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What does skin cancer look like?
I am going to describe the more common skin cancers: Basal
Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). These cancers tend to
start out subtly. Don’t let yourself get fooled, rather recognize the signs
and symptoms and get checked. Melanomas are covered on a separate page: melanoma .
BCCs, the most common form of skin cancer, are often found on
the face, especially the nose, cheeks and forehead. They tend to range from ¼
inch to a number of inches in diameter. You can often notice a pearlescent,
raised up outer edge with a depressed scabbed center, much like an
ulceration. BCC often makes quite a
deep hole, more than you might expect. If you have an abnormality on your skin,
get it checked, be sure. Generally, if caught early, SCC and BCC can be easily
cured. Some people wait and then wind up requiring large surgical procedures to
remove an advanced cancer. BCCs are the least likely to spread, but that doesn’t
mean they won’t and they certainly can make for a very deep skin problem. Don’t
be a waiter.
SCC, the second most common form of skin cancer, usually
starts as a small patch of pink skin, which may be a little scaly. It may be
small such as ¼ inch or it may be inches in size. Areas most often affected are
those that see the sun such as the face, neck, back chest, arms and legs. Often
people find that there may be a scaly surface, which they mistake for a scrape.
This scale may fall off and for a little while one might imagine that the area
is better. However, the pink area doesn’t go away. The edges are usually
irregular. I am not going to give you all kinds of additional details, but
rather say that if you have a suspicious area, you should be seen by a
physician who is familiar with the diagnosis and treatment of skin cancer.
Squamous Cell Carcinomas can metastasize and thousands of people die from
this cancer every year. The good news is that caught early, it is usually easily
treated.
What causes skin cancer?
Frequent or excessive sun exposure results in the skin
receiving levels of UV radiation that it cannot protect against. These UV rays
damage DNA in the nucleus of the skin cells and transform normal cells into
cancerous cells. For example, it has been found that sun induced mutations are present
in over 90% of all BCCs.
Fortunately, the skin has a repair mechanism that is
constantly trying to repair the DNA, however, occasionally the damage cannot be
repaired or a mistake is made during the repair process and the result is a mutation which can be cancer. Additionally, UV radiation also suppresses
the immune systems ability to fight skin cancer.
Sun exposure is dangerous. Tanning salon exposure is also
dangerous. That means that exposure is putting you at an increased risk of skin
cancer. People with fair skin (e.g. blue eyes, blond or red hair) have
especially sensitive skin. We have seen many people who remember getting one
significant burn at the beach 30 or 40 years ago. And now they have lots of
skin cancers.
How can you avoid getting skin cancers?
Prevention of skin cancers depends on preventing the genetic
mutations that lead to the cancer. We know that sun exposure leads to DNA
breakage and increases the chance of mutations. Therefore, avoid sun exposure, especially
during the brightest part of the day. You don’t even have to see reddened skin
in order to be sustaining damage from the suns rays. Cover exposed areas of the skin when you are outside and use skin
care products with high levels of SPF (such as 30 and up). Do not use tanning
salons. This is good advice for everyone and crucial for those with fair skin
or a family history of skin cancer. Another important key to the prevention of
skin cancer is screening. This should be a combination of careful self-examination
and getting your skin checked for precancerous or suspicious areas by a
physician. In this way, if something requiring attention is discovered, you can
receive early, simple treatment, thereby avoiding cancer.
Treatment
The treatment for skin cancers needs to be individualized and treatments for BCC and SCC may include: surgical excision, shave excision with
curettage and desiccation, Mohs Surgery, cryosurgery, radiation, intralesional
injections (interferon, 5-fluorouracil), chemotherapy, electrochemotherapy with
Bleomycin, Phytodynamic therapy.
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