My husband and I are both fair and freckled. We grew up in the seventies and eighties, slathering ourselves with baby oil in pursuit of a tan that would never be. If you are in your 40’s or older, you remember the days of baby oil and foil tanning mats.
Today we are paying the price. My husband was recently diagnosed with his first basal cell carcinoma. I say first because that’s the way these things work. He probably has a lifetime of MOHS surgeries to look forward to.
So far I’ve escaped an actual diagnosis of skin cancer, but I’m covered with actinic keratoses. These landmines are just waiting for the right moment to transform into something more sinister.
The Scope of the Skin Cancer Problem
My husband and I aren’t alone. A 2010 study in the Archives of Dermatology estimated that skin cancer was more prevalent than all other cancers combined over the previous three decades. In 2006 alone, 2.2 million people in the U.S. were diagnosed with skin cancer.
Outside of melanoma, skin cancer is rarely fatal. However, the costs and disability associated with the large number of diagnoses are significant. Treatment of skin cancer in the U.S. costs a whopping 8.1 billion dollars annually.
Skin cancer comes in three primary flavors. Here is a brief description of each of them, along with a precursor condition, that we should all be familiar with.
Actinic Keratosis These lesions are not cancerous, but about two-thirds of squamous cell and one-third of basal cell carcinomas arise from them. Typically they show up as slightly raised, scaly dry patches.
Basal Cell Carcinoma This is the most common form of skin cancer. The good news is that it rarely spreads or metastasizes beyond it site of origin. However, the tumor will continue to grow locally if unchecked, invading local structures, typically of the head and face. Without treatment it can be disfiguring, cause disability and, rarely, death.
Basal Cell tumors can show up as a shiny bump, a scar-like area, a sore that won’t heal, or a reddish or irritated patch. Meaning, it can look like almost any skin lesion, so don’t ignore changes in your skin.
Squamous Cell Carcinoma The second most common form of skin cancer, these lesions are rough and scaly, and may bleed easily if bumped or scratched. It is very common in fair-skinned, fair-haired individuals. Notably, it is also the most common form of skin cancer in African-Americans, and there has been a recent significant rise in Squamous Cell Carcinoma in Latinos as well. A dark skin pigment doesn’t mean you are immune to skin cancer.
Melanoma Melanoma is the most deadly form of skin cancer – nearly 10,000 people die from the disease each year in the U.S. The prognosis for this disease is closely related to early detection and treatment. Those caught early are highly treatable. This means vigilance is key where melanoma is concerned. Keep an eye out for the following warning signs and see a doctor if you find any of these:
- Asymmetry – a mole that is asymmetric,
- Borders – a mole with irregular borders that are not smooth,
- Color – a mole with more than one color,
- Diameter – melanomas are typically larger than benign moles, but they can start out smaller,
- Evolving – moles shouldn’t change. Melanomas can grow and change shape or color.
How to Prevent or Stop Skin Cancer
The sun is not your friend. Even if, like me, you’ve already allowed yourself a significant amount of sun damage, you can always make it worse. Avoid the sun, particularly from 10 am to 4 pm when its rays are strongest.
Use a broad-spectrum sunscreen with an SPF of 30 or higher. Reapply frequently if you are swimming or exercising.
Use protective clothing when possible. Rash guards for swimming, or broad-rimmed hats and clothing with SPF offer excellent protection.
Just say no to tanning beds. These devices can cause just as much damage as the sun itself.
Examine your skin monthly. Keep a record of anything unusual after your doctor has determined it is benign. Then it will be obvious to you if there is any change in the future. This form provided by the American Academy of Dermatology is an excellent aid for record keeping.
See your doctor if you notice any unusual skin lesions. Otherwise see him every year to have your skin checked.
Skin cancer doesn’t carry the weight of lung, colon or other more deadly cancers, so it often doesn’t receive the same attention. However, skin cancer is expensive – on both a personal and a national level. Often surgeries and drugs are required – repeatedly – to treat skin cancer. And it can be disfiguring, disabling or deadly.
Fortunately the disease is highly treatable, and with awareness of the symptoms, you can often prevent the worst outcomes by simply being alert.
Amy Rogers MD is not a practicing physician and nothing written here should be taken as medical advice from either Amy or AssetBuilder. Medical decisions should be made with care in consultation with your health care provider. Photo by: Twin Design / Shutterstock.com