Skin Cancer

• UV radiation from the sun is associated with 90% of nonmelanoma skin cancer, and 86% of melanomas.
• People who have ever used indoor tanning have a 67% increased risk of SCC and a 29% increase in BCC. More people develop skin cancer from indoor tanning than lung cancer from smoking.
• A history of indoor tanning increases the risk of BCC before age 40 by 69%. Indoor tanning is responsible for about 6200 cases of melanoma.
• 5 or more sunburns double the risk for developing melanoma.
• Just one blistering sunburn in childhood or adolescence more than doubles the lifetime risk of developing melanoma.

In addition to the appearance of the lesion, skin cancer is always diagnosed with a biopsy.

Melanoma is the deadliest form of skin cancer. It begins in the cells that give the skin color (melanocytes) and often spreads quickly. Melanoma can also be found in the eyes, and other parts of the body including under the toenails. 7% of new cancer cases in men, and 5% of new cancer cases in women are melanomas. Men are more likely to develop melanoma on the chest and back, while women are more likely to develop melanoma on the legs. The majority of people who develop melanoma are white men over the age of 55.

Risk Factors for Melanoma

• UV radiation from the sun is the most common cause.
• Only 20-30% of melanomas are found in existing moles. The rest appear on what looks like normal skin, often on the face and neck.
• A family history of melanoma.
• Having an organ transplant
• Pale skin and light-colored hair
• A high number of moles
• Age

Melanoma Diagnosis

The ABCDE’s of melanoma are the warning signs.

• Asymmetric: Normal moles are round and symmetrical, melanomas are not.
• Borders: Borders are irregular, not smooth. They can be ragged, notched or blurred.
• Color: Melanomas usually include more than one color including black, brown, tan, white and blue.
• Diameter: Melanomas are larger than a normal mole (larger than 1/4-inch diameter).
• Evolving: The mole changes appearance

Tumor Staging

When the diagnosis is made the tumor is staged to determine the aggressiveness and treatment options.

• Stage 0 means it is in the outermost layer of the skin.
• Stage I means it is thick (2MM) but has not spread and may be ulcerated.
• Stage II means the cancer is thicker (4MM) and has not spread.
• Stage III the cancer has spread to the lymph nodes.
• Stage IV means the cancer has spread to the lymph nodes, the lymph system and the brain, lungs and/or liver.

Only a decade ago, people with advanced stage melanoma lived only a few months. Recent advances in the treatment of melanoma means that about 50% of people with advanced stage melanoma can now survive the disease for at least 5 years with the use of immunotherapy.

Melanoma Treatment

Treatment depends on the stage of the tumor. Complete surgical removal is the goal.

BCC is a slow growing cancer that does not spread. Fair skinned people with years of sun exposure are at risk for BCC on the face, nose, chest, neck and back of the hands. It often looks like a flesh-colored, pearl-like bump or pink patch of skin. Early diagnosis and treatment can reduce the risk that BCC will grow deep and destroy tissue and bone. Mohs surgery is often recommended to spare healthy tissues and prevent disfigurement.

SCC is also caused by years of sun exposure. It can appear anywhere including the mouth, lips and genitals. Women usually get SCC on their legs. It looks like firm, red bumps, scaly patches, or a sore that doesn’t heal. SCC can spread to other parts of the body. When caught early it can be cured. Mohs surgery is the treatment of choice.