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Skin Cancer
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Resource Description: 
Provides information on all forms of cancer and offers numerous brochures and publications for patients and healthcare professionals.
The American Academy of Dermatology is a membership organization of over 14,000 dermatologists. It features a Public Resource Center with a variety of educational resources and materials about a broad range of skin conditions, including skin cancer.
This U.S. government site provides information on skin cancer treatment, screening, prevention, genetics, clinical trials and supportive care.
This site is dedicated to helping melanoma patients make informed decisions about their treatment. Their Patient's Network helps people with similar conditions connect with each other.
This non-profit foundation site seeks to change public attitudes towards tanning and sun exposure, to encourage detection of skin cancers at the earliest stage when they are almost always curable and to support research into new diagnostic techniques and therapies.
Episode number: 
212

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Transcript: 
Skin Cancer (transcript)

Skin cancers, which develop in the cells of the skin, are named after the type of cell in which they start. They include:

  • Basal cell carcinoma (BCC) is the most common type of skin cancer. It usually occurs in people over 40, but it can also develop in younger people. Most BCCs form on areas of the skin that are commonly exposed to the sun, such as the head, neck, upper body, arms, and legs.  BCCs, which develop in cells in the lower part of the epidermis, are small, round, or flattened in shape and can be red, pale or pearly in color. These lesions may bleed easily with mior trauma such as washing your face. This type of skin cancer tends to grow slowly and usually doesn't spread to other parts of the body. However, if left untreated, BCCs may grow deeper into the skin and damage nearby tissues. This can make treatment more difficult and increase the chance of the skin cancer coming back.
  • Squamous cell carcinoma (SCC), the second most common form of skin cancer, occurs primarily in people over 50. While SCC usually forms on the head, neck, hands, and forearms, it can also develop on the upper body or the legs. SCCs appear as thickened red, scaly spots, which may bleed easily or be tender to touch. Some patients describe SCC as a sore that hasn't healed. It tends to grow quickly, often in the span of several months, and can spread to other parts of the body. SCCs that form on your lips or ears have a high risk of spreading and should be examined by a doctor without delay.
  • Melanoma, the potentially most serious type of skin cancer, can be treated successfully when diagnosed early. The first sign of a melanoma is usually the appearance of a new dark spot on your skin or a change in an existing freckle or mole. The change may be in size, shape or color that takes place over several weeks or months. A normal freckle or mole usually has an even color and a smooth edge. A melanoma often has an irregular edge or surface. It may be blotchy with brown, black, blue, red, white or light grey color. A freckle or mole that itches, bleeds or becomes larger or irregular in shape may be a melanoma. Nodular melanoma, is a highly dangerous form of the disease that can grow more quickly in depth than other melanomas. Nodular melanoma can resemble a blood blister, appearing as a small round lump on the skin. Melanoma has a higher chance of spreading that BCC or SCC, but has an excellent prognosis if caught in its early stages.
 

Quick Facts

  • Melanoma represents only 4% of all skin cancers in the U.S., but accounts for more than 75% of all skin cancer deaths.
  • More than one million cases of non-melanoma skin cancer are diagnosed every year in the U.S.
  • Although exposure to the sun's ultraviolet (UV) rays is said to be the most important factor in the cause of skin cancers, about 70% of American adults don't use sun-protection measures.
  • Most skin cancers appear after age 50, but skin damage from the sun begins at an early age. Therefore, protection should start in childhood to prevent skin cancer later in life.
  • Melanoma incidence rates are 20 times higher for Caucasians than for African-Americans. However, people with dark-pigmented skin can also develop melanoma, particularly on the palms of the hands, on the soles of the feet, under the nails, and inside the mouth.
  • Melanoma is more common than any non-skin cancer among women between 25 and 29 years old.
  • Both basal cell and squamous cell carcinomas have a 95% cure rate when detected and treated early.

*Quick Facts have been reviewed by Medical Advisors and are current as of October 2005.

 

Ask Your Doctor

This list of questions is a good starting point for discussion with your doctor. However, it is not a comprehensive list.

  • What is this spot on my skin?
  • Do I need tests and, if so, what do they involve?
  • What happens if the results are not normal?
  • What are the results of my tests? Do I have a form of skin cancer? 
  • What type of skin cancer do I have and what are the risks involved?
  • What is the stage or extent of my cancer?
  • Do I need treatment? What are my options?
  • Which type of treatment do you recommend and why.
  • What does the treatment involve?  What are the benefits, risks, and potential side effects?
  • Based on the type of skin cancer I have, can you give me an idea of my chance of recovery and what to expect in the future?
  • What will happen if I don't have treatment?
  • If surgery is involved in my treatment, will it leave a noticeable scar? Is there a way to minimize scarring?
  • Did my treatment remove all of the cancer or has it spread (metastasized) to other areas of my body?  If so, where??
  • Is this skin cancer likely to come back?
  • What can I do to prevent a recurrence?
  • How often should I have follow-up skin checks?

Key Point 1

Skin cancer is serious and is the most-diagnosed cancer in the U.S. You need to pay attention to all of your skin – even the skin you can't see. And you need to see your doctor if you notice anything unusual or see any changes.
 
While overexposing your skin to sunlight isn't the only thing that can put you at risk for developing skin cancer (check out the risk factors covered in Key Point 2), it's definitely a major factor in a disease that's ranked as the most common of all cancers in the United States. If that fact alone doesn't cause you to think twice about baking your skin at the beach, the recent statistics [Link to Quick Facts section] probably will.

Watch for Warning Signs
Get to know your skin and check it regularly – all over – so that you'll notice any changes that occur. To help you remember, keep a record of the date you last checked your skin, or check each time there is a change of season.

It's important to check your whole body, including the soles of your feet, between the toes and your nails. Use a mirror or ask a friend or relative to check areas that are hard to see, such as your back, or the back of your legs. You can also ask your doctor to check your skin or ask for a referral to a dermatologist.

The more often you examine your skin, the more you will learn about it – what is normal for you and what has changed since the last time you looked. Skin cancers don't all look the same. Signs to look for include:

  • A new spot that is different from other spots on the skin around it.
  • A sore that doesn't heal.
  • A spot, mole or freckle that is new or an existing one that has changed in size, shape, or color.

What to Do If You Notice a Problem
See your doctor right away. Your physician knows your medical history, can examine your skin, and advise you on appropriate care. Your doctor may suggest that you see a specialist, such as a dermatologist. A dermatologist is a doctor who has completed special training in preventing, diagnosing and treating skin disease, including skin cancer. If your doctor suspects that you may have melanoma, the doctors you will be referred to depend on the depth of the melanoma.

How Skin Cancer is Diagnosed
First, your doctor will examine the suspicious spot, mole, or freckle. If he or she suspects skin cancer, a biopsy will most likely be done to confirm the diagnosis. A biopsy is a quick, simple procedure. Your doctor may do it during your exam or refer you to a specialist. Here's what's involved:

  • After administering a local anesthetic, your doctor and will take a sample of the spot. (This may require a stitch or stitches to help the wound to heal.)
  • The tissue that is cut out will be sent to a laboratory where a pathologist will examine it under a microscope. It will probably take at least a week for the results of your tests to be ready. 
  • Your doctor will review the results from your biopsy, share the information with you, and help you explore treatment options if the test indicates that you have skin cancer.

Early Treatment Can Literally Save Your Skin...and Your Life

If tests confirm that you have skin cancer, your doctor will probably recommend that you get treatment without delay. The Skin Cancer Foundation outlines the latest treatment options.

    

Key Point 2

Most skin cancers are caused by ultraviolet injury to the skin. Thecommon underlying message is that sun exposure is bad for your skin and you have to limit it.

Unprotected exposure to ultraviolet (UV) radiation – from the sun or other sources such as tanning devices – is the most important risk factor for skin cancer. UV radiation cannot be seen or felt but can cause:

  • Sunburn
  • Early aging of the skin
  • Damage to the skin that builds up over time and can lead to skin cancer. Skin cancer is usually related to lifetime exposure to UV radiation.

While skin cancer usually appears in older adults, the damage begins at an early age from exposure to UV radiation, especially sunburn. New research suggests that while cells are often damaged in childhood, it may be sun exposure in adulthood that triggers cells to turn cancerous.

Skin Cancer Risk Factors
Anyone can develop skin cancer. But the risk is increased if you:

  • Do not protect your skin from the sun.
  • Work or spend a lot of time in the sun.
  • Have infrequent but intense exposure to the sun.
  • Suffered sunburn, especially in childhood.
  • Have fair skin that burns easily, freckles, and doesn't easily tan. (People who have dark or olive-colored skin generally have more protection against skin cancer because they produce more melanin than fair-skinned people.)
  • Have red or fair hair and blue or green eyes.
  • Have a lot of moles.
  • Have sunspots (solar keratoses).
  • Have a compromised immune system (due to taking certain drugs after an organ transplant or being HIV positive, for example)

    


Key Point 3

While skin type and genes do play a role in developing skin cancer, there are many modifiable factors. Wearing sunscreen properly, covering up with clothes that block out UVA and UVB, and enjoying the sun in non-peak hours will go a long way in protecting you from developing skin cancer.

The best way to prevent skin cancer is to protect your skin from the sun. Here are some easy steps you can take to reduce your risk:

  • Stay out of the sun between 11 am and 3 pm during daylight saving hours (10 am and 2 pm at other times of the year) when the sun is strongest. These are the hours when more than 60% of the sun's UV radiation reaches the earth's surface.
  • Use shade from trees, umbrellas, buildings, or any type of canopy. And be sure to choose your shade carefully. UV radiation is reflective and bounces off surfaces like concrete, water, and sand (causing you to burn even when you think you're protected).
  • Wear clothing that covers as much of your skin as possible, including the back of the neck. A shirt with long sleeves and a collar, slack, skirts, or long shorts that cover your legs (or a large part of them) are best. Tightly woven fabrics provide the best protection.
  • Wear a hat with a generous brim that shades the face, neck, and ears.
  • Use sunscreen with sun protection factor (SPF) of at least 30, preferably a water-resistant one that protects against UVA and UVB rays.
  • Apply sunscreen 20 minutes before going out into the sun and reapply every two hours and after swimming or any activity that causes you to sweat or rub it off.
  • Protect your eyes with sunglasses that provide protection against UVA and UVB rays.
  • Avoid using tanning beds and sun lamps, which give off UV radiation that increases the risk of skin cancer.
  • Don't rely on sunscreen as the only form of skin protection. Use it with shade, hats and clothing.

Moms & Dads:
Don't Let Your Babies Grow Up to be Skin Cancer Victims
Take care to protect infants and young children from direct exposure to sunlight. Use shade, umbrellas, clothing, and hats to protect them. Use sunscreen with sun protection factor (SPF) of 30+ on the areas of skin that cannot be protected with clothing or hats, such as the face and the back of the hands.

Medline Plus

Medline Description: 

Conduct an off-site search for Skin Cancer information from MedlinePlus.  These up-to-date search results are based on search terms specific to Second Opinion Key Points.

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