Shedding Light on Skin Cancer: Awareness, Prevention & Early Detection

May is Skin Cancer Awareness Month. Awareness of the risks and ways to prevent skin cancer is near and dear to every person that practices dermatology and to those who have walked the path of receiving skin cancer diagnoses. This blog will cover some skin cancer statistics, what skin cancer is, the three most common types of skin cancer, and most importantly, skin cancer prevention. 

• Most Common Cancer: Skin cancer is the most common cancer globally. Each year, there are more new cases of skin cancer than the combined diagnosis of breast, prostate, lung, and colon cancers. 
  

• Types of Skin Cancer: There are three main types of skin cancer: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma. BCC and SCC are the most common types, while melanoma is less common but more aggressive. 
  

• Melanoma on the Rise: Melanoma, the deadliest form of skin cancer, has been increasing at a steady rate over the past few decades. It is the second most common cancer in individuals ages 15-29. 
  

• UV Radiation Exposure: Exposure to ultraviolet (UV) radiation from the sun and indoor tanning devices is a main risk factor for skin cancer. Approximately 90% of nonmelanoma skin cancers and 86% of melanomas are linked to UV radiation. 
  

• Geography: Skin cancer rates vary by geographic location. Higher rates of cancer occur in regions closer to the equator where UV radiation levels are higher. However, no one is immune to the risk of skin cancer. 
  

• Risk Factors: In addition to UV exposure, other risk factors for skin cancer include a history of sunburn, having fair skin, a family history of skin cancer, a weakened immune system, and exposure to certain chemicals or radiation. 
  

• Early Detection and Survival Rates: Early detection is critical for positive skin cancer outcomes. When detection is early, the five-year survival rate for Melanoma is approximately 99%. However, survival rates decrease drastically if Melanoma has spread to other parts of the body. 
  

Skin Cancer Awareness

Skin cancer occurs when the skin cells become cancerous or abnormal. The most common cause is ultraviolet (UV) radiation from the sun or from artificial sources like tanning beds. There are three main types of skin cancer which we will cover below: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma.

1. Basal Cell Carcinoma (BCC) 

This is the most common type of skin cancer and is formed in the basal cells in the outermost layer of the skin, the epidermis. Basal Cell Carcinoma usually appears as a small, shiny bump or nodule that may be pearly or translucent in appearance. It can also appear as a red, scaly patch or a sore that does not heal. It is less common for this type to spread or metastasize to other parts of the body. However, if left untreated, this type of cancer can cause damage to the surrounding areas of the skin, especially the eyes, nose, and ears. 

Risk factors for Basal Cell Carcinoma (BCC) include: 

• Not protecting from UV exposure (sun or indoor tanning)

• Suppressed or weakened immune system

• Previous history of skin cancer

• Greater than 50 years of age

• Fair skin

• Having a condition that causes sensitivity to the sun

• Males at greater risk

Treatment of Basal Cell Carcinoma 

Treatment for Basal Cell Carcinoma normally involves removal of the tumor through a surgical procedure known as an excision or Mohs micrographic surgery. Mohs is a specialized technique to ensure the complete removal of the tumor. Other treatment methods include cryotherapy (freezing), curettage and electrodesiccation (scraping/burning), topical medications, and radiation therapy.  

2. Squamous Cell Carcinoma (SCC) 

Squamous Cell Carcinoma (SCC), another common type of skin cancer, comes from the squamous cells found in the outermost layer of the skin, the epidermis. Like Basal Cell Carcinoma, SCC is primarily caused by excessive sun exposure, although it can develop on areas of the skin not frequently exposed to sunlight. 

Squamous Cell Carcinoma typically appears as a firm, red bump, or a scaly patch on the skin. It may also appear as a sore that does not heal. Squamous Cell Carcinoma is less likely to spread to other parts of the body compared to melanoma, but it can be more aggressive than basal cell carcinoma and can spread if left untreated, particularly on the lips, ears, or genital area. 

Risk factors for Squamous Cell Carcinoma (SCC) include:

• Not protecting from UV exposure (sun or indoor tanning)

• Suppressed or weakened immune system

• Previous history of skin cancer

• Greater than 50 years of age

• Fair skin

• Having a condition that causes sensitivity to the sun

• History of precancers

• History of HPV (human papilloma virus)

• History of chronic inflammatory conditions that results in skin injury or scars from previous burns

• Males at greater risk

Treatment of Squamous Cell Carcinoma 

Squamous Cell Carcinoma treatment usually involves removal of the tumor with surgery and may be followed with radiation therapy or chemotherapy if the cancer has spread or is at risk for recurrence. Mohs micrographic surgery may be recommended for squamous cell cancer located in areas where skin tissue needs to be preserved, especially on the face.  

3. Melanoma 

Melanoma is the most dangerous form of skin cancer because it can spread (metastasize) to other areas of the body like internal organs, bones, or lymph nodes. It develops from melanocytes, pigment producing cells. Melanoma most commonly occurs on the skin, but it can develop in other parts of the body, such as the eyes, mouth, or even internal organs.

Melanoma can occur in both existing and new moles. Regular self-exams and annual skin checks by a dermatology provider are critical for catching skin cancer in the early stages when treatment is most effective.

Risk factors for Melanoma include:

• Not protecting from UV exposure (sun or indoor tanning)

• Suppressed or weakened immune system

• Multiple moles: An increased number of moles can correlate with an increased risk of melanoma

• Fair skin including light eyes/light or red hair

• Previous history of skin cancer (melanoma or nonmelanoma types)

• Genetics: A family history of melanoma can increase a person’s risk

Melanoma Treatment 

Melanoma treatment normally involves surgical removal of the tumor. In some cases, additional treatments such as immunotherapy, targeted therapy, chemotherapy, or radiation therapy may be recommended, especially if the Melanoma has spread. 

The ABCDE Rules: What to Look for With Moles

• Asymmetry: One half of the mole or lesion doesn't match the other half. 

• Border: Irregular, blurred, or jagged edges. 

• Color: Variation in color, including shades of brown, black, red, white, or blue. 

• Diameter: Melanomas are typically larger than the size of a pencil eraser (6mm), but they can be smaller. 

• Evolution: Any changes in size, shape, color, or elevation of a mole or lesion over time should be evaluated promptly. 

Skin Cancer Prevention Tips

• Sun Protection: Wear broad-spectrum sunscreen with an SPF of 30 or higher, even on cloudy days. Reapply every two hours or after swimming or sweating. Remember to get those commonly overlooked areas like the ears, back of the neck, and tops of feet. 

• Protective Clothing: Clothing that offers UPF (Ultraviolet Protection Factor) is wonderful protection. Also consider wide-brimmed hats and sunglasses to shield your face and eyes. 

• Seek Shade: Limit your time in the sun, especially during peak UV hours between 10 a.m. and 4 p.m. If you are outdoors, seek shade under trees, umbrellas, or canopies. 

• Avoid Tanning Beds: Artificial UV radiation from tanning beds significantly increases the risk of skin cancer. Embrace your natural skin tone and avoid indoor tanning! 

Get Involved and Spread the Word! 

Skin cancer does not discriminate – it affects people of all ages, genders, and ethnicities. However, with knowledge and proactive measures, we can reduce its prevalence and impact. Practice sun safety, get regular skin checks, and spread awareness in your communities. When it comes to skin cancer, prevention and early detection are our most promising methods for positive outcomes. 

And remember, whether it is clouds or rays, where your SPF every day!