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Skin Cancer and Prevention

Blog by Dr. Raetasha Dabney

 

Skin cancer is the most common type of cancer. There are two main types of skin cancer: non-melanoma and melanoma. The two most common types of non-melanoma skin cancer are basal cell carcinoma and squamous cell carcinoma. Skin cancer is often caused by sun exposure and sunburn. Skin cancer can occur anywhere on the skin, but it is often on the head, face, neck and the back of the hands. The incidence of skin cancer has been increasing over the past few years. This is associated with multiple factors, such as better skin cancer detection, people getting more sun exposure and people are living longer. It is estimated that non-melanoma skin cancer affects more than 3 million Americans a year. It is estimated that 192,310 new cases of melanoma, 95,830 noninvasive (in situ) and 96,480 invasive, will be diagnosed in the U.S. in 2019.

 

Keep reading to learn more about the different skin cancers, risk factors, available treatments and preventions.

 

 

Non-melanoma skin cancer:

Basal cell and squamous cell carcinomas are the two most common forms of skin cancer, and they are highly curable if detected early and treated properly. These cancers affect the epidermis (outermost layer of skin). These cancers have very similar risk factors, but can have distinct characteristics.

 

Basal cell carcinoma: It often looks like open sores, red patches, pink growth, shiny bumps or scars and it usually is caused by sun exposure. It almost never spreads beyond the original tumor site.

 

Squamous cell carcinoma: Precancerous lesions (actinic keratosis) can give rise to squamous cell carcinoma. They typically appear as persistent, thick, rough, scaly patches that may bleed. They often look like warts or open sores with raised borders. The surrounding skin often shows signs of sun damage (wrinkling, pigment changes and loss of elasticity). The majority of skin cancer in African-Americans are squamous cell carcinoma, usually arising on the sites of preexisting inflammatory conditions or burn injuries. Metastases commonly arise on sites of chronic inflammatory skin conditions and on the ear, nose and lip.

 

Risk Factors

  • Ultraviolet (UV) light exposure
  • Older age
  • Male gender
  • Fair skin, blond or red hair, and blue, green, grey eyes
  • Chemical exposure
  • Radiation exposure
  • Previous skin cancer
  • Long-term or severe skin inflammation or injury
  • Psoriasis treatment
  • Xeroderma pigmentosum
  • Weakened immune system
  • Human papilloma virus (HPV) infection
  • Smoking

 

Melanoma skin cancer:

The most dangerous and potentially deadly form of skin cancer. This cancer originate in the pigment-producing melanocytes in the basal layer of the epidermis. Melanomas often resemble moles or develop from moles. There are four basic types of melanoma (superficial spreading, lentigo maligna, acral lentiginous, and nodular). Acral lentiginous melanoma is the most common melanoma in African-Americans and Asians. The most frequent locations are the trunk, legs and arm, and the scalp in men. There may be a genetic component to melanoma so if someone has the below genetic risk factors, they should discuss genetic testing with their primary care physician.

 

Risk Factors

  • Ultraviolet (UV) rays
  • Moles (dysplastic nevi, dysplastic nevus syndrome, congenital melanocytic nevi)
    • Anyone with 50 or more moles is at greater risk
    • Anyone with large moles
  • Fair skin, blond or red hair, and blue, green, grey eyes
  • Personal history of melanoma or other skin cancers
  • Family history of melanoma
  • Weakened immune system
  • Older age
  • Male gender
  • Xeroderma pigmentosum

 

Genetic Risk Factors

  • Personal history of more than one melanoma
  • Several members on one side of your family have had melanoma
  • A family member has had more than one melanoma
  • A family member has had both melanoma and pancreatic cancer

 

As stated before, melanoma is the deadliest form of skin cancer and warning signs need to be recognized early. One strategy for early recognition is the ABCDEs of moles.

 

ABCDEs

Asymmetry: one half unlike the other

Borders: irregular, scalloped or poorly-defined

Color: has multiple shades

Diameter: usually greater than 6mm, but can be smaller

Evolving: changing in any way

 

Diagnosis:

Diagnosis and staging are based on tissues examination (biopsy or excision).

 

Treatment:

There are multiple treatments available. The type of treatment is determined by how deeply the melanoma has grown into the skin, whether the melanoma has spread to other parts of the body, and the individual’s overall health. Treatments are listed below.

 

  • Surgery (excision, Mohs surgery)
  • Local treatment other than surgery
  • Radiation therapy
  • Targeted therapy
  • Chemotherapy
  • Immunotherapy
  • Clinical trials

 

Prevention:

Prevention strategies are the same for all skin cancers:

 

  • Protection from UV rays (cover up, avoid peak times)
  • Avoid getting sunburn
  • Avoid tanning and never use UV tanning beds
  • Use broad spectrum (UVA/UVB) sunscreen
  • Apply sunscreen to entire body 30 minutes before sun exposure and reapply every 2 hours or after swimming or excessive sweating
  • Keep newborns out of the sun
  • Examine skin head to toe every month
  • Have professional skin exam at least once a year

 

All skin types are at risk of skin cancer. Like most other cancers, early detection improves survival. Skin examinations are vital. If any changes are noted, contact your physician. Lifelong prevention strategies need to be implemented and followed not only during summer months, but all year round.

 

 


 

Dr. Raetasha Dabney is a medical oncologist and hematologist. She has a special interest in gastrointestinal malignancies and breast cancer. She is committed to quality care using evidence-based medicine. Dr. Dabney is dedicated to treating the whole person. Her approach is to educate the patient and his/her family about their illness so that they can make informed treatment decisions. Her clinical practice emphasizes a strong patient-doctor relationship and effective communication.