Tru Skin shares why you need a skin-cancer screening.
By Dr. Robert Harla
Skin cancer is the most common cancer in the United Sates. More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined. One in five Americans will develop skin cancer by the age of 70.
The factor that predisposes someone getting skin cancer most often is sun exposure. Skin cancer is primarily seen in exposed areas, but a significant number of non-melanomas and melanomas occur in typically non-sun-exposed regions. Other contributing factors include genetics, blistering sunburns, tanning beds and having more than 50 moles. Non-Caucasians who develop skin cancer tend to have more aggressive cases because of a lack of early diagnosis, often because such patients believe they are moreprotected.
Skin cancer is usually classified as either non-melanoma skin cancer or melanoma skin cancer. The former usually carries lower morbidity and mortality and is defined by basal cell carcinoma and/or squamous cell carcinoma. BCC is the most common form of skin cancer.
Experts estimate more than four million cases are diagnosed each year and that there are more than 3,000 deaths related to BCC each year. SCC is diagnosed more than a million times per year, with SCC causing more than 15,000 deaths. Organ-transplant patients are 100 times more likely than the general public to develop SCC.
BCC and SCC are highly curable when detected early and treated appropriately. The most common treatment options include surgical excision, Mohs micrographic (tissue-sparing) surgery and superficial radiation therapy, with the latter having the lowest incidence of postoperative complications.
One person dies from melanoma every hour. The five-year survival for people with melanomas that are thin and have not spread to regional lymph nodes is 99 percent. Survival rates go down if the tumor is thicker and has spread from the primary site. In addition to regular full-body skin exams, patients who have had a melanoma need baseline evaluations by an ophthalmologist, dentist and gynecologist to look for unseen lesions.
Most skin cancer is preventable because, for the most part, the lesions are visible to the naked eye. No special equipment is needed, only a willingness to look and suspicion for new pigmented or raised lesions where once the skin was flat. There is a pneumonic to help remember what to look for:the ABCDEs of melanoma. These can be used for any new or changing skin lesions. A stands for asymmetry, meaning not round or oval. B stands for border irregularity, meaning not smooth and notched. C stands for color, meaningmore than one. D stands for diameter, meaning more than 6 millimeters, the size of a pencil eraser. E is for elevation, meaning it’s growing up out of skin or is raised. Images of all of these examples can be easily obtained by an online search.
The most important thing to do is look. The American Academy of Dermatology and the American Cancer Society do not have specific guidelines for the early detection of skin cancer. Obviously, fair-skinned people, people with a family history of melanoma or non-melanoma skin cancer, and people with multiple moles have a potential higher risk for skin cancer than others. In some, there is a genetic tendency toward skin cancer, regardless of sun exposure.
Knowing your own skin is important. Note the presence or absence of raised, pigmented growing lesions on diﬀerent body areas. Someone should look at your back and the back of your legs. Superficial scalp exams may be done by an adult in your home or by a hair stylist or barber. The most significant thing to do is note where you have moles or other raised or colored lesions and whether they change with time.
Any lesion that is painless and bleeds easily or doesn’t heal in a reasonable period of time should be evaluated with a biopsy by your physician or a dermatologist. In addition, anything that is new and not symmetrical should be pointed out to your skin-care physician.