Skin Cancer

Skin cancer is the most common type of cancer in the United States. The number of people getting non-melanoma and melanoma skin cancers is increasing, and people are getting it at younger ages. The good news is that with early detection, skin cancer can be cured in 85 to 95 percent of all cases. It is also preventable.

Ultraviolet (UV) radiation from the sun is the main cause of skin cancer. Artificial sources of UV radiation, such as sunlamps and tanning booths, can also cause skin cancer.

Risk Factors

Some people are at higher risk than others for getting skin cancer, and the risk factors vary, depending on whether it is melanoma or non-melanoma skin cancer. Factors that can put you at higher risk for melanoma include:

• Fair to light complexion

• History of sunburns in childhood, including those that were severe and blistering

• Large number of moles (more than 50)

• Family history of skin cancer, especially two or more close relatives who had melanoma

• Dysplastic nevi, which is a mole that looks different from an ordinary mole; these are more likely to become cancerous

• Personal history of melanoma

• Weakened immune system, whether caused by certain cancers, organ transplant medication or AIDS

Factors that put you at higher risk for non-melanoma skin cancer include:

• Fair to light complexion

• Chronic exposure to the sun without sunscreen and protective clothing

• Psoriasis and treatments for psoriasis

• Smoking

• External radiation therapy

Where you live can affect your risk for developing skin cancer. Latitude, altitude and location are all important. The sun is more direct in lower latitudes. UV light is not filtered out as much at higher altitudes, and areas such as the South and Midwest with clear skies most of the year are more conducive to developing skin cancer. As a result, in the United States, skin cancer is more common in southern and southwestern states, where the sun is stronger. Age can also be a factor. Most skin cancers appear after age 50.

Types of Skin Cancer

There are three common types of skin cancer: basal cell carcinoma and squamous cell carcinoma (together known as non-melanoma skin cancers), and melanoma.

Basal Cell Carcinoma

Basal cell cancer is the most common skin cancer in the United States, accounting for more than 90 percent of all cases; 85 percent are found on the head and neck, with up to 30 percent of those appearing on the nose. It is slow growing and rarely spreads to other parts of the body. Basal cell cancers may look like pearly or waxy lumps that sometimes have depressions in the middle, or have blue or black areas. They can also be reddish and scaly. As the cancer grows, the center becomes more ulcerated and looks "gnawed." They bleed easily.

Squamous Cell Carcinoma

Squamous cell cancer is often raised or lumpy with rough, scaly surfaces on a reddish base, or appears as flat, reddish patches. Often the border is irregular. Squamous cell cancers occurring on sun-exposed skin uncommonly spread to other parts of the body, though it happens more often than with basal cell cancer. They are commonly found on areas usually exposed to the sun such as the scalp, forehead, backs of the hands, forearms and ears. They bleed easily.

Malignant Melanoma

Malignant melanoma may appear as a mole or freckle that changes size, color, surface, shape or border. The faster these changes occur, the more suspicious it is. Look for an irregular border with different colors in the same mole and some black color. Most melanomas are not bumps. In the early stage, most resemble a very dark and larger-than-normal freckle. Melanomas are most often found on the back in men and on the back, thighs and calves in women. If not detected early, malignant melanoma can spread to other areas of the body -- mainly the lymph nodes, liver, lungs and central nervous system -- and once metastasized, is frequently lethal.

How To Do a Skin Self-Exam

After your shower or bath, start by noticing where birthmarks, moles and blemishes are and what they look like. Be sure to check your entire body, including back, scalp, buttocks and genitals. Use a mirror to check hard-to-see areas. Check for anything new -- a change in the size, texture or color of a mole or a sore that does not heal. Do a skin self-exam once a month.

Treatment for Non-melanoma Skin Cancer

Non-melanoma skin cancer can be treated in several ways, including chemotherapy for the skin, removal by laser, surgery or freezing.

Treatment for Melanoma

Melanoma is removed by surgery, at which time they usually remove surrounding lymph nodes. Chemotherapy or radiation therapy may also be used to damage cancer cells and stop them from growing. If a large cancer is removed, your doctor may perform a skin graft. In this procedure a piece of healthy skin from another part of your body is used to close the wound and reduce the amount of scarring.

What to Do

The most common warning sign of skin cancer is a change on the skin, especially a new growth, a sore that crusts or bleeds occasionally, or in a change in the size, shape, color or feel of an existing mole. Not all skin cancers look the same. It is rare for skin cancer to cause pain.

Actinic keratosis, which appears as rough, scaly, red or brown patches on the skin, is known as a precancerous condition because it sometimes develops into squamous cell cancer. It usually appears on sun-exposed parts of the body, especially the ears, face, scalp and hands. The scaly areas may be easier to feel than to see. These can be easily treated in your health care provider's office to reduce the risk of cancer.

Self-Care Steps for Skin Cancer

• Avoid too much sun, particularly between 10 a.m. and 2 p.m. and in midsummer. In the winter, keep in mind that your face (and eyes) are at higher risk for UV damage when you are on snow or ice. Avoid any sunburn.

• Use a broad-spectrum sunscreen with an SPF of 15 or higher that protects against both UVA and UVB rays. Make sure you apply sunscreen thoroughly to all exposed skin, so you don't leave unprotected areas; use at least two tablespoons to cover arms, legs, face and neck. Don't assume that you can stay out longer just because you use sunscreen. It's still best to limit your time in the sun.

• Wear a wide-brimmed hat and long-sleeved shirt and pants when you're in the sun.

• Do not use sunlamps and tanning beds. They damage the skin, despite what tanning-salon owners and employees might tell you.

• Use sunscreen even on cloudy days.

• Use lip balm with the sunscreen paraaminobenzoic acid (PABA), wear UV-opaque sunglasses to protect your eyes, and be sure to apply sunscreen around eyes, ears, mouth and any bald or thinning areas on your head.

• UV rays can penetrate through loosely woven clothing and beach umbrellas, so wear sunscreen even when using these other forms of sun protection. Also, look for the sun-protective clothing that's now available, including shirts, pants and hats for adults and children.

• Some medicines can make you more sensitive to UV radiation. Check with your doctor or pharmacist.