The Surprising Link Between Breast Cancer and Skin Cancer
Medical Review By: Dr. Ted Schiff
Anyone who’s had breast cancer or skin cancer should know the unfortunate truth: Having one of these diseases seems to increase the likelihood of developing the other.
The risk for getting hit with this double whammy appears to be highest among younger women. And unfortunately, the form of skin cancer most closely associated with breast cancer also happens to be the most dangerous, melanoma.
Here’s a summary of what the science says.
Young breast cancer survivors at increased melanoma risk
A 2004 study looked at a large database of health records for women in nine regions of the United States. Breast cancer survivors age 50 and younger had a 46% increased risk for later being diagnosed with melanoma. Women who’d had melanoma were more likely than others to develop breast cancer, though the increase in risk was much lower.
In a 2011 study, female breast cancer survivors under age 45 had a 38% increased risk for developing melanoma compared to the general population. Among women over 45 who survived breast cancer, the increased risk for melanoma was 12%.
A weaker link between other skin cancers and breast cancer
Any association between breast cancer and non-melanoma forms of skin cancer, which include basal cell and squamous cell cancers, is less clear. Study have yielded mixed results.
A 2013 study found that women (average age 66) who’d had non-melanoma skin cancer had a 19% increased risk for eventually being diagnosed with breast cancer. A study of more than 70,000 postmenopausal women published the same year found no link between non-melanoma skin cancers and breast cancer, but it discovered that women with a history of basal cell or squamous cell cancer who developed breast cancer were more likely to have an advanced case of breast cancer.
Are BRCA genes a double threat?
If your mom or sister had both breast cancer and skin cancer, does that mean a similar fate may await you? Research offers clues that a risk for both conditions could be inherited in your genes, though whether that’s true remains unclear.
Genes called BRCA1 and BRCA2 increase the risk for breast cancer. Some research has linked them, especially BRCA2, to melanoma, too. But the authors of a 2021 scientific review of the current evidence called that association “relatively weak” and argued that neither gene is likely to have much influence over whether or not a person develops melanoma.
What you can do
Researchers still have a lot to learn about the link between breast cancer and skin cancer, but early diagnosis of either disease is critical no matter what, as are skin cancer prevention measures.
Mammograms
Most women should consider having annual mammograms when they turn 40, according to the American Cancer Society, and make mammograms a yearly event at age 45 (then consider reducing the frequency at age 55). Women who have a family history of breast cancer or who know they carry genetic mutations such as the BRCA gene that increase their risk should begin screening earlier.
The benefits of having a doctor physically examine your breasts, or examining your own breasts regularly, has recently come into question, but the American Cancer Society suggests at least being familiar with your breasts and reporting any changes to a doctor.
Skin checks and self-exams
Frequent skin self-exams, on the other hand, are essential. Your dermatologist can advise on how often to perform them, though monthly is a common rule of thumb. The American Cancer Society has a guide on how to do a skin self-exam.
Most people should also have an annual full-body skin exam at their dermatologist’s office.
Sun protection
Everyone should protect their skin from the damaging effects of the sun, but double down on those efforts if you’re a breast cancer survivor or if you’re undergoing treatment for breast cancer or any other malignancy. Chemotherapy may make skin more vulnerable to the harms of UV rays, and radiation may have already caused skin redness or burns.
You know the rules: Use a broad-spectrum sunscreen with an SPF of 30 or higher on any day that you’ll be outside, and cover up with protective clothing.
Article Written By: Timothy Gower, an award-winning journalist who writes about medicine and health. His work has appeared in more than two dozen national magazines.
What Does Lip Cancer Look Like?
Medical Review By: Thomas Pham, MD
Your lips are important for lots of things, including chewing and kissing. While the occasional cold sore or cause of chapped lips is annoying, lip cancer is another story entirely.
Lip cancer in its early stages is hard to notice, but that’s when it’s most treatable. By the time a lip tumor becomes obvious, cancer requires more invasive treatment, and it may spread to other parts of your body.
If you get a lot of sun exposure, or you smoke, chew tobacco, or drink heavily, it’s time to learn how to spot it.
Types of lip cancer
Lip cancer usually takes the form of squamous cell carcinoma. This type of cancer occurs in the squamous cells, which are thin, flat cells found in the middle and outer layers of the skin. Squamous cell cancer of the lip is much more aggressive than squamous cell cancer found in other places of the skin. It’s more likely to spread to the head and neck and harder to treat.
Much less frequently, lip cancer is melanoma, one of the deadliest types of cancer.
Lip cancer symptoms
The lower lip is more vulnerable to lip cancer because it gets more sun exposure than the upper lip. Symptoms to watch for include:
- A sore, ulcer or lesion on your lip that doesn’t heal (a cold sore, unlike lip cancer, does heal)
- A lump or thickened area on the lip
- Whitish or reddish patches on the lip
- Lip pain, bleeding or numbness
- A lump in your neck or swollen glands
- Jaw swelling or tightness
A precancerous condition that can lead to squamous cell cancer of the lip is actinic cheilitis. Symptoms include:
- Scaly whitish patches on the lip
- Dryness or peeling that won’t heal
- A rough, sandpapery texture
- Blurring of the border between the lip and the adjacent skin
- Loss of color in the skin of the lip
- Swelling or redness of the lip
Who gets lip cancer?
UV radiation from spending a lot of time in the sun or using tanning beds is the leading cause of lip cancer. Certain habits, such as smoking or chewing tobacco and excessive drinking, also increase the risk.
Other risk factors for lip cancer include having a weakened immune system, having fair skin, being over 40 years old, and being infected with certain strains of human papillomavirus (particularly strains 16 and 18). Lip cancer is more common in men, possibly because they are more likely to work outdoors and less likely to use lip balm with SPF. They may also be more likely to have smoked or consumed too much alcohol in the past.
Recent research suggests that taking hydrochlorothiazide, a diuretic, is strongly associated with an increased risk of developing lip cancer. This drug is used alone or in combination with other medications to treat high blood pressure.
Lip cancer treatment
Lip cancer is usually curable; most people survive it and have a good outcome after treatment.
The doctor may recommend Mohs surgery to remove the tumor. In this procedure, the surgeon gradually removes layers of the tumor and a small amount of tissue surrounding it, checking each layer for cancer cells. The surgery ends when cancer cells can no longer be detected under a microscope. Mohs surgery lets surgeons identify and remove tiny roots of cancer, which helps prevent it from spreading to other parts of the body.
Advanced cases are usually treated by an ear, nose, and throat doctor (ENT). Radiation and/or chemotherapy may be used in conjunction with surgery. In rare cases, radiation “seed” therapy is used to treat patients who opt out of surgery. Reconstructive surgery may be necessary to repair the lip.
Protect your lips by following these tips:
Wear lip balm with SPF. Choose a lip balm with an SPF of at least 30 and wear it whenever you go outside. A wide-brimmed hat is also a good idea.
Don’t use tanning beds. Indoor tanning isn’t any safer for your skin than lying in the sun.
Limit or quit smoking and drinking. This is especially important if you drink and also smoke. These habits together put you at much higher risk for lip cancer than either habit alone.
See your dentist regularly. Dentists are often the ones to detect lip cancer, so keep up with routine cleanings and exams.
If you notice any unusual changes in your lip when you look in the mirror, don’t panic. But if something looks or feels different and the problem doesn’t resolve quickly, call your dermatologist ASAP. Treating lip cancer early means less risk of spoiling your smile.
Article Written By: Jessica Brown, a health and science writer/editor based in Brooklyn, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.
Foot Melanoma: The Hidden Skin Cancer It Pays to Watch For
Medical review by Ted Schiff, MD
When you examine your feet, you’re probably more concerned about dry heels or nail problems than melanoma. After all, melanoma usually occurs in parts of the body that get a lot of sun exposure.
But foot melanoma — the skin cancer that killed reggae star Bob Marley — is real. And because they’re not looking for it, most people notice it too late, when it has already spread to other organs.
Foot melanoma can occur anywhere on the foot, including the top and bottom, between the toes, and even under a toenail. It can arise from an existing mole or from clear skin. It can strike any age group and is equally common in African Americans and Caucasians. For people of African or Asian descent, the feet and hands are the most common places for melanoma to develop.
No matter your skin color or age, the message is the same: Check your feet for melanoma.
What to look for
The signs are different depending on the type of foot melanoma, but be on the lookout for:
- A spot or growth that may be pinkish-red, brown, black, blue, white or some combination of these colors
- A new spot or growth that appears where you have injured your foot
- A sore that is slow to heal, does not heal or keeps coming back
- Pigment that spreads from a growth to the surrounding skin
- An open wound or sore that resembles a diabetic ulcer
- A dark vertical line under a toenail
Follow the ABCDE rule for evaluating skin spots and growths. Look for asymmetry (one side doesn’t match the other), an irregular border and changes in size, shape or color. A melanoma of the foot may feel tender, itch, ooze, bleed or become scaly.
Types of foot melanoma
Not all foot melanomas are the same. If you have foot melanoma, a dermatologist can determine which of these types it is:
Superficial spreading melanoma. This is the most common type of melanoma. When it affects the foot, it typically appears on the top. The spot or growth may be raised or flat and usually has an irregular shape. It may be tan, brown, black, red, blue, white or a combination of any of these colors. It gets larger before it penetrates deeper skin layers.
Acral lentiginous melanoma. This can develop on the sole of the foot or in the toenail bed. When it affects the sole, it looks like a flat, black or brown discoloration that gets larger over time. It may resemble a bruise or stain. When it develops in the bed of the nail (this condition is called subungual melanoma), it appears as dark vertical streaks. Subungual melanoma can cause cracks or breaks in the nail as it progresses.
Nodular melanoma. Nodular melanoma usually appears as a round bump or nodule. It’s usually black but can also be blue, gray, red or white. It may even be the same color as your skin. It spreads quickly. While anyone can develop nodular melanoma, it’s more common in people with light skin who are over the age of 65.
Amelanotic melanoma. This a rare form of melanoma. It appears as a raised growth that is often skin-colored, which makes it hard to detect. The growth may also be red or pink. The best way to spot it is to look for any raised growth that is new or has changed. Risk factors include having red hair, pale and/or sun-sensitive skin, freckles and a lack of moles on your back.
Foot Melanoma Treatment
Your doctor will recommend a treatment based on your overall health and the stage of your skin cancer.
If the melanoma is caught early, the doctor may be able to cut out (excise) the growth and surrounding skin during an office visit. If the melanoma is advanced, it may require chemotherapy, radiation therapy, and/or immunotherapy. If cancer has spread to the lymph nodes, the nodes may need to be removed.
The best way to avoid more invasive treatment is to notice the signs of foot melanoma as soon as possible and see your dermatologist right away.
Written by Jessica Brown, a health and science writer/editor based in Brooklyn, New York. She has written for Prevention magazine, jnj.com, BCRF.org and many other outlets.
A Melanoma Warning for Millennials and Gen Z
Medical review by Alissa O'Brien, MD
Whether you’re in your 30s, 20s or teens, chances are you think of skin cancer as a vague and distant threat, if you think of it at all. But the statistics may surprise you.
It’s true that melanoma, which can be fatal, is most often seen in older adults. The average age at diagnosis is 63. But that doesn’t mean it can’t happen earlier in life — it can, and more and more often, it does. In fact, melanoma is the most diagnosed age-related cancer among people ages 25 to 29. In people ages 15 to 29, it’s the third most common age-related cancer for males and fourth most common for females.
Young women get melanoma more often than young men. Before age 50, women are more likely to develop melanoma than any other cancer except breast and thyroid cancer.
But men should wake up and smell the sunscreen, too. Cases of melanoma on the head and neck increased by 51% among children, teens and young adults in the U.S. and Canada between 1995 and 2014 according to a 2019 study; and in the U.S., most of the increase was driven by melanoma in white males.
A deadlier threat in men
Melanoma is deadlier in men, including young men, than women. One study found that while teen and young adult males were less likely than females of the same age to develop melanoma, they were 55% more likely to die of it, regardless of tumor thickness.
Experts don’t understand all the reasons men face worse melanoma survival rates than women, but they do know that men’s skin and women’s skin are structurally different. Women are also more likely to wear sunscreen — and are less hesitant to see a doctor when they suspect something’s wrong.
An ounce (or two) of prevention
Sun protection is the key to preventing most cases of melanoma. That means staying out of the sun when its rays are strongest and protecting yourself from head to toe with clothing, hats and broad-spectrum sunscreen (SPF 30 or more). Don’t skimp on the sunscreen, either. Imagine filling a shot glass, which holds 1.5 ounces, with sunscreen. That’s about how much you need to cover your face and body.
Guys: If you are bald or balding and choose not to wear a hat, put sunscreen on your head. Men are more prone to skin cancer on the scalp (and ears) than women. A gel or spray sunscreen works well on hairy areas. If you wear a hat, you still need to apply sunscreen to your face, ears and neck.
If you go shirtless, apply sunscreen all over, including under your arms. But even if you keep your shirt on, it’s smart to apply sunscreen underneath. If you can see light through your shirt when you hold it up to the sun, UV rays can get to your skin through it.
No such thing as a healthy tan
In 2019, Blue Cross Blue Shield published results of a survey showing that among millennials:
- 58% think a tan makes you more attractive
- 53% believe a tan makes you look healthy
- 31% use tanning beds to get a base tan
Attractiveness is objective, so you should ask yourself if you’d rather have a tan or skin cancer. As far as “base tans” go, there’s no such thing. And tanning bed use before the age of 35 increases the risk of melanoma by 75%.
Male or female, light skinned or dark, melanoma prevention should be on everyone’s radar, especially those of us living in Florida. In addition to protecting yourself from UV rays, it’s also important to heed the warning signs of melanoma. The reason is simple: Early diagnosis and treatment just may save your life.
Written by Ann Pietrangelo, an author and freelance writer specializing in health and wellness.
First Monday in May is Melanoma Monday
Did you know that skin cancer is the most common cancer? Approximately 9,500 people in the U.S. are diagnosed with skin cancer every day. That means approximately one in five Americans develop skin cancer. While melanoma is not the most common type of skin cancer, it is the most dangerous. It is responsible for 10,000 American lives lost every year and is the second most common form of cancer in females ages 15 to 29. The good news is that skin cancer is also the most preventable cancer.
To raise awareness of melanoma and to encourage annual skin checks to help prevent skin cancer in general, the American Academy of Dermatology designates the first Monday in May as Melanoma Monday.
Who gets melanoma?
People of all colors and races get melanoma. Those with light skin who sunburn easily are at higher risk. If you have any of the following risk factors, you need to take extra caution in protecting your skin from the harmful rays of the sun:
- History of sunburns
- Family history of skin cancer
- Exposure to X-rays
- Use of tanning beds or sunlamps
What does melanoma look like?
Melanoma often develops in a mole or appears suddenly as a new dark spot on the skin. Be on the lookout for changes in moles, and if you see irregular edges or unusual colors in a mole, schedule a visit with your Water’s Edge Dermatology provider right away. Catching melanoma early (before it can spread) is key to stopping it. Even though melanoma can be deadly, survival rates can be greater than 90% when treated early.
Preventing melanoma
Tips to help prevent melanoma:
- Wear broad-spectrum, water-resistant sunscreen with an SPF of 30 or more on exposed skin
- Cover up with a hat and clothing
- Stay in the shade when possible, especially 10am-4pm when the sun’s rays are the strongest
- Protect children from sun exposure by playing in the shade, wearing protective clothing and applying sunscreen
- Avoid tanning beds, which can cause skin cancer and wrinkling
- Check your birthday suit on your birthday. If you notice any skin changes, skin growths or bleeding on your skin, see a Water’s Edge Dermatology practitioner immediately
In addition to doing self-exams on your birthday, May is a great month to schedule a skin check by a highly specialized skin care expert. At Water’s Edge Dermatology, our providers are experts in spotting melanoma and treating it early with procedures just right for each of our valued patients. Be safe and schedule your skin cancer check now.
Request an appointment with one of our skin care experts at Water’s Edge Dermatology.