14 Apr Skin Cancer – Warning Signs and Prevention Tips

BY MICHAEL MCGUINESS, M.D.

Every year, there are about as many new cases of skin cancer diagnosed in the U.S. than all other types of cancer combined. As a dermatologist, this always impresses me. It is really amazing to think of the magnitude of skin cancer here in our country.

Your skin is your body’s biggest organ, and there are many different kinds of cancer that can affect it. The appearance of these cancers varies quite a bit. Some are fairly obvious, with associated bleeding, pain, poor healing, crusting, etc. But others are quiet and inconspicuous, with minimal visible signs and no significant symptoms to draw your attention.

Skin cancer can be treatable. Its many treatments include prescription creams, cryotherapy, superficial radiation therapy, simple surgery, and Mohs surgery, and more.

But it is even better to never get it in the first place! So how do we prevent skin cancer?

Sometimes, skin cancer is a matter of “bad genes” or unknown causes—simple “bad luck”, if you will. But in most cases, it begins with excessive exposure to UV radiation from the sun or tanning beds.

How much UV exposure does it take to cause a skin cancer? The amount varies widely from person to person, but there is no “safe” level. UV exposure always causes damage—at any age, and in any amount. Exposure during the younger years—especially from sunburns and even minimal tanning bed use—frequently causes skin cancer ten or more years later, even if further exposure was curtailed. (The unsightly wrinkles, sagging skin, and age spots that UV exposure also causes are a topic for another discussion, another time… soon!)

So obviously, prevention begins with avoiding UV exposure. During the summer, stay out of the sun between 10:00 a.m. and 7:00 p.m. Coat exposed skin with sunscreen rated at least SPF 30 (higher is even better, to a point). Don’t forget the legs, ladies! The leg is one of the most common locations for melanoma in women; yet in the summer, women most often wear skirts, dresses, shorts, or poolside cover-ups that only shield from the hips up.

Wear protective clothing. Use sunglasses that block 100% of UV rays. Your hat must have a solid top and a wide brim all the way around (baseball hats and visors do not qualify). I am a huge advocate of long-sleeved, high-necked, sun-protective shirts; these are usually SPF 50, and where they cover, no sun screen is needed. Some are sleek, fitted sun shirts for swimming; others look like normal, regular shirts (promise!).

But, you may ask, what about Vitamin D? I do not endorse UV exposure as a means to raise your vitamin D level—it is an inefficient and dangerous means of doing so. Taking vitamin D pills is safer and more effective. If you make a habit of putting yourself under the scorching orb of the sun or the glowing bulbs of a tanning bed, you could easily end up, as many do, under another bright light… in the surgery suite!

Finally, see a skin specialist—a dermatologist—for regular, total body skin exams. Your dermatologist is the medical provider to see for this exam. No other provider in any specialty has the training needed to identify possibly harmful lesions in your skin. So it only makes sense to trust your skin to a dermatologist—a specialist with the training needed to identify and treat the sometimes silent killers called skin cancer.

The three most common skin cancers are basal cell skin cancer, squamous cell skin cancer, and melanoma. These are three distinct and separate cancers—they do not turn into one another. But if you have one, you are more likely to develop another at some time.

Basal Cell Cancer (BCC) generally occurs from exposure to ultraviolet (UV) radiation from the sun or tanning beds. Thus, it appears in sun-exposed body areas. Usually fairly evident to the trained eye, BCC often appears as a raised or flat pink area with scaly or pearly appearance. It frequently has more prominent blood vessels within, and tends to bleed with minimal trauma. It rarely spreads to distant internal organs; but if untreated, it can easily grow deep and wide. This can result in severe disfigurement, or rarely, death.

Squamous Cell Cancer (SCC) is similar in many ways to BCC; but its scales or crustiness are sharper. SCC is also more aggressive than BCC; if not treated promptly, it can readily metastasize to internal organs.

Melanoma is potentially and frequently the most dangerous of the three most common skin cancers. It readily metastasizes, and often has a subtle appearance with few, if any, early symptoms. If caught early, while only in the skin, it is completely curable. But if it spreads internally (which it does easily), it is often fatal. Furthermore, although UV exposure can cause melanoma, it is not necessary for you to get melanoma. So even if you avoid sunburns and tanning beds, you can still develop melanoma. And you can get it anywhere on your body—even on hidden areas.