There is a phenomenon in our midst – as technology and knowledge advance, skin cancer rates continue to soar. How can this be? Several factors explain this, such as increasing temperatures, thinning ozone layer, tanning beds, and improved skin cancer detection and reporting. But, in my opinion, as disappointing as the global weather changes and the existance of tanning beds, is the lack of sufficient emphasis on, let alone discussion about, skin cancer prevention.
Let’s Start with Some Stats
- One in five Americans will develop skin cancer.
- Each year, five million skin cancer cases are reported (which means that even more cases occur but remain undiagnosed or unreported).
- A study by The Mayo Clinic found that melanoma, the most serious type of skin cancer, has increased by eight times for women under the age of 40 since 1970 – and the study’s a few years old.
- A 2013 study in the journal, Pediatrics, found that the number of cases of skin cancer among children and adolescents has been increasing each year by about two percent.
- Reported skin cancer cases exceed those of breast, lung, and prostate cancers combined.
And the craziest part of all of this is that most skin cancers are completely preventable.
The following questions are some of the most common I have encountered regarding skin cancer.
- How does skin cancer form?
When DNA damage occurs and the body cannot repair that damage, a person’s risk for cancer increases. Damaged DNA results in altered, atypical cells that proliferate (grow and divide) uncontrollably. Skin cancer tumors generally form in the outermost layer of the skin, the epidermis, which, thankfully, makes it more visible and detectable than other more internal forms of cancer.
- Where is skin cancer most likely to appear?
Skin cancer occurs most often on the body surfaces we expose most often to the sun, namely the head, face, neck, and extremities. Those who are bald or have thinning hair can also get skin cancer appear on the scalp. However, skin cancer can grow anywhere on the body where skin exists, which highlights the importance of routine skin examinations.
- What are the types of skin cancer?
1. Basal cell carcinoma (BCC) occurs in the basal cells, which exist in the deepest level of the epidermis. It wears many masks. It can appear as a shiny translucent or pearly nodule, a sore that continuously heals and then reopens, a pink slightly elevated growth, reddish irritated patches of skin, or a waxy scar. It is the most common form of skin cancer, often appearing on the face and neck.
2. Squamous cell carcinoma (SCC) occurs in the upper layer of the epidermis. It typically looks like a crusty, red patch of skin or a crater-like nodule with a concave, scaly center.
3. Melanoma begins in the melanocytes, the cells in the epidermis that give the skin its color. It is the most deadly form of skin cancer because it can quickly spread into the lymph system and then metastasize to vital organs. Melanoma has many disguises, but it typically forms in a pre-existing mole or appears as a new mole.
Check out FACTS for more information on skin cancer types and their detection.
What causes skin cancer?
According the the American Cancer Society, exposure to sunlight is the primary culprit – and by a landslide. While the sun’s ultraviolet (UV) rays of may be more intense during the summer months, especially when reflected off of water, over-exposure during any season can lead to skin cancer. UV reflects off of snow, too, thus becoming concentrated. If you ski like my family, bear in mind that you’re experiencing an exposure trifecta on the slopes – direct UV, reflected UV, and more intense UV at higher altitudes. No matter how many layers a person wears during cooler weather, the head and neck tend to remain exposed to the sun’s radiation year-round.
Skin cancer occurs at higher rates among those with fairer skin types; those who have a tendency to burn or freckle when exposed to the sun. Nonetheless, everyone should be vigilant and cover up when spending time outdoors. I have biopsied many skin cancers on dark-skinned individuals in clinical practice, and the diagnosis usually shocked these patients. Beyond skin cancer, UV also causes photo-damage to and premature aging of the skin (uneven skin tone, dark or “hyperpigmented” spots, wrinkles, and sagging) – and this happens to all skin types. Absolutely no one out of utero is immune to the sun’s power, and the expression “healthy tan” is defunct.
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