CONDITIONS

Skin Cancer

What Is Skin Cancer

Skin cancer is a term used to describe the uncontrollable growth of abnormal skin cells. 1 in 5 Americans will be diagnosed with skin cancer in their lifetime.

There are three main types of skin cancer:

  1. Melanoma. This type of cancer is characterized by the appearance of malignant tumors known as melanomas that develop within the skin or on surface as mole-like growths. The abnormal cell division that gives rise to melanomas is caused by damage to crucial DNA segments, most often due to excessive UV radiation from sun exposure. Melanoma causes an estimated 9,710 deaths in the US each year, making it the most dangerous form of skin cancer. According to the American Cancer Society, more than 120,000 new cases of melanoma are diagnosed each year.
  2. Basal cell carcinoma (BCC). This type of cancer is characterized by lesions that form in the innermost layer of the skin. Basal Cell Carcinoma is thought to be the result of long-term exposure to excessive UV radiation or exposure to short-term, intense UV radiation. BCC is the most common type of skin cancer, with an estimated 2. 8 million cases diagnosed yearly, though it rarely spreads to other parts of the body and is typically treatable if caught early.
  3. Squamous cell carcinoma (SCC). This type of cancer is characterized by the abnormal growth of cells known as squamous cells, which are located in the epidermis, or the outermost layer of the skin. These growths often look similar to scabs, warts, or sores, and are generally raised with a depression in the middle. According to the American Cancer Society, about 20% of skin cancer cases are diagnosed as squamous cell carcinoma. Like basal cell carcinoma, squamous cell carcinoma rarely metastasizes (spreads to other parts of the body), and is usually treatable with an early diagnosis.

What Causes Skin Cancer

Skin cancer is believed to be caused largely by exposure to ultraviolet (UV) radiation. UV radiation causes damage to cell DNA that can lead to cell mutations and the interruption of the cell’s ability to regulate cell division. The exact process of DNA damage and cell mutations are the focus of ongoing research. Individuals who have received prolonged doses of UV radiation, whether from unprotected sun exposure, tanning bed use, or other sources, are at an elevated risk for developing skin cancer.

Risk Factors For Skin Cancer

There are several factors that can affect the risk of developing skin cancer. These include:

  • Skin type. People with fair or freckled skin are more likely to develop skin cancer.
  • Hair color. When paired with a pale skin type, naturally blonde or red haired individuals have a higher risk of getting skin cancer.
  • Eye color. Those with blue, green, or grey eyes along with pale skin have a higher risk of getting skin cancer.
  • Personal history of sun exposure. Past sunburns or time spent in intense sunlight without proper protection can significantly increase the risk of skin cancer.
  • Family history. If a close relative has skin cancer, an individual’s risk of developing skin cancer significantly increases. For melanoma, this incidence rate can be as high as 10% (as opposed to the approximate 2% risk for the general public.)
  • Medical history. Previous cases of skin cancer, conditions that require extensive x-ray imaging, and several rare diseases affecting the skin are known to increase the risk of developing skin cancer.
  • Environmental factors. Exposure to arsenic, coal, and industrial tar can increase the risk of skin cancer. Studies have found that workers in the coal and asphalt industries experienced a higher rate of skin cancer occurrence.
  • Tobacco. In addition to raising the risk of cancers of the lungs, larynx, mouth, and stomach, exposure to tobacco smoke, whether secondhand or primary, can increase the risk of developing skin cancers.

Diagnosing Skin Cancer

Before your doctor arrives at a skin cancer diagnosis, he or she will most likely:

  • Conduct a physical exam to check for any abnormal moles, lesions or growths on the skin.
  • Take a medical history to assess the risk of skin cancer based on sun exposure, family history, and environmental factors.
  • Take a tissue biopsy.  If your doctor finds anything of suspicion on your skin, he or she will most likely conduct a biopsy in which samples of the growth cells are removed and sent to a lab for testing. There, they will be able to determine whether or not they are cancerous or benign (non-cancerous).

Warning Signs of Skin Cancer

The following may be warning signs of skin cancer:

  • Waxy, pearly, or firm nodules beneath the skin.
  • Flat lesion with scab-like appearance
  • Scar-like lesions that arise without notice
  • A large brownish spot with darker speckles
  • A mole or freckle that changes in color, size, or feel
  • Moles or lesions with irregular borders
  • Dark lesions on skin surface or the lining of the mouth, nose, vagina, or anus

Prognosis

The prognosis for skin cancer largely depends on the type of cancer and when it is detected. With recent advancements in treatment technologies, early detection of melanomas, BCCs, or SCCs have high chances of successful treatment. Melanoma is the most deadly form of skin cancer, though if caught before it spreads to the lymph nodes, the five-year survival rate can be as high as 98%. For distant stage (advanced) cases of melanoma, the five-year survival rate can be as low as 16%. Both BCC and SCC are highly curable with early detection and treatment.

Living With Skin Cancer

Receiving a skin cancer diagnosis can be a difficult and challenging experience. The following tips can help you live more comfortably with skin cancer:

  • Protect your skin from further damage. Use 30+ SPF sunblock with broad spectrum coverage and try to avoid long periods of prolonged sun exposure. This will help protect your already vulnerable skin from developing further cancerous tumors.
  • Be observant when toweling off from the shower or while getting changed. Check your skin for new growths or lesions and report any suspicions to your doctor. Pay special attention to areas that receive frequent sun exposure, but don’t neglect other parts of the body.
  • Be open with your doctor and trusted family/friends about any concerns you may have about your treatment or condition.
  • Talk to survivors in support groups or online forums. Getting support from others who have had your condition can help you make choices about your treatment and lifestyle changes.
  • Stay positive. Cancer research and advancements in treatment and detection technologies have greatly increased the average skin cancer survival rate. Stay positive about your chances of survival.

Screening

Because 1 in 5 Americans will get skin cancer at some point in their lives, and because the rate of survival is so much higher when detected early, regular screening for skin cancer is recommended. The Skin Cancer Foundation recommends scheduling an annual appointment with your dermatologist to receive a full body skin exam. During a full body skin exam, your doctor will check all of your surfaces (including toenails and fingernails) for signs of cancerous growths. Self-monitoring is also recommended. Pay close attention to new moles or growths that arise on the skin and report them to your doctor if you notice any abnormalities including irregular borders and rapid growth.

Prevention

Since the majority of skin cancers are caused by UV radiation exposure, the best thing that you can do to prevent skin cancer is to protect yourself from the sun. The following are tips on how to properly protect your skin from sun damage:

  • Use a broad-spectrum, waterproof sunscreen SPF 30 or higher while enjoying the outdoors. Reapply every two hours and remember that UV radiation can cause damage to the skin in any weather or season.
  • Avoid tanning beds. Tanning beds work by treating your skin with high concentrations of UV radiation, which cause damage to the skin cells as it tans them. As an alternative, consider a spray tan or home-use product.
  • Stay in the shade when the sun is strongest (between 10am and 2pm), especially in equatorial locations that receive more intense sunlight.
  • Wear the proper gear. Wide brimmed hats, sunglasses, and specialized clothing with built in UV protection can help you stay shielded from sun rays.

In addition to protecting your skin from the sun, you should monitor your skin for any suspicious moles or growths. Early detection of possibly carcinogenic growths is the most effective means of preventing skin cancer from advancing.

Common Treatment

The following treatments are available for patients with skin cancer:

Surgery. Surgical removal of the tumor is often the most effective way of treating early-detected skin cancers. Types of surgery include:

  • Mohs micrographic surgery. In this procedure, the tumor is cut from the skin in thin layers and examined under a microscope after each layer is removed. Layers continue to be removed until no cancerous cells remain in the tissue. This procedure removes as little skin as possible, making it a popular treatment option for facial skin cancer lesions.
  • Simple excision, in which the tumor and a small amount of surrounding skin is removed.
  • Shave excision, in which the tumor is shaved off the skin with the use of a sharp blade.
  • Electrodesiccation/curettage. In this procedure, a curettage (sharp, spoon-shaped tool) is used to cut the tumor from the skin. An electrode is then used to treat the area with an electric current, stopping bleeding and destroying the remainder of cancer cells.
  • Cryosurgery, in which the tumor is frozen off the skin with the use of pinpointed liquid nitrogen or liquid carbon dioxide.
  • Laser surgery, in which a laser beam is used to cut out the tumor.
  • Dermabrasion, in which a rotating wheel removes any potentially cancerous cells from the top layer of skin.

Radiation therapy. Radiation therapy can be given internally and externally, and involves the use of high-power x-rays or radioactive substances. Radiation treatments vary greatly from case to case depending on the extent of the cancer and can be effective in treating skin cancers that aren’t easily excisable.

Chemotherapy. In chemotherapy, high strength drugs target and kill or interrupt the growth process of cancerous cells. Unless the cancer has spread to other parts of the body, chemotherapy for skin cancer patients is most often given topically in the form of a cream or lotion.

Photodynamic therapy (PDT). Photodynamic therapy involves the administration of a drug that collects more in cancer cells than in regular cells, and the subsequent treatment of those cells with a special type of laser light. When the laser light is shined on the cells that have collected the drug, the drug is activated and the cells are killed. This method of treatment causes minimal damage to non-cancerous tissue.

Biologic therapy or Immunotherapy. These treatments involve the use of drugs to stimulate a patient’s immune system to help it better fight against cancerous cells. Biologic therapies may include interferon injection or a topical imiquimod cream.

Complementary and Alternative Treatment

Though there are many theories on possible alternative treatments for skin cancers, there is little evidence that proves their effectiveness.

Some potentially cancer-fighting alternative therapies include:

  • BEC-5, a natural compound found in certain plants such as eggplants. BEC-5 is thought to trigger the release of cancer-fighting enzymes in the cell.
  • Specialized diet. Some believe that making radical changes to the diet, such as cutting out all sugars and processed foods and eating more lean protein, nut oils, and vegetables, can help the body fight off the cancerous division of cells.
  • Vitamin E. A limited number of studies have shown that vitamin E can help protect against UV radiation-induced skin cancers.
  • Selenium. This supplement has also been shown (in a limited number of studies) to help protect against DNA damage from UV radiation.

Speak with your doctor before pursuing any alternative or complementary skin cancer treatment therapies.

Care Guide

The most important things you can do for your body while fighting skin cancer are staying in overall good health and protecting your skin from further damage. Tips for living well and protecting yourself from the sun include:

  • Eat a healthy, balanced diet. Eating a balanced diet with plenty of fruits and vegetables can give the body the right fuel it needs to fight off cancer and recover from treatment therapies.
  • Drink plenty of water. This rule applies to all people, whether they have skin cancer or not. Water helps to keep you hydrated and can assist your body in flushing out toxins.
  • Stay in the shade as much as possible when the sun is the strongest, from the hours of 10am to 2pm. If you live in or are visiting areas where sun radiation is particularly strong (equatorial regions) be sure to take extra care in seeking shade. If shade is unavailable, protect your skin from the sun with broad-rimmed sunhats, sunglasses, and UV-protected clothing.
  • Use a broad-spectrum sunscreen, 30+ SPF. UV radiation can cause damage no matter the weather or season. Be sure to use sunscreen when spending time out in the sun to prevent against damaging sun burns. Consider using a daily SPF moisturizing cream.
  • Keep your routine. Even during treatment, try not to give up on your regular activities and hobbies. Advancements in treatment technology allow many skin cancer treatments to be relatively non-invasive, giving you a shorter recovery time. Keeping up with hobbies and favorite activities can help keep your mind off of your treatment and prognosis.
  • Talk to trusted family, friends, or other cancer survivors. Sharing your experience can help you process your condition as well as help others that are going through the same thing.

When To Contact A Doctor

Schedule an appointment with your dermatologist if you notice any spots, growths, lesions, or moles on your skin that appear to be abnormal or have rapidly appeared/recently grown.

If you are undergoing treatment for skin cancer, contact your doctor if you:

  • Notice any rapid or unusual changes at the site of your treatment
  • Feel moderate to severe pain or burning at the treatment area.
  • Experience prolonged nausea or diarrhea.
  • Have a sore or lesion that will not heal

Notice any extensive blood or pus at the treatment site

Questions For Your Doctor

In addition to your primary care physician, you may need a dermatologist on your skin cancer care team.

To find a registered dermatologist, visit The American Academy of Dermatologists.

To find a physician registered with the Skin Cancer Foundation, click here.

 

Questions For A Doctor

You may want to ask your doctor the following questions about your condition:

  • What type of skin cancer do I have?
  • What is the prognosis for my skin cancer?
  • Is it possible that the cancer has spread or that I have cancer in other areas of my body?
  • What is the best treatment method for me?
  • What is the recovery time?
  • How will I know if I am cancer free?
  • What can I do to help make the most of treatment?
  • What is the risk that my family will develop this type of skin cancer?

Resources

For more information on skin cancer, visit:

For more information on skin cancer treatment options, visit:

For statistical information on specific skin cancer types, visit:

For more information on skin cancer prevention, visit: