Dear Patient, The glorious summer sun does, alas, take its toll on our skin. Try as we may, applying sunscreen
What is a skin cancer and how would I recognize one? This is one of the most frequently asked questions that we encounter in clinical practice. Skin cancer (like many other cancers) is the result of DNA damage to a cell or group of cells that cause them to grow uncontrollably. Identifying skin cancer can be tricky. In fact, quite often, individuals come to our practice worried about one spot (which turns out to be fine), while another spot close by is the actual skin cancer!
Let’s begin with some background information about skin cancers. There are literally several skin cancer types. However, the three most common ones are basal cell carcinoma, squamous cell carcinoma and melanoma. In fact, basal cell cancer is the most common human malignancy! Skin cancers have been steadily increasing in incidence over the last several years. For all three types of skin cancer, the estimated number of new cases for 2013 is 82,770. With all three skin cancers, early detection is the key to prevent larger surgeries and scars, and death with melanoma. The number of skin cancers diagnosed has increased with the estimated deaths at 12,650. This month, we will focus on non-melanoma skin cancer (basal and squamous cell carcinoma). Next month we will focus only on melanoma – since most skin cancer deaths result from this.
For basal cell carcinoma, one should look for a lesion that resembles a pimple or small cyst but does not go away, in an area that has been sun-exposed. As the lesion grows, it can develop a scab that does not heal or that heals and frequently recurs. The lesion can also bleed with very little trauma such as rubbing on a pillow at night or with washing or drying the area with a towel. Often, early lesions that are red and scaly can be mistaken for ringworm and treated as such. If the lesion does not respond to treatment, biopsy (a small sample) should be taken by the physician. Once the diagnosis is made, multiple factors must be considered in formulating the treatment plan. There are potentially many treatment options depending on the type of basal cell and its location. This is best determined by a trained physician who can help guide and council you to achieve the best possible outcome. Basal cells grow slowly and usually never spread beyond their local site of origin. However, if ignored long enough, they can be locally destructive and cause lots of trouble!
Squamous cell carcinoma is a type of skin cancer that can also occur in sun-exposed areas as well as in areas that have been exposed to human papilloma virus (the wart virus). Therefore this type of cancer can also occur in the genital area in both men and women. Other causes include ionizing radiation and immunosuppression, such as chemotherapy or organ transplantation. Squamous cell carcinoma starts as a small red scaly lesion that can grow slowly or sometimes very rapidly. With time, the lesion can also form a scab that bleeds easily. It can also form a scale that becomes very thick and hard. If left untreated, squamous cell carcinoma can be more aggressive and serious than basal cell, in that it has the potential to metastasize (spread) to other places such as the lymph nodes or lungs. Similar to basal cell, the diagnosis is made by performing a biopsy. Treatment depends on the subtype and location of the lesion and is best determined in close consultation with a physician.
So, what can you do? Do a monthly self-exam and get a yearly skin cancer screening from your doctor! Full-body skin exams performed by a physician are an easy and inexpensive screening that can save lives. But, before you go to your doctor, it is worthwhile to first examine yourself, so you can point out questionable lesions to them at the time of your visit.
Remember these points, look your skin over, wear your sunscreens, and a get a yearly full body skin examination.