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 Healthy Steps to Skin Cancer Prevention
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Each year, about a million people in the United States learn that
they have skin cancer. Cancer is a group of more than 100 diseases.
Although each type of cancer differs from the others in many ways,
every cancer is a disease of some of the body's cells.
Healthy cells that make up the body's tissues grow, divide, and
replace themselves in an orderly way. This process keeps the body in
good repair. Sometimes, however, normal cells lose their ability to
limit and direct their growth. They divide too rapidly and grow
without any order, too much tissue is produced, and tumors begin to
form. Tumors can be benign or malignant.
- Benign tumors are not cancer. They do not spread to other
parts of the body and are seldom a threat to life. Often, benign
tumors can be removed by surgery, and they are not likely to return.
- Malignant tumors are cancer. They can invade and destroy
nearby healthy tissues and organs. Cancer cells also can spread, or
metastasize, to other parts of the body and form new tumors.
Types of Skin Cancer
The two most common kinds of skin cancer are basal cell carcinoma
and squamous cell, Carcinoma is cancer that begins in the cells that
cover or line an organ. Basal cell carcinoma accounts for more than 90
percent of all skin cancers in the United States. It is a slow-growing
cancer that seldom spreads to other parts of the body. Squamous cell
carcinoma also rarely spreads, but it does so more often than basal
cell carcinoma. However, it is important that skin cancers be found
and treated early because they can invade and destroy nearby tissue.
Basal cell carcinoma and squamous cell carcinoma are sometimes called
nonmelanoma skin cancer. Another type of cancer that occurs in the
skin is melanoma, which begins in the melanocytes.
Cause and Prevention
Skin cancer is the most common type of cancer in the United States.
According to current estimates, 40 to 50 percent of Americans who live
to age 65 will have skin cancer at least once. Although anyone can get
skin cancer, the risk is greatest for people who have fair skin that
freckles easily - often those with red or blond hair and blue or
light-colored eyes. Ultraviolet (UV) radiation from the sun is the
main cause of skin cancer. UV radiation is invisible rays that are
part of the energy that comes from the sun. UV radiation also comes
from sun lamps and tanning beds. UV radiation can damage the skin and
cause melanoma and other types of skin cancer. UV radiation that
reaches the Earth's surface is made up of two types of rays, called
UVA and UVB rays. UVB rays are more likely than UVA rays to cause
sunburn, but UVA rays pass deeper into the skin. Scientists have long
thought that UVB radiation can cause melanoma and other types of skin
cancer. They now think that UVA radiation also may add to skin damage
that can lead to skin cancer and cause premature aging. For this
reason, skin specialists recommend that people use sunscreens that
reflect, absorb, or scatter both kinds of UV radiation.
The risk of developing skin cancer is affected by where a person
lives. People who live in areas that get high levels of UV radiation
from the sun are more likely to get skin cancer. In the United States,
for example, skin cancer is more common in Texas than it is in
Minnesota, where the sun is not as strong. Worldwide, the highest
rates of skin cancer are found in South Africa and Australia, areas
that receive high amounts of UV radiation.
In addition, skin cancer is related to lifetime exposure to UV
radiation. Most skin cancers appear after age 50, but the sun's
damaging effects begin at an early age. Therefore, protection should
start in childhood to prevent skin cancer later in life.
Whenever possible, people should avoid exposure to the midday sun
(from 10 a.m. to 2 p.m. standard time, or from 11 a.m. to 3 p.m.
daylight savings time). Keep in mind that protective clothing, such as
sun hats and long sleeves, can block out the sun's harmful rays. Also,
lotions that contain sunscreens can protect the skin. Sunscreens are
rated in strength according to a sun protection factor (SPF), which
ranges from 2 to 30 or higher. Those rated 15 to 30 block most of the
sun's harmful rays.
Symptoms
The most common warning sign of skin cancer is a change on the
skin, especially a new growth or a sore that doesn't heal. Skin
cancers don't all look the same. For example, the cancer may start as
a small, smooth, shiny, pale, or waxy lump. Or it can appear as a firm
red lump. Sometimes, the lump bleeds or develops a crust. Skin cancer
can also start as a flat, red spot that is rough, dry, or scaly.
Both basal and squamous cell cancers are found mainly on areas of
the skin that are exposed to the sun - the head, face, neck, hands,
and arms. However, skin cancer can occur anywhere.
Actinic keratosis, which appears as rough, red or brown scaly
patches on the skin, is known as a precancerous condition because it
sometimes develops into squamous cell cancer. Like skin cancer, it
usually appears on sun-exposed areas but can be found elsewhere.
Changes in the skin are not sure signs of cancer; however, it is
important to see a doctor if any symptom lasts longer than 2 weeks.
Don't wait for the area to hurt - skin cancers seldom cause pain.
Detection
The cure rate for skin cancer could be 100 percent if all skin
cancers were brought to a doctor's attention before they had a chance
to spread. Therefore, people should check themselves regularly for new
growths or other changes in the skin. Any new, colored growths or any
changes in growths that are already present should be reported to the
doctor without delay. (See the
How to do a Skin Self-Exam) section for a simple guide on how to
do a skin self-exam.)
Doctors should also look at the skin during routine physical exams.
People who have already had skin cancer should be sure to have regular
exams so that the doctor can check the skin - both the treated areas
and other places where cancer may develop.
Diagnosis
Basal cell carcinoma and squamous cell carcinoma are generally
diagnosed and treated in the same way. When an area of skin does not
look normal, the doctor may remove all or part of the growth. This is
called a biopsy. To check for cancer cells, the tissue is examined
under a microscope by a pathologist or a dermatologist. A biopsy is
the only sure way to tell if the problem is cancer.
Doctors generally divide skin cancer into two stages: local
(affecting only the skin) or metastatic (spreading beyond the skin).
Because skin cancer rarely spreads, a biopsy often is the only test
needed to determine the stage. In cases where the growth is very large
or has been present for a long time, the doctor will carefully check
the lymph nodes in the area. In addition, the patient may need to have
additional tests, such as special x-rays, to find out whether the
cancer has spread to other parts of the body. Knowing the stage of a
skin cancer helps the doctor plan the best treatment.
Treatment Planning
In treating skin cancer, the doctor's main goal is to remove or
destroy the cancer completely with as small a scar as possible. To
plan the best treatment for each patient, the doctor considers the
location and size of the cancer, the risk of scarring, and the
person's age, general health, and medical history.
It is sometimes helpful to have the advice of more than one doctor
before starting treatment. It may take a week or two to arrange for a
second opinion, but this short delay will not reduce the chance that
treatment will be successful.
For more information see UA Extension Factsheet FSHEL 15 Skin
Cancer
How To Do a Skin Self-Exam
You can improve your chances of finding skin cancer promptly by
performing a simple skin self-exam regularly.
The best time to do this self-exam is after a shower or bath. You
should check your skin in a well-lighted room using a full-length
mirror and a hand-held mirror. It's best to begin by learning where
your birthmarks, moles, and blemishes are and what they usually look
like. Check for anything new - a change in the size, texture, or color
of a mole, or a sore that does not heal.
Check all areas, including the back, the scalp, between the
buttocks, and the genital area.
- Look at the front and back of your body in the mirror, then
raise your arms and look at the left and right sides.
- Bend your elbows and look carefully at your palms; forearms,
including the undersides; and the upper arms.
- Examine the back and front of your legs. Also look between
your buttocks and around your genital area.
- Sit and closely examine your feet, including the soles and the
spaces between the toes.
- Look at your face, neck, and scalp. You may want to use a comb
or a blow dryer to move hair so that you can see better.
By checking your skin regularly, you will become familiar with what
is normal. If you find anything unusual, see your doctor right away.
Remember, the earlier skin cancer is found, the better the chance for
cure.
Source: National Cancer Institute
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