May is National Skin Cancer Awareness Month
May 23, 2016
Gentlemen, we’re talking to you too.
This statement from the American Academy of Dermatology should get everyone’s attention: “Skin cancer is the most common form of cancer in the United States, and it is estimated that one person dies from melanoma — the deadliest form of skin cancer — every hour.” Every hour. Sobering, to say the least.
While there has been a plethora of information and advice for decades on how to protect oneself from skin cancer, that statistic tells us, the healthcare community, that we need to continue to beat the drum about skin cancer prevention, early detection, and treatment.
And, gentlemen, you’re significantly more likely to develop skin cancer than women. This particular fact has nothing to do with genes or DNA – it has to do with generally more sun exposure over a lifetime while being less likely to use sunscreen and take other sun protection measures.
Overall, one in 33 men and one in 52 women will develop melanoma in their lifetimes.
An estimated 6,750 men and 3,380 women in the U.S. will die from melanoma in 2016.
The majority of people diagnosed with melanoma are white men over age 55.
– “Skin Cancer Facts & Statistics”, SkinCancer.org
Women, in general, are accustomed to using creams, lotions, and makeup, many of which now contain sunscreen, and are – again, generally – more focused on skin care and wrinkle prevention. Men, well . . . check out this quote from a 2012 Skin Cancer Foundation press release highlighting a survey done on the gender divide on skin cancer awareness:
“The survey results reveal that nearly half (49per cent) of men in the US admit to not using sunscreen in the past 12 months and an alarming 70 percent of men don’t even know what skin cancer warning signs to look for. In almost every case, men prove to be less knowledgeable than women about the proper methods to protect themselves against sun exposure and skin cancer.”
Skin cancer: Who, what, and where
Who is most at risk for skin cancer? Anyone can get skin cancer but some are at a greater risk. Those would be people with:
- a lighter natural skin color that burns and freckles easily
- blonde or red hair
- blue or green eyes
- certain types and a large number of moles
- a family and/or personal history of skin cancer
- a history of severe sunburns, especially in childhood
- a history of using tanning beds
Indoor tanning and tanning outside are both dangerous. . . . A base tan is not a safe tan.
What causes skin cancer? In 99 percent of non-melanoma skin cancers and 95 per cent of melanoma, the cumulative effect of ultraviolet (UV) radiation from sunlight or man-made sources like tanning beds has damaged the DNA in the cells of the epidermis. With enough damage, the body cannot repair itself and certain cells start to grow out of control, becoming cancerous.
What are the types of skin cancer? The most common types of skin cancer are basal cell and squamous cell carcinomas, and melanoma. Merkel cell carcinoma is very rare.
- Basal cell carcinoma (BCC), the most common form of skin cancer, is a lesion that starts in the deepest layer of the epidermis and upon making an appearance resembles a small raised bump like a pimple, a shiny red or pink scaly patch, or a bump with a depression in the center. It’s generally caused by the cumulative effect of exposure to ultraviolet (UV) radiation from sunlight or man-made sources like tanning beds. It most commonly occurs on the head and neck but can appear on the trunk, arms, and legs. BCC is easily treated in the early stages and rarely spreads to other parts of the body but the lesion will enlarge. Therefore, a basal cell carcinoma needs to be removed promptly to avoid a disfiguring large and deep excision.
- Squamous cell carcinoma (SCC) is the second most common form of skin cancer and, like BCC, develops as a result of damage from UV radiation. It starts in the upper layers of the epidermis as an uncontrolled growth of abnormal cells. The lesion first appears as a scaly red patch or dome-shaped lump, which bleeds easily when scratched. As it grows, the lesion can itch and hurt. There is a greater risk of SCC spreading to the bones, tissues, and lymph nodes as compared to BCC. However it’s easy to treat when caught early.
- Cutaneous Melanoma (melanoma of the skin) develops in melanocytes, the cells that produce melanin in our skin, hair, and eyes – and moles. Most often this change is a result of UV radiation. Family history also plays a major role in developing melanoma.
Each person with a first-degree relative diagnosed with melanoma
has a 50 percent greater chance of developing the disease
than people who do not have a family history of the disease.
– Skin Cancer Foundation, SkinCancer.org
There are four types of cutaneous melanoma. Three start out superficially – only in the top layer of the skin – and sometimes become more invasive, being spread by the lymphatic system as opposed to the bloodstream like other melanomas. The fourth type is extremely aggressive and is invasive from the start.
The most common melanoma is Superficial Spreading Melanoma (SSM). This is the melanoma most often seen in young people. SSM accounts for approximately 70per cent of diagnosed melanomas and most often develops in a benign mole on the trunk, head, and back in men and on the legs and back in women. However, melanoma can also appear as a new mole. Look for asymmetry, an irregular border, uneven color, and a change in size over a relatively short period of time.
Lentigo maligna is most common in the elderly, again, on chronically sun-damaged skin. It is also the most common form of melanoma in Hawaii. When this superficial cancer spreads to other parts of the body, it’s referred to as lentigo maligna melanoma.
Acral lentiginous melanoma also spreads superficially before spreading to other parts of the body, and can do so more quickly than SSM or lentigo maligna. It develops as black or brown discoloration under the nails or on the soles of the feet or palms of the hands. It’s the most common melanoma in African-Americans and Asians, and the least common in Caucasians.
Nodular melanoma is the most aggressive type of melanoma and has generally spread to other parts of the body by the time it’s detected. The first sign is a bump, often black in color, on the trunk, arms, and legs of elderly people, and also the scalp on men.
- Merkel Cell Carcinoma (MCC) is a rare and very aggressive skin cancer. MCC most often (but not exclusively) develops in sun-damaged areas of the head and neck, and more than half of those who develop MCC are elderly and/or are immunosuppressed. It has a very high risk of recurring and spreading throughout the body with a fatality rate twice that of melanoma.
What are actinic keratoses (AK)? These red, pink, or tan-colored raised lesions resemble warts and are caused by sun damage. Approximately 10 per cent will develop into squamous cell carcinomas if left untreated. AKs can also turn into basal cell carcinomas.
What is a dysplastic nevus? This is an atypical, benign mole that may look like melanoma. It’s typically bigger than a common mole and with a different color, texture, and border. People who have dysplastic nevi are at greater risk of developing melanoma. And the greater number of these moles, the higher the risk. But that is not to say that a dysplastic nevus will definitely turn into melanoma.
“You’ve got my attention. What should I be doing?”
Starting today, be committed to applying a broad spectrum (UVA/UVB) sunscreen with an SPF of at least 15 like you would an all-over body lotion, even if you’re going to be indoors all day. If you know you’re going to be outdoors for an extended period of time, use an SPF of at least 30 and reapply it every couple of hours. Don’t forget your ears and feet. Cover up with clothing including a hat and UV-blocking sunglasses.
Additionally, the healthcare professionals at Rapid Med highly recommend patients be seen in a dermatologist’s office for a full-body screening, where all moles and spots are mapped and noted for future reference. The patient should return annually for a skin exam and comparison.
Every person, regardless of skin color, should make self-examination a regular part of their personal grooming routine. If you observe a change in a mole or spot, have your doctor check it out. With a previous full-body screening on file, the doctor can make a comparison and decide if a biopsy is warranted.
During a biopsy, a healthcare professional removes a small bit of tissue from the lesion under local anesthetic. The tissue sample is sent to a laboratory for testing. Depending on the results, there may be no further treatment needed if no cancerous cells are detected other than continuing to watch the area, or the doctor may need to completely excise the lesion including a margin of tissue surrounding it to be certain all cancerous or concerning cells are removed.
Rapid Med wants everyone to be sun-safe and sun-wise
The bottom line for both men and women regardless of ethnicity, the young and the young at heart, is to take the health of your skin, the largest organ you have, seriously. Use sunscreen every day no matter what, wear protective clothing, get a full-body screening with a follow-up visit every year, and make it a habit to do self-exams at home.
While there is a vast amount of additional information online, it can be overwhelming to search for even the simplest of answers. Don’t hesitate to contact Rapid Med with your questions and concerns – we’re here for you.
Additional reading – “Melanoma: A Surgeon and Survivor’s Perspective”. This is an important message from a melanoma survivor who also happens to be a surgical oncologist and a board-certified surgeon specializing in the surgical care of melanoma patients.