Everything You Need To Know About Skin Cancer and Preventing It!

Article by Judy K. Chiang, MD

Did you know that skin cancer is the most common of all cancers? In the United States alone, more than one million people develop skin cancer each year. There's good news though, skin cancer can be cured if caught early. The first step in catching skin cancer early is learning what it is and how to identify it. The three most common types of skin cancer are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma.

Basal Cell Carcinoma and Squamous Cell Carcinoma

BCC accounts for the majority of all skin cancers and it usually appears as a pearly pink papule or patch on sun-exposed areas of the skin such as the face, scalp and neck. Usually, BCC is described as a pimple-like growth which bleeds intermittently and never goes away. On close examination, tiny blood vessels called telangiectasias are apparent.

Prognosis for BCC is excellent as this type of cancer rarely metastasizes or spreads to other parts of the body; however, early diagnosis and treatment is advised as it can be locally aggressive and possibly extend to surrounding bones and nerves. Additionally, the earlier the cancer is caught and treated, the smaller the length of the scar, which is best for cosmetic reasons.

Basal Cell Carcinoma Squamous Cell Carcinoma
Basal Cell Carcinoma, Skin Cancer
Squamous Cell Carcinoma, Skin Cancer

The second most common type of skin cancer is SCC and it usually appears as red, scaly patches on sun exposed regions. Often, these patches can develop into larger, thicker masses. SCC has a higher chance of metastasis than BCC. This is especially true in immunocompromised patients such as those who have had an organ transplant or have HIV/AIDS. The cure rate for both BCC and SCC is more than 95 percent if diagnosed early and treated properly.

Treatment for BCC and SCC may include topical medications or creams, electrodessication and curettage (scraping or burning), liquid nitrogen (freezing), radiation, general biopsy and/or Mohs Micrographic Surgery (Mohs). Mohs surgery is a state-of -the-art, specialized treatment for BCC and SCC that is usually used only on patients who are surgical candidates with advanced stages of BCC or SCC on cosmetically important areas such as the face.

Melanoma

Finally, the third most prevalent type of skin cancer, melanoma is the most deadly. It is estimated that more than 7,000 Americans die from it each year. When looking for melanoma, patients should use the ABCD method, which means looking closely at each mole or pigmented area, paying close attention to the asymmetry, borders, color and size.

ABCDs of Melanoma                             

Asymmetrical  Borders Irregular
Asymmetrical, ABCD's of Melanoma
Borders Irregular, ABCD's of Melanoma
Color Non-Uniform   Diameter more than 6mm
Color Non-Uniform, ABCD's of Melanoma
Diameter, ABCD's of Melanoma

In addition to the ABCDs, many patients notice change in the size or color of a mole, bleeding tendency or change in sensation of a mole. You should see your doctor if you feel you have a changing mole or are concerned about any particular area on your skin.

The best way to diagnose melanoma is with an excisional biopsy in which a dermatologist will remove the mole for biopsy. The prognosis for people diagnosed with melanoma depends on the depth of the lesion and whether it has spread to other areas such as the lymph nodes, lungs, brain or other organs of the body.

Treatment of melanoma depends on how far the tumor has spread. If the depth of the lesion is shallow and it has not reached other organs, a dermatologist often will remove the lesion, as well as some of the normal, surrounding tissue. However, if the melanoma is deep in the skin and/or it has spread to other parts of the body, consultation with an oncologist is necessary to discuss chemotherapy and other treatment options.

Prevention

Prevention for all types of skin cancers includes sun avoidance during the hours of 10 a.m. to 4 p.m., which is when sun rays are strongest. While spending time outdoors a sunscreen with a Sun Protection Factor (SPF) of 15 or greater is highly recommended. Tanning beds should be avoided at all times and routine self examination is crucial, especially if you have a family or personal history of skin cancer.

About the Author

Judy K. Chiang, MD, practices dermatology on the Swedish Medical Center campus in Englewood and specializes in treating patients with skin cancer. Dr. Chiang is one of only ten physicians in the Denver-metro area specially trained to perform Mohs surgery. Dr. Chiang can be reached at 303-788-1766. 

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