Skin Cancer

What is skin cancer?

Skin cancer is an uncontrolled growth of abnormal cells in the skin. It is one of the most common types of cancer. Skin cancer appears as a change on the skin. It can occur anywhere but is found mainly on areas of the skin that are exposed to the sun, like the head, face, neck, hands, and arms.

The 3 main types of skin cancer are:

• basal cell carcinoma
• squamous cell carcinoma
• melanoma.

Basal cell carcinoma accounts for over 90% of all skin cancers in the US. It is slow growing and seldom spreads to other parts of the body. Squamous cell carcinoma also rarely spreads, but it does so more often than basal cell carcinoma. Both basal and squamous cell are common in people who are regularly in the sun for long periods of time. Both have a high rate of cure when treated right away.

A melanoma usually develops from a mole. It is also caused by too much sun. Melanoma is not as common as the other 2 types of skin cancer, but it is more serious and more likely to spread to other parts of the body.

How does it occur?

Skin cancer is related to how much you are out in the sun without protecting your skin. Exposure to UV rays from sunlight or tanning beds is the most common and easily preventable cause. Most skin cancers appear after age 50, but the sun's damaging effects begin at an early age. Therefore, protection should start in childhood to prevent skin cancer later in life.

The risk of skin cancer is greatest for people who have fair skin that freckles easily. Frequently these are people with red or blond hair and blue or light-colored eyes. High-risk professions for skin cancer include farmers, construction workers, other sun-exposed outdoor workers, and vehicle drivers (their sun-exposed arm). Where you live can also be a risk. People who live in areas where there are high levels of UV radiation from the sun are at greater risk of getting skin cancer.

What are the symptoms?

Many skin cancers occur on the face, but they can appear anywhere. Symptoms of skin cancer may include:

• a new growth or sore that does not heal
• a small, smooth, shiny, pale, or waxy lump
• a firm red lump that sometimes bleeds or develops a crust
• a flat, red spot that is rough, dry, or scaly
• a change in the color, shape, or thickness of a mole.

The earliest precancerous skin condition is keratosis. This is also called solar keratosis, senile keratosis, or actinic keratosis. It is a rough, scaly area of skin that forms on sun-exposed areas and does not go away. Your healthcare provider can easily treat this condition.

How is it diagnosed?

Your healthcare provider will:

• Look at your skin.
• Ask about your symptoms and medical history and if the affected area of skin has changed in any way.
• Do a biopsy to remove all or part of the skin growth for lab tests.

How is it treated?

The treatment for basal cell carcinoma and squamous cell carcinoma is removal of the growth or to destroy the cancer completely with as small a scar as possible. The choice of treatment depends on the type of cancer and its size and position on the skin. Possible treatments are:

• cutting out the growth with a scalpel
• Mohs' chemosurgery, which is removal and tests of layers of the growth and surrounding skin
• curettage and electrodesiccation, which is removal of the cancer with a sharp tool shaped like a spoon and use of an electric current to control bleeding and kill any cancer cells that may be left
• cryotherapy, which is freezing the affected area with liquid nitrogen
• topical chemotherapy, which uses an anticancer drug put on the skin to kill cancer cells
• radiation therapy, which uses high energy rays to destroy cancer cells.
• laser therapy, which uses a narrow beam of light to remove or destroy cancer cells.

When a cancer is cut out, your skin will be numbed first so that you do not feel pain during the surgery.

How long will the effects last?

If you have had skin cancer, you are at a higher risk for developing skin cancer again. You should be sure to have regular exams so that your healthcare provider can check your skin in treated areas as well as other places where cancer may develop.

How can I help prevent skin cancer?

Check your skin regularly and report any changes to your healthcare provider right away. If you are at high risk, see your healthcare provider for a baseline skin exam and regularly scheduled examinations as recommended.

Avoid being in too much sun. Wear clothing and hats that cover you, and stay out of the midday sun as much as possible. Use sunscreen lotions to protect against UV light when you are outdoors. The higher the SPF number (sun protection factor) of the sunscreen, the greater the protection. Use a lotion with an SPF of at least 15. For water sports, use a sunscreen lotion that does not wash off in the water. If you are allergic to PABA, use PABA-free sunscreen lotions. And remember that UV rays from the sun can cause sunburn or damage even on cloudy days.

Do not use sunlamps or tanning booths.

To get more information about skin cancer, talk to your provider or contact:

• American Cancer Society, Inc.
  Phone: 800-ACS-2345 (800-227-2345)
  Web site: http://www.cancer.org
• AMC Cancer Research Center and Foundation
  Phone: 800-525-3777
  Web site: http://www.amc.org
• Cancer Information Service
  Phone: 800-4-CANCER (800-422-6237)
  Web site: http://cis.nci.nih.gov