Understanding Skin Cancer: Causes, Diagnosis, and Treatment
Skin cancer is the most commonly diagnosed cancer in the U.S. It affects more Americans than prostate cancer, breast cancer, lung cancer and colon cancer combined. It is also one of the most preventable cancers.
The Skin Cancer Foundation provides some sobering statistics. More than 5.4 million cases of nonmelanoma skin cancer are diagnosed and treated every year, and 90 percent of them are linked to sun exposure. People who earn a living outside are understandably at high risk, but there’s no excuse for endangering your health just to get a tan.
According to the foundation, more people develop skin cancer from indoor or outdoor tanning than develop lung cancer from smoking. Every year, approximately 419,000 cases of skin cancer are linked to indoor tanning devices. Twelve U.S. states, as well as many countries around the world, prohibit minors from using indoor tanning devices. Brazil and Australia have banned tanning beds altogether. Skin cancer is a widespread problem, but there are smart ways to avoid it.
Types of Skin Cancer
There are three layers of skin tissue. The epidermis is outermost, and the dermis is just beneath it. The hypodermis is the deepest layer. Since various skin cancers manifest themselves in different ways, it’s important to know how they’re distinguished.
Melanoma is the most well known and most aggressive form of skin cancer, but you may be surprised to learn that it’s also the rarest. Two others, basal cell carcinoma and squamous cell carcinoma, are much more common. These are referred to as nonmelanoma cancers.
Nonmelanoma cancers are confined to the middle and outer layers of skin. They usually form on areas that are regularly exposed to the sun. Fair-skinned people with light eyes who are prone to sunburns are the most susceptible to them.
Unlike basal cell and squamous cell carcinoma, Melanoma forms deep in the hypodermic tissue. It’s more serious than the others because it usually spreads to other parts of the body. Lymph nodes and organs are especially vulnerable. It is estimated that close to 10,000 people will die of Stage IV melanoma in 2017.
Signs and Symptoms
Most other forms of cancer have obvious signs. The appearance of a small lump or a chronic cough, for example, would prompt you to seek medical attention right away. Early detection of skin cancer is not that simple, but there are a few symptoms to watch for:
- Basal cell carcinoma usually appears on sun-exposed skin surfaces like the face, neck, hands and legs. Brown, scaly patches or white bumps that have a waxy texture should be taken seriously.
- Squamous cell carcinoma sometimes manifests as an ulcer, a lump or a scaly spot on the skin.
- Melanoma affects people of all skin tones and can form anywhere. Dark lesions often appear on the palms, fingertips, toes or mucus membranes. Other symptoms might include changes in an existing mole or a new growth.
Human skin has all sorts of variances, and most of them are quite normal. It’s important to keep an eye on existing moles, cysts, skin tags, or rough patches so that you can spot changes.
Moles, for instance, form early in life and have consistent shapes and coloring. If a mole starts to bleed, grow, change color or become irregular in shape, seek medical attention as soon as possible.
If skin cancer is suspected, your doctor will first do a thorough physical examination of your skin. Worrisome areas will be biopsied to determine if there is a problem or to identify what type of cancer it is. More lab tests may be ordered if the results are inconclusive.
Superficial skin cancers like basal cell carcinoma rarely spread, so the doctor might remove an entire growth for biopsy rather than just a tissue sample. If the growth is benign, the problem is already taken care of.
If initial test results are positive for malignancy, additional testing will be scheduled to determine the extent of the disease. Imaging tests are useful for finding out if the cancer has spread and if it is an immediate threat to any vital organs.
Roman numerals I through IV are used to indicate the four stages of cancer’s development. The greater the number, the farther and faster the cancer is spreading. How aggressively a cancer is treated depends on which stage it is in.
There are several treatment options for cancer, but their effectiveness is dependent on many factors. A doctor recommends treatment based on the type of cancer, where it’s located, the depth of penetration and whether it has spread or is likely to spread. A treatment that is effective for one patient may not be advised for another.
Common treatments for nonmelanoma cancers and early-stage melanoma include the following:
- Mohs micrographic surgery
If the cancer is not in an advanced stage, Mohs surgery has a high cure rate. The procedure takes place in the doctor’s office, and only a local anesthetic is required. The growth is removed along with a thin layer of surrounding tissue. While the patient waits, the sample is examined under a microscope. If abnormal cells are still present in the excised tissue, the procedure is repeated until the tissue is cancer-free.
This is typically used for small growths. The tumor is scraped off with a curette, and an electrocautery needle is applied to the area. Searing heat destroys cancerous cells and controls bleeding. The procedure is usually repeated a few times to ensure that tumor cells have been eradicated.
Although it has a slightly lower cure rate than other treatments, this is a good option for people with bleeding disorders or intolerance to anesthesia. The tumor tissue is frozen with liquid nitrogen. The growth scabs over and usually falls off in a few weeks. Sessions may be repeated until no malignancy remains.
For advanced nonmelanoma cancer, radiation may be recommended. A small number of patients benefit from topical or oral medications.
Effectively treating advanced melanoma is far more challenging. Since it tends to spread to nearby lymph nodes, a sentinel lymph node biopsy is usually ordered. In some cases, both lymph nodes may have to be removed. If the cancer has spread to other organs, those metastases must also come out.
For growths that can’t be completely excised, radiation, chemotherapy, immunotherapy, and targeted therapy are options worth trying. Although melanoma is the deadliest of all skin cancers, many patients in later stages have undergone successful treatment and lived for years.
Following these guidelines will greatly reduce your risk of developing skin cancer:
- Avoid outdoor activities between 10 a.m. and 4 p.m.
- Avoid both indoor and outdoor tanning.
- Wear protective clothing, a broad-brimmed hat and sunglasses.
- Generously apply sunscreen thirty minutes before going outside, and reapply it every two hours.
- Use mirrors to inspect all your skin once a month. Ask your intimate partner to tell you about anything on your skin that’s out of the ordinary. Schedule a doctor’s visit each year for a professional inspection.
Be good to your skin. Take prevention seriously, and quickly report problems.