Checking for and Preventing Skin Cancer

By Jon R. Ward, MD, Robert Calcote, MD, John H. Phillips III, MD, John L. Ratz, MD

Each year in the U.S. over 5.4 million cases of nonmelanoma skin cancer are treated in more than 3.3 million people. And, it is estimated that over 140,000 more will be diagnosed with melanoma in 2016. Because we know that ultraviolet radiation causes 90% of skin cancers, the key is to limit exposure, especially in those at highest risk for skin cancer. The majority of these types of skin cancers is highly curable. Basal cell carcinoma, the most common form of skin cancer, and squamous cell carcinoma, the second most common form, rarely spread beyond the skin. Melanoma is the most lethal form of skin cancer and is fortunately the least common of the three main types of skin cancer. The rates of melanoma continue to rise, largely affecting young women, and it is now the most common cause of cancer death in young adults ages 25 to 29.

Who is at greatest risk for skin cancer?
The greatest risk factors for melanoma are a personal or family history of melanoma and the presence of atypical or numerous (>50) moles. Other risk factors for all forms of skin cancer include fair skin, a history of blistering sunburns (especially in childhood), excessive sun exposure, UV tanning booth usage, personal or family history of skin cancer, a weakened immune system, and advanced age.

How can you prevent skin cancer? 
The best way to prevent skin cancer is to avoid exposure to ultraviolet radiation. Ultraviolet radiation from either the sun or other sources causes DNA damage to the skin. Cells with damaged DNA are the ones that form cancer. Wear protective clothing when outdoors and consider avoiding outdoor exposure from 10 AM to 4 PM when the ultraviolet light is strongest. On exposed skin, wear a sunscreen with SPF 30 or greater. Apply it prior to sun exposure and reapply every two hours, especially if swimming or with excessive sweating. And, avoid indoor tanning beds altogether.

What are the signs of skin cancer? 
Melanoma, the most lethal form of skin cancer, either develops new or within a pre-existing mole. It is normal to develop new moles into young adulthood. Any person over age 40 who develops a new mole should be evaluated by a Board-Certified dermatologist. An existing mole that exhibits any of the ABCDE features should also be referred for expert consultation. Asymmetry, Border Irregularity, Color Change, Diameter > 6mm, and Evolution/Elevation are all signs that a previously benign mole has changed and now needs further scrutiny. Basal cell and squamous cell carcinomas appear as non-healing pearly or scaly bumps that bleed easily and are sometimes tender to the touch.

How is skin cancer diagnosed? 
All three types of skin cancer are best diagnosed by biopsy. A small sample of the skin can be taken with almost no pain. A small needle is used to numb the skin and the straight blade can be used to shave a small portion of the skin for evaluation and diagnosis. This technique requires no suture and when performed properly on a small tumor leaves no perceivable scar.

How is skin cancer treated?
Early forms of basal cell and squamous cell skin cancer may be treated non-surgically using liquid nitrogen (cryosurgery), electrocautery, currettage, light-based treatments, laser treatments and topical creams. Surgical removal is also used to eliminate these cancers, by excision or by performing Mohs micrographic surgery. For patients who are poor surgical candidates, superficial radiation therapy may be recommended. If melanoma is diagnosed, and is in its earliest stages, a dermatologist may choose to surgically remove it in their office. However, if the melanoma has spread beyond the top layer of the skin, more extensive treatment will be needed. This often requires having the melanoma removed by a general surgeon or surgical oncologist, and may also include radiation, chemotherapy and/or immunotherapy treatments.

Where can you learn more about skin cancer and its prevention? 
Visit www.skincancer.org, the website of the Skin Cancer Foundation, or visit www.aad.org, the website of the American Academy of Dermatology. Or, schedule a visit with a Board-Certified dermatologist for a skin screening and more information.

Scheduling a comprehensive skin screening with Dermatology Specialists?
We encourage you to take the time, not the risk, and schedule your appointment for a comprehensive skin screening by calling us at 877-231-3376.