Skin Cancer

     Skin cancer accounts for more than half of all new cancers diagnosed in the United States. Over 1.3 million new cases will be diagnosed in the US this year. Risk factors for developing skin cancer include chronic or intermittent sun exposure, fair skin, light colored hair, personal or family history of skin cancer, tanning bed use, numerous moles or large moles, prior history of radiation, and systemic immunosuppression (transplant patients, etc).
     BCC, SCC, and Melanoma are the 3 most common skin cancers accounting for 80%, 15%, and 4% of all skin cancers respectively. Over 10,000 people will die from skin cancer in the US this year. Approximately 80% of these deaths will be due to Melanoma, and approximately 20% will be due to the other forms of skin cancer (including SCC and BCC).
     Melanoma is the most deadly form of skin cancer, and may develop from or near an existing mole, or may arise in previously normal appearing skin. This cancer can occur anywhere on the body, but is most common on the upper back of men and women, and on the legs of women. Melanoma has a tendency to spread to other parts of the body, especially as the lesions grow deeper into the skin. Treatment of melanoma is extremely difficult, making early diagnosis crucial.
     The A-B-C-D-E criteria have been used to aid in the detection of melanoma. The criteria are not perfect, but may help with the diagnosis of certain cases of melanoma. When looking at moles on the skin, the following criteria should be evaluated:
     Asymmetry of the lesion, Border irregularity, Color variegation (or irregularity of color), Diameter greater then 6mm (size of a pencil eraser) - Though you can see melanomas that are smaller, and Evolving or changing in appearance. If a mole with one or more of these characteristics is observed, it should be evaluated by a Dermatologist, or another physician.
     BCC and SCC arise in the top layer of the skin, and are generally seen on sun-exposed parts of the body. These cancers may appear as a sore or bump that comes up and will not completely go away, a lesion that bleeds with minimal trauma, or a scaly or crusted bump or plaque. These cancers can be extremely destructive, and can erode through anything in the surrounding area, including muscle and bone. Often, it is difficult to tell how far these cancers extend by just looking at them, so early detection and treatment are important. It is rare for a BCC to metastasize (spread to another part of the body), but up to 5% of SCCs may metastasize.
     As sun exposure is the leading factor in the development of skin cancer, protecting your skin is important. Certain steps can be taken to limit the potential damage, including:
 · Using a broad spectrum sunscreen, SPF 15 or higher that covers both UVA and UVB
 · Reapplying sunscreen every 2 hours, or after exercise or swimming
 · Protecting your lips with lip balm with sunscreen
 · Wear protective clothing including a wide brimmed hat and sunglasses
 · Try to stay in shaded areas
 · Avoid tanning beds
 · Protecting children from sun damage is particularly important, and can significantly decrease their lifetime risk of skin cancer
     Treatment of skin cancer is dependant on the type of cancer, the location, and how far the lesion has progressed. When detected early, most skin cancers, including thin melanomas, BCCs, and SCCs, may be surgically removed. Non-melanoma skin cancers in some cases may also be treated with electrodessication (tissue destruction with heat), topical chemotherapy creams and radiation. More advanced cancers may require more extensive surgery, radiation, and/or chemotherapy.