Skin Cancer Education

Skin cancer is the most common form of cancer in the United States and involves abnormal growths of skin cells that can form anywhere on the body, but most frequently appear on skin that is exposed to the sun.  There are more than a million new cases of skin cancer in the US each year.  Although most cases of skin cancer can be successfully treated, it is still important to keep skin safe and healthy and try to prevent this disease.

There are three major types of skin cancer that affect associated layers of the skin.  These major types are:

• Squamous cell carcinoma affects the squamous cells, which are just below the outer surface of the skin and serve as the inner lining.
• Basal cell carcinoma affects the basal cells, which lay under the squamous cells and produce new skin cells.
• Melanoma is the most serious form of skin cancer and affects the melanocytes, which produce melanin.

 

Skin Cancer Causes

Everyday skin cells die and new ones form to replace them in a process controlled by DNA.  Skin cancer can form when this process does not work properly because of damage to DNA.  New cells may form when they are not needed or older cells may not die.  This can cause a growth of tissue known as a tumor.  DNA damage is often a result of ultraviolet (UV) radiation from sunlight or tanning lamps.  Since skin cancer can sometimes affect areas not exposed to the sun, heredity may also be a factor.

 

Sun protection should be the first thing on everyone’s mind when they venture outside, whether its 89 degrees or 34 degrees. Ultraviolet radiation from sun exposure and exposure to sun beds and lamps are known as carcinogens (a substance known to cause cancer) therefore it is vital to protect skin from ultraviolet radiation. The skin is an organ that protects the body from external factors such as bacteria and helps maintain homeostasis. It is composed of three layers: the epidermis, the outermost layer; the dermis, the middle layer; and the hypodermis the innermost layer. Melanin cells found in the epidermis are an important chemical pigment defense against UV rays that may damage skin cells.

Cells are the tiny individual structures that make up all parts of the body. Normal growth and repair of tissue takes place in an orderly fashion through cell division. When cell division is not orderly and controlled, abnormal growth occurs. Masses of tissue develop and may become cancerous. Not all cancerous cells develop into malignant cells, most develop into a benign form of cancer such as basal cell carcinoma and squamous cell carcinoma.

Different skin types are affected differently by UV radiation. Although lighter skin is more prone to sun damage, darker skinned people such as African Americans and Hispanics are also susceptible to sun damage. 

Certain factors, such as fair skin, moles, a weakened immune system and age, can also increase the risk of skin cancer.

 

Skin Cancer Signs and Symptoms

Skin cancer can often be identified as a new or changed growth on the skin that may often occur on the scalp, face, lips, ears, neck, chest, arms, hands or legs.  The appearance of the growth depends on the type of cancer, but can appear as:

• Pearly or waxy bump
• Flesh-colored or brown scar-like lesion
• Firm, red nodule
• Crusted, flat lesion
• Large brown spot with darker speckles
• Mole that changes shape or color
• Shiny, firm bumps

 

 

Diagnosis

It is important to see your doctor if you notice any skin changes.  Early detection is valuable in successfully treating skin cancer.  Regular full body screening is recommended as well.  A biopsy is performed to properly diagnose suspected cancerous growths. 

 

Skin Cancer Treatment

Treatment for skin cancer depends on the type, size and location of the tumor.  Most options remove the entire growth and are usually effective.  Removal procedures are usually simple and require only a local anesthetic in an outpatient setting.  Some of the treatment options for skin cancer include:

• Freezing - also known as cryosurgery, kills tissue by freezing them with liquid nitrogen
• Excision - the abnormal tissue, as well as some surrounding healthy tissue, is cut out of the skin
• Laser therapy - destroys cancerous growths with little damage to surrounding tissue and few side effects
• Mohs surgery - removes larger skin growths layer by layer until no abnormal cells remain to prevent damage to healthy skin
• Chemotherapy - uses drugs to kill cancer, may be applied through creams or lotions for top layer tumors

Other treatment options are also available, including new methods that are currently being studied.

Although most treatment for skin cancer is successful, new tumors can still form.  It is important to practice preventive measures and see your doctor on a regular basis.  You can also perform self skin checks to spot any changes as soon as possible.

The following are patients whom Dr. Walden performed reconstruction on after excision of their skin cancers:

Before After     Age: 39 Diagnosis: Basal cell carcinoma of the right lower lid Procedure: MOH’s excision of basal cell carcinoma and local flap closure of defect.	Before After     Age: 69 Diagnosis: Basal cell carcinoma of the right nostril Procedure: MOH’s excision of basal cell carcinoma and composite graft closure of defect (donor site: left ear)
Before After Age: 63 Diagnosis: Left temporal squamous cell carcinoma Procedure: MOH’s excision of squamous cell carcinoma and facial flap closure of defect.	Before After Age: 63 Diagnosis: Squamous cell carcinoma of upper lip Procedure: MOH’s excision of squamous cell carcinoma and local flap closure of defect.

 

 

Prevention

Having fun under the sun can be done safely. Here are some helpful tips to protect you against skin cancer:

1. Seek shade between 10am and 4pm.
2. Try to avoid tanning and UV tanning booths.
3. Apply sunscreen with an SPF of 15 and higher 30 mins. before going outside.
4. See your physician every year for a skin check-up.
5. Try to wear clothing that covers exposed areas.
6. Check your own skin and learn the pattern of moles, blemishes, and other marks on your skin so that you’ll notice any changes next time.

 

The American Cancer Society recommends performing a monthly self-exam by the following steps:

1. Check your face, ears, neck, chest and belly. Women will need to lift breasts to check the skin underneath.
2. Check the underarm areas, both sides of your arms, the tops and bottoms of your hands, in between your fingers, and fingernail beds.
3. Sit Down: Check the front of your thighs, shins, tops of your feet, in between your toes, and toenail beds.
4. You will need a hand mirror for your thighs, back, and scalp.
5. Now look at the bottoms of your feet, your calves, and the backs of your thighs, first checking one leg and then the other.
6. Use the hand mirror to check the buttocks, genital area, lower back, upper back, and the back of the neck.
7. Use a comb or hair dryer to part your hair so that you can check your scalp.

Additional Resources For More Info

The Skin Cancer Foundation
The American Cancer Society
The National Cancer Society