An Introduction to Skin Cancer

According to The Skin Cancer Foundation, “skin cancer is the most common form of cancer in the United States”;  in fact, more than a million Americans will be diagnosed with some form of skin cancer this year alone—a disheartening statistic considering that a majority of skin cancers are directly attributable to sun exposure and are, therefore, preventable.

Cancer occurs when normal cells mutate and begin to multiply uncontrollably; with skin cancer, these rapidly multiplying cells form lesions in the outer layers of the skin, which, when not treated promptly, can spread to other parts of the body via the lymph system or bloodstream.  More common in people with light colored skin who have spent a lot of time in sunlight, skin cancer can occur anywhere on the body and may appear in many different guises.

There are three major types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma.  The vast majority of skin cancers are BCCs or SCCS; while malignant, these cancers are not as aggressive and are unlikely to spread to other parts of the body.  Typically distinguished by a raised, smooth, pearly bump on sun-exposed skin of the head, neck, or shoulders, basal cell carcinomas are often mistaken for sores that do not heal.  On the other hand, squamous cell carcinomas are commonly well-defined, red, scaling, thickened patches, which may ulcerate and bleed.  Treatment for BCCs and SCCs is usually straightforward, as surgical removal of the lesion is generally adequate treatment.

A small but significant number of skin cancers are malignant melanomas, highly aggressive cancers that often spread to other parts of the body.  The majority of malignant melanomas are brown or black pigmented lesions  that are generally asymmetrical, have irregular borders, and are larger than 6mm in diameter.  Due to the aggressive nature of melanomas, treatments for these diagnoses may involve a combination of different therapies, including surgery, radiation therapy, and/or chemotherapy.

While ultraviolet (UV) light exposure, most commonly from sunlight, is overwhelmingly the most frequent cause of skin cancer, a woman’s risk for skin cancer depends on several factors:

• Sun exposure—Both UVA and UVB rays are dangerous to the skin and can cause skin cancer.  In fact, one blistering sunburn in childhood or adolescence more than doubles a person’s chances of developing melanoma later in life; a person’s risk for melanoma also doubles if she has had five or more sunburns at any age.
• X-ray exposure—Exposure to unusually high levels of x-rays, such as the exposure caused by aggressive radiation therapy treatments, can increase one’s risk for skin cancer.
• Tanning booths/beds—As the use of tanning booths/beds increases a woman’s UV exposure, it also increases her risk for melanoma and other skin cancers.  In fact, exposure to tanning beds before the age of 35 increases a woman’s melanoma risk by 75%.
• Weakened immune systems—People with compromised immune systems due to chemotherapy, organ transplants, excessive sun exposure, or diseases such as HIV/AIDS and lymphoma are at increased risk for developing skin cancer.
• Moles—Regardless of whether her moles are atypical or not, the more moles a woman has, generally the greater her risk for skin cancer.
• Skin type—With all skin cancers, people with fairer skin are at an increased risk of developing some form of the disease; however, while melanoma is uncommon in African Americans, Latinos, and Asians, it is frequently more aggressive for these populations, as they have a greater tendency than Caucasians to present with advanced disease at the time of diagnosis.
• Contact with caustic agents—Contact with some chemical agents, including arsenic, tar, certain oils, and soot, can increase one’s risk for skin cancer.
• Family history—According to the Skin Cancer Foundation, “about one in every ten patients diagnosed with [skin cancer] has a family member with a history [of the disease.]”  In fact, having a first-degree relative with a skin cancer diagnosis gives you a 50% greater chance of developing the disease than someone without a family history.
• Personal history—Once a woman has had skin cancer, she has an increased chance for recurrence.
• Living environment—As UV light gets stronger in higher elevations, individuals who frequent or live at these higher elevations may be at a greater risk for the development of skin cancer.  Additionally, individuals who live or frequent areas near the Earth’s equator are exposed to higher levels of UV rays and are also, therefore, at an increased risk for skin cancer.

While avoiding the sun entirely may not be possible, the American Academy of Dermatology and the Skin Cancer Foundation recommend the following tips to help reduce the risk of sunburn and skin cancer: 

• Minimize your exposure to the sun at midday, between the hours of 10:00am and 4:00pm.
• Apply sunscreen with an SPF of at least 15 to all areas of the body that will be exposed to the sun.
• Reapply sunscreen at least every two hours, even on cloudy days. Additionally, reapply sunscreen after swimming or perspiring.
• Wear clothing that covers your body and shades your face; note that hats should provide shade for both the face and the back of the neck.
• Avoid exposure to UV radiation from sunlamps or tanning booths/beds.
• Protect your children by keeping them from excessive sun exposure and applying sunscreen liberally and frequently.  Note that sunscreen should not be used on children under the age of 6 months.
• Examine your skin head-to-toe every month and see your physician at least once a year for a professional skin exam.

With these tips and a little common sense, it’s possible to enjoy the sun, while protecting yourself from its dangers!