Skin Cancer

Skin Cancer

What Is Skin Cancer?

Skin cancer is a malignant growth on the skin which can have many causes. Skin cancer generally develops in the epidermis (the outermost layer of skin), so a tumor is usually clearly visible. This makes most skin cancers detectable in the early stages. There are three common types of skin cancer, each of which is named after the type of skin cell from which it arises. Cancers caused by UV exposure may be prevented by avoiding exposure to sunlight or other UV sources, wearing sun-protective clothes, and using a broad-spectrum sun screen.

Skin cancers are the fastest growing type of cancer in the United States. Skin cancer represents the most commonly diagnosed malignancy, surpassing lung, breast, colorectal and prostate cancer. More than 1 million Americans will be diagnosed with skin cancer in 2007.

What Are The Risk Factors?

Skin cancer is most closely associated with chronic inflammation of the skin. This includes: 

  • Sunburn or excessive sun damage, especially early in life. UVA & UVB have both been implicated in causing DNA damage resulting in cancer.
  • Sun exposure between 10AM and 4PM is thought to be most harmful.
  • Natural (sun) & artificial UV exposure (tanning salons) are associated with skin cancer.
  • Chronic non-healing wounds, especially burns. These are called Marjolin’s ulcers based on their appearance and can develop into squamous cell carcinoma.
  • Genetic predisposition, including “Congenital Melanocytic Nevi Syndrome”. CMNS is characterized by the presence of “nevi” or moles of varying size that either appear at or within 6 months of birth. Nevi larger than 20 mm (3/4″) in size are at higher risk for becoming cancerous.

What Are The Symptoms?

There are a variety of different skin cancer symptoms. These include scabs or changes in the skin that do not heal, ulcers in the skin, discoloration, and changes in existing moles.

  • Basal cell carcinoma usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck or shoulders. Sometimes small blood vessels can be seen within the tumor. Crusting and bleeding in the center of the tumor frequently develops. It is often mistaken for a sore that does not heal.
  • Squamous cell carcinoma is commonly a red, scaling, thickened patch on sun-exposed skin. Ulceration and bleeding may occur. When SCC is not treated, it may develop into a large mass.
  • Melanomas are brown to black looking lesions. Signs that might indicate a malignant melanoma include change in size, shape, color or elevation of a mole. The appearance of a new mole during adulthood, or new pain, itching, ulceration or bleeding of an existing mole should be checked.

What Is The Treatment?

Most skin cancers can be treated by removal of the lesion, making sure that the edges are free of the tumor cells. These excisions provide the best cure for both early and high-risk disease. For low-risk disease, radiation therapy and cryotherapy (freezing the cancer off) can provide adequate control of the disease; both, however, have lower overall cure rates than surgery.

Moh’s Microsurgery is a technique used to remove the cancer with the least amount of surrounding tissue and the edges are checked immediately to see if tumor is found. This provides the opportunity to remove the least amount of tissue and provide the best cosmetically favorable results. This is especially important for areas where excess skin is limited, such as the face. Cure rates are equivalent to wide excision. In the case of disease that has spread (metastasized) further surgical or chemotherapy may be required.

How Can You Reduce The Risks?

Although it is impossible to completely eliminate the possibility of skin cancer, the risk of developing such a cancer can be reduced significantly with the following steps:

  • Reducing exposure to ultraviolet (UV) radiation, especially in early years.
  • Avoiding sunburns.
  • Avoiding sun exposure during the when the sun is highest in the sky
  • Wearing protective clothing (long sleeves and hats) when outdoors.
  • Using a broad-spectrum sunscreen that blocks both UVA and UVB radiation.
  • Reapply sun block every 2 hours and after swimming.