Skin cancer

Skin cancer is a growing epidemic in the U.S. Hereditary factors combine with lifestyle exposures leading to cancer risks.

Active, outdoor lifestyles, while wonderful in many ways, lead to substantial lifetime exposure to intense sunlight. More recently the easy availability of tanning parlors has led many to get substantial ultraviolet light exposure, often on a year-round basis. The net result is a marked increase in skin cancer in this country.

Types of Skin Cancer

There are three major types of skin cancer, melanoma, squamous cell, and basal cell carcinoma.

Melanoma

Melanoma is the most serious type of skin cancer. It is a cancer of the melanocytes, the pigment cells in the skin. As a result, they are most commonly darkly pigmented, taking a black or blue-black coloration. Some begin as moles which over time eolve into cancerous growths. Others appear to arise on their own. Unlike the other forms of skin cancer, melanomas can arise at an earlier age, and melanomas are seen commonly in patients in their 20s and 30s. Sun exposure, and in particular, sunburns, appear to significantly increase the risk of melanoma.The reason melanoma is the most feared form of skin cancer is that it is a rapidly growing tumor, and one which rapidly can grow to the point where it begins to spread through the bloodstream and lymphatic channels to lymph nodes, and other organs. Once melanoma has spread, it has an extremely hgih mortality rate. Unfortunately there are no currently available treatments which have been shown to actually improve survival. A very high percentage of patients with melanoma that has spread (metastatic melanoma) die within a short time. Thus, early detection is critical to survival, as melanomas that are diagnosed early can be surgically removed with a high cure rate. Any skin growth that is noted to be large, irregular in shape or color, and in particular, those which are rapidly becoming much darker, growing or raising up quickly, bleeding, or itching constantly, should be checked immediately by a dermatologist.

Squamous Cell Carcinoma

Squamous cell carcinoma (SCC) is the next most dangerous skin cancer. It is a cancer of the skin cells on the outermost layer of the akin. It is strongly assoiciated with sun exposure, and appears to correlate most with cumulative total lifetime sun or ultraviolet exposure. In some ways, the skin has a memory which recalls all of the sun to which it has been exposed. As a result, it is a cancer most commonly seen on sun-exposed areas: scalp for men, chest and legs for women, and face, arms, and hands for both sexes. SCCs are rough, raised, "crusty" growths, typically with little to no pigmentation. Often they begin to scab, bleed, and do not heal well. Many SCCs develop from precancerous actinic keratoses. If the actinic keratosis can be treated before progressing to cancer, SCC can be prevented. If allowed to grow to large size, typically over years, they can spread, but it is much less common than with melanoma.

Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common, but least dangerous form of skin cancer. It too is found predominantly in sun-exposed areas of the body. It develops from skin cells at a lower layer than SCC. Like melanoma, it seems to correlate more with intense sun exposure and sunburns rather than just total number of hours in the sun. It is particularly prone to developing on the face and ears. They are distinct in appearance, typically beginning as a small pink, almost translucent-appearing growth. With time they enlarge and eventually tend to scab, bleed, and ulcerate. It is true that BCC does not under normal circumstances spread or metastasize, no matter what. This does not mean, though, that BCC cannot cause major problems. BCC, if allowed to grow for long periods of time, can spread to the point where the patient loses an entire ear, or nose, or a huge area of scalp when the tumor is removed. BCC does not have a precancerous stage, and thus early detection is again critical to allow treatment before the cancer becomes large and more challenging to remove.