SKIN CANCER—KEEPING YOUR SKIN IN THE GAME
Yesterday I saw my dermatologist for my quarterly skin checkup. Nothing new, thank goodness. Besides these regular appointments, I keep a continual skin watch on myself. You see I had melanoma 20 years ago. I lived in Portugal for three years in the mid 1990s and didn’t bother having a physical exam. When I got home and finally went in, the doc spotted a lesion with an irregular border on my back. “Oh, oh, we need to biopsy this,” he said. Sure enough it was the melanoma variety of skin cancer and it had developed to a dangerous stage—the stage where it could have metastasized to other parts of my body. But I was lucky and it hadn’t. My dear brother a few years later also developed melanoma but he wasn’t as lucky—his had spread to his brain and he died from it.
Now that we’re into the summer sun season, I thought it made sense to post about skin cancer. I’ve relied on the June 2015 Mayo Clinic article Skin Cancer Symptoms and Causes. Here are excerpts:
Overview
Skin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight.
There are three major types of skin cancer — basal cell carcinoma, squamous cell carcinoma and melanoma.
You can reduce your risk of skin cancer by limiting or avoiding exposure to ultraviolet (UV) radiation. Checking your skin for suspicious changes can help detect skin cancer at its earliest stages. Early detection of skin cancer gives you the greatest chance for successful skin cancer treatment.
Symptoms
Where skin cancer develops
Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. Skin cancer affects people of all skin tones, including those with darker complexions.
Basal cell carcinoma signs and symptoms
Basal cell carcinoma usually occurs in sun-exposed areas of your body, such as your neck or face. It may appear as:
- A pearly or waxy bump
- A flat, flesh-colored or brown scar-like lesion
Squamous cell carcinoma signs and symptoms
Most often, squamous cell carcinoma occurs on sun-exposed areas of your body, such as your face, ears and hands. People with darker skin are more likely to develop squamous cell carcinoma on areas that aren’t often exposed to the sun. It may appear as:
- A firm, red nodule
- A flat lesion with a scaly, crusted surface
Melanoma signs and symptoms
Melanoma can develop anywhere on your body, in otherwise normal skin or in an existing mole that becomes cancerous. Melanoma most often appears on the face or the trunk of affected men. In women, this type of cancer most often develops on the lower legs. In both men and women, melanoma can occur on skin that hasn’t been exposed to the sun.
Melanoma can affect people of any skin tone. In people with darker skin tones, melanoma tends to occur on the palms or soles, or under the fingernails or toenails.
Melanoma signs include:
- A large brownish spot with darker speckles
- A mole that changes in color, size or feel or that bleeds
- A small lesion with an irregular border and portions that appear red, white, blue or blue-black
- Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus
When to see a doctor
Make an appointment with your doctor if you notice any changes to your skin that worry you. Not all skin changes are caused by skin cancer. Your doctor will investigate your skin changes to determine a cause.
Causes
Skin cancer occurs when mutations occur in the DNA of skin cells. The mutations cause the cells to grow out of control and form a mass of cancer cells.
Cells involved in skin cancer
Skin cancer begins in your skin’s top layer — the epidermis. The epidermis is a thin layer that provides a protective cover of skin cells that your body continually sheds. The epidermis contains three main types of cells:
- Squamous cells lie just below the outer surface and function as the skin’s inner lining.
- Basal cells, which produce new skin cells, sit beneath the squamous cells.
- Melanocytes — which produce melanin, the pigment that gives skin its normal color — are located in the lower part of your epidermis. Melanocytes produce more melanin when you’re in the sun to help protect the deeper layers of your skin.
Where your skin cancer begins determines its type and your treatment options.
Ultraviolet light and other potential cause
Much of the damage to DNA in skin cells results from ultraviolet (UV) radiation found in sunlight and in the lights used in tanning beds. But sun exposure doesn’t explain skin cancers that develop on skin not ordinarily exposed to sunlight. This indicates that other factors may contribute to your risk of skin cancer, such as being exposed to toxic substances or having a condition that weakens your immune system.
Risk factors
Factors that may increase your risk of skin cancer include:
- Fair skin. If you have blond or red hair and light-colored eyes, and you freckle or sunburn easily, you’re much more likely to develop skin cancer than is a person with darker skin.
- A history of sunburns. Having had one or more blistering sunburns as a child or teenager increases your risk of developing skin cancer as an adult. Sunburns in adulthood also are a risk factor.
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Excessive sun exposure. Tanning, including exposure to tanning lamps and beds, also puts you at risk. A tan is your skin’s injury response to excessive UV radiation.
- Sunny or high-altitude climates
- Moles. People who have many moles or abnormal moles called dysplastic nevi are at increased risk of skin cancer. These abnormal moles — which look irregular and are generally larger than normal moles — are more likely than others to become cancerous.
- Precancerous skin lesions. Having skin lesions known as actinic keratoses can increase your risk of developing skin cancer. These precancerous skin growths typically appear as rough, scaly patches that range in color from brown to dark pink.
- A family history of skin cancer. If one of your parents or a sibling has had skin cancer, you may have an increased risk of the disease.
- A personal history of skin cancer. If you developed skin cancer once, you’re at risk of developing it again.
- A weakened immune system.
Prevention
Most skin cancers are preventable. To protect yourself, follow these skin cancer prevention tips:
- Avoid the sun during the middle of the day.
You absorb UV radiation year-round, and clouds offer little protection from damaging rays. Avoiding the sun at its strongest helps you avoid the sunburns and suntans that cause skin damage and increase your risk of developing skin cancer. Sun exposure accumulated over time also may cause skin cancer.
- Wear sunscreen year-round. Sunscreens don’t filter out all harmful UV radiation, especially the radiation that can lead to melanoma. But they play a major role in an overall sun protection program.
Use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring. Use a generous amount of sunscreen on all exposed skin, including your lips, the tips of your ears, and the backs of your hands and neck.
Wear protective clothing. Sunscreens don’t provide complete protection from UV rays. So cover your skin with dark, tightly woven clothing that covers your arms and legs, and a broad-brimmed hat, which provides more protection than a baseball cap or visor does.
Don’t forget sunglasses. Look for those that block both types of UV radiation — UVA and UVB rays.
- Avoid tanning beds.
- Check your skin regularly and report changes to your doctor. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp. Examine your chest and trunk, and the tops and undersides of your arms and hands. Examine both the front and back of your legs, and your feet, including the soles and the spaces between your toes. Also check your genital area.
I hope you can use this info. Enjoy your summer! But stay out of the sun as much as possible. And check your skin out regularly.