years of sun exposure. But even teens can have AKs when they live in sunny areas or use indoor tanning.
AKs form on skin that gets lots of sun exposure, such as the head, neck, hands, and forearms. Because AKs increase the risk of getting SCC, AKs are usually treated. Proper use of sunscreens can help prevent AKs.
BASAL CELL CARCINOMA
This is the most common type of skin cancer. It frequently looks like a flesh-colored, pearl-like bump. It also can appear as a pinkish patch of skin. Like AKs, basal cell carcinoma (BCC) develops on skin that gets frequent sun exposure, such as the head, neck, and arms. Many BCCs also form on the trunk and lower limbs.
BCC frequently develops in people who have fair skin, but it can occur in people with dark skin. BCC usually does not grow quickly and it rarely spreads to other parts of the body, but it should be treated promptly. This cancer can invade the surrounding tissue and grow into the nerves and bones, causing damage and disfigurement.
SQUAMOUS CELL CARCINOMA
Squamous Cell Carcinoma Squamous cell carcinoma (SCC) is the second most common type of skin cancer. This skin cancer often looks like a firm bump, scaly patch, or an ulcer that heals and then re-opens. It is usually reddish in color.
SCC tends to form on skin that gets frequent sun exposure, such as the rim of the ear, face, neck, arms, and trunk. People who have light skin are most likely to develop SCC, but it can also develop in dark-skinned people, especially those who have scarring.
Because SCC can grow deep, it can cause damage and disfigurement. Early treatment can prevent this and stop SCC from spreading to other areas of the body.
MERKEL CELL CARCINOMA
Merkel cell carcinoma (MCC) is a rare and aggressive type of skin cancer that’s potentially even more dangerous than melanoma.
It typically appears as a single firm bump that may be skin-colored, red, blueish-red or purple. It can develop anywhere on the body, but it most often appears on areas exposed to sunlight, such as the face, neck and arms. The cancer can spread quickly to other parts of the body.
MCC can affect anyone, but it is most common in Caucasian males over the age of 50. Because it spreads quickly, it’s important to catch it early, when it’s easier to treat.
MELANOMA
This skin cancer frequently develops in a mole or appears suddenly as a new dark spot on the skin. Either way, melanoma can be deadly. Every year, more than 76,000 Americans develop melanoma and over 10,000 (nearly one person per hour) die from melanoma, making it the deadliest form of skin cancer.
Are there warning signs for melanoma?
A change is often the first sign of melanoma; therefore, it is important to know where moles appear and what they look like. When detected and properly treated before it spreads, melanoma has a high cure rate.
The ABCDE warning signs of melanoma can help people detect change. Changes that can indicate melanoma are pain, itching, or bleeding in a mole or new spot on the skin.
ATYPICAL FIBROXANTHOMA
Atypical fibroxanthomais a rare skin cancer that often appears on the head, ears or neck in the form of a red or pink bump. The lesions are typically small (1 to 2 centimeters in diameter) but often develop quickly. They usually aren’t itchy or painful. They can be crusty, scaly or broken open in the middle, and they may bleed.
Atypical fibroxanthoma is most often caused by cumulative sun exposure and typically appears in older adults with fair skin. It doesn’t normally spread to other parts of the body.
KAPOSI SARCOMA
Kaposi sarcoma (KS) is a rare type of cancer that develops in cells that line blood vessels and lymphatic vessels. Kaposi sarcoma lesions usually appear on the skin and mucous membranes (such as inside the mouth or throat), but they can also develop in the lymph nodes, lungs and digestive tract. They can be flat patches, raised patches or bumps and may be red, purple or brown. They commonly appear on the face, legs and feet.
The lesions are usually painless, but lesions on the legs or in the groin area may cause painful swelling of the legs and feet.
How Is Skin Cancer Diagnosed and Treated?
The Water’s Edge dermatologist will diagnose skin cancer with a biopsy taken in the office. He or she will remove a small amount of tissue so that it can be examined under a microscope.
If skin cancer is diagnosed, there are a variety of surgical and nonsurgical treatment options available. Treatment depends on the location, size, and microscopic characteristics of the skin cancer, as well as the health of the patient and other factors.
Skin Cancer Treatment Options Include:
- Simple surgical excision. The dermatologist cuts out the cancer and some of the surrounding healthy tissue. The removed specimen is examined under a microscope to determine if all of the skin cancer has been removed.
- Mohs Micrographic Surgery. Performed by a specially trained dermatologic surgeon, Radiation therapy damages or kills the cancerous cells with high-energy X-rays, which also help to prevent continued growth.
- Topical therapy. Medications such as imiquimod and 5-fluorouracil can be applied at home to treat the cancer.
What Are the Risk Factors for Developing Skin Cancer?
Several risk factors increase a person’s likelihood of getting skin cancer. One risk factor is sun exposure. It is important to protect the skin with sunscreen and clothing, and never sunburn.
Another risk factor is light skin. However, people with skin of color get melanoma as well. In skin of color, melanoma usually appears on the palms of the hands, soles of the feet, under the nails, in the mouth, or on the genitals.
A few risk factors significantly increase a person’s risk of getting melanoma.
- If one or more first-degree relatives (parent, sibling, or child) has had melanoma, the risk significantly increases.
- Having many moles (50-100 or more) or several atypical moles also increases the risk. An atypical mole is not cancerous, but because of its different appearance, these moles need to be closely monitored for any changes.
- Having had melanoma also increases your chances of having additional melanomas.
Most skin cancer can be found early.
Are Skin Exams Important?
With early detection and proper treatment, the cure rate for BCC and SCC is about 95 percent. When melanoma is detected before it spreads, it also has a high cure rate. Regular skin exams help people find skin cancers early.
One type of skin exam is the skin self-exam. During a self-exam, people examine their own skin for signs of change. If a growth, mole, sore, or skin discoloration appears suddenly, or begins to change, see a Water’s Edge Dermatology practitioner.
People who have spent time in the sun, have a family history of skin cancer (especially melanoma), have many moles or atypical moles, or have other risk factors for skin cancer should see a dermatologist for regular skin exams. Some people should have this exam once a year. Others need more frequent exams. A Water’s Edge Dermatology practitioner will recommend the frequency that is best for each patient.
If the dermatologist sees a potential skin cancer during the skin exam, he or she will remove the growth (or part of it) so it can be examined under a microscope. This is called a biopsy. A Water’s Edge dermatologist can safely and quickly perform this procedure during an office visit.
If the biopsy report confirms that the suspicious growth is skin cancer, more treatment may be needed. When caught early and when the entire growth is removed, sometimes further treatment is not needed.
If further treatment is needed, the dermatologist will choose from an array of medical and surgical treatments for skin cancer. Treatment varies with the type of skin cancer, the size and location of the skin cancer, and the needs of the patient.
How Can I Protect Myself?
Sun exposure is the most preventable risk factor for all skin cancers, including melanoma. You can have fun in the sun and decrease your risk of skin cancer. Here’s how to stay safe in the sun:
- Generously apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or more to all exposed skin. Broad spectrum provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately every two hours, even on cloudy days, and after swimming or sweating.
- Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.
- Seek shade when appropriate, remembering that the sun’s rays are strongest between 10 am and 4 pm. If your shadow is shorter than you are, seek shade.
- Protect children from sun exposure by playing in the shade, wearing protective clothing, and applying sunscreen.
- Use extra caution near water, snow, and sand because they reflect the damaging rays of the sun, which can increase your chance of sunburn.
- Get vitamin D safely through a healthy diet that may include vitamin supplements. Don’t seek the sun.
- Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
- Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a Water’s Edge Dermatology practitioner. Skin cancer is very treatable when caught early.