Keep Your Skin in the Game Part 1 Identifying Skin Cancer

Did you know that skin cancer is the most common type of cancer? And, even more concerning, it often goes unrecognized.

What Are the Three Main Types of Skin Cancer?

#1: Basal Cell Carcinoma

Basal cell carcinoma is the most common. With an estimated 4.3 million cases diagnosed in the U.S. each year, this condition affects more people than lung cancer, breast cancer, and prostate cancer combined.

Basal cell carcinoma is caused by an abnormal growth of basal cells, which originate from the base of the topmost layer of skin. This type of cancer appears most often on parts of the body frequently exposed to the sun, like the head and neck. It is often mistaken for a "pimple," except this "pimple" doesn't go away and will often bleed with minimal trauma. Surgery is the most common treatment. The prognosis for basal cell carcinoma is generally very positive when caught early, with most patients making a full recovery after treatment.

#2: Squamous Cell Carcinoma

Squamous call carcinoma is the second most common type, with an estimated 1 million cases diagnosed in the U.S. each year.

Like basal cells, squamous cells originate from the epidermis, the top layer of the skin. Damage to these cells, caused by cumulative ultraviolet (UV) exposure, can lead to squamous cell carcinoma. These can look like red crusty lesions. While the majority of squamous cell carcinomas have a good prognosis, this condition should be caught early to avoid deeper invasion and spread.

#3: Melanoma

Melanoma, although less prevalent than basal cell carcinoma and squamous cell carcinoma, is typically more aggressive. In 2020, approximately 196,000 cases of melanoma are expected to be diagnosed in the U.S. Unlike non-melanoma skin cancers, melanoma can occur anywhere on the body, including areas not typically exposed to the sun. This type of cancer can spread beyond the skin to other parts of the body and therefore early detection and treatment is key to a good prognosis.

Although melanomas can often be fully treated with surgery, they may require radiation, chemotherapy, and other drug treatments if they have spread beyond the skin. The prognosis for this condition depends on several factors, including the thickness of the melanoma and the extent of spread. The five-year survival rate for all people diagnosed with melanoma is 92%.

LISTEN: Dr. Deng discusses skin cancer in the Medical Intel podcast.

What Causes Skin Cancer?

There are several significant risk factors, including:

Sun Exposure: Sun exposure is cumulative. Each time a person gets a sunburn, their skin is damaged on a genetic level. The damage increases over the individual's lifetime and may eventually cause this condition.

Use of Tanning Beds: Because indoor tanning beds emit more UV radiation than the sun, their use is directly tied to increased risk for this type of cancer.

Genetics: Some people are more genetically predisposed to it than others. People with fair skin, and especially individuals with red hair, are at greater risk of developing both non-melanoma and melanoma skin cancers. Individuals with a family history also have a higher chance of developing one of these conditions.

The A-B-C-D-Es of Skin Self-Exams

Conducting regular skin self-exams can help you detect skin cancer early. I recommend checking your skin for any bleeding or changing lesions no more than once a month. If you check too frequently, you run the risk of not noticing that a spot has changed.

When it comes to basal or squamous cell carcinoma, keep an eye out for any spot on your skin that keeps recurring. These spots can bleed, often with minimal rubbing, but don't usually hurt.

When checking your skin for signs of melanoma, remember your A-B-Cs...and don't forget D and E! If you notice one or more of these indicators, schedule an appointment with a dermatologist:

• Asymmetry: Regular moles are usually symmetric, while melanomas often lack symmetry.
• Borders: Regular moles typically have smooth, round borders. If you have any spots with jagged or irregular edges, have them checked by a dermatologist.
• Color: Regular moles tend to have one or two brown shades at most. A mole with multiple colors, such as grey, black, white, or pink, could be a melanoma.
• Diameter: Any mole with a diameter larger than about 5 mm (around the size of a pencil eraser) should be checked by a doctor. However, keep in mind that melanomas can start out much smaller than this. Don’t wait for an irregular mole to grow larger before having it examined by a dermatologist.
• Evolution: This is the most important sign! Any mole that is changing in appearance should be examined, even if you haven’t noticed any of the other four signs above.

Protect Yourself

Although skin cancer is the most common type of cancer, it’s also the most preventable. The best step you can take to reduce your risk is to protect yourself from the sun.

When you spend time outside, be sure to wear sunscreen. The American Academy of Dermatology recommends SPF 30 sunscreen or higher. However, people often don’t apply enough sunscreen, so I recommend using SPF 50 to ensure your skin is protected. Try to choose a broad-spectrum sunscreen with zinc oxide and titanium dioxide for the best protection. And don’t forget to reapply your sunscreen every two hours, or every hour if you’re swimming.

It’s also important to minimize your time spent in direct sunlight. Of course, there’s no need to stay indoors all the time, but be aware of the time you’re spending in the sun—particularly between 10 a.m. and 2 p.m. Wear protective clothing, including a hat, and stay in the shade as much as possible.

If you notice any changes in your skin, schedule an appointment with a dermatologist. At MedStar Health, our team of board-certified dermatologists can conduct a head-to-toe skin check to help you examine any areas of concern.