Saanichton, BC

Dr. Miguel A. Lipka

Skin Cancer

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Skin cancer is one of the most common forms of cancer today with about 1 million new cases diagnosed each year in North America. The good news is that nearly 90 percent of skin cancers are preventable. If caught early, most are highly curable. For these reasons, it's important to protect yourself from the sun and to check your skin regularly for signs of cancer. Left undetected or untreated, skin cancer can be damaging — even deadly.

Although it is impossible to completely eliminate the possibility of skin cancer, the risk of developing such a cancer can be reduced significantly with the following steps:

  • Avoid the use of tobacco products
  • Wearing long sleeves and hats when outdoors
  • Using a broad-spectrum sunscreen that blocks both UVA and UVB radiation
  • Reapply sun block as per the manufacturers directions
  • Reducing overexposure to ultraviolet (UV) radiation, especially in early years
  • Avoiding sun exposure during the peak UV times during the day, typically from 10 AM to 3 PM (dependent on country) when the sun is directly overhead

Treatment of skin cancer varies based on the type and location of the cancer, age of the patient, and whether the cancer is primary or a recurrence. Some treatments include:

  • Radiation therapy (external beam radiotherapy or brachytherapy)
  • Topical chemotherapy
  • Cryotherapy (freezing the cancer off)
  • Surgery
  • Photodynamic therapy
  • Electrodessication and curettage

Basal Cell and Squamous Cell Carcinoma

The two most common kinds of skin cancer are basal cell carcinoma and squamous cell carcinoma, which are sometimes called nonmelanoma skin cancer. These cancers are carcinomas that begin in the cells that cover or line an organ.

Basal cell carcinoma accounts for more than 90 percent of all skin cancers in North America and is the most common of all cancers. Typically, it is a slow-growing cancer that seldom spreads to other parts of the body.

Squamous cell carcinoma also rarely spreads, but does so more often than basal cell carcinoma. It is important that skin cancers are found and treated early because they can invade and destroy nearby tissue. Organ transplant recipients have a 65-fold higher risk of developing squamous cell carcinoma than others.

The most common warning sign of skin cancer is a change on the skin, especially a new growth or a sore that doesn't heal. The cancer may start as a small, smooth, shiny, pale or waxy lump. It also may appear as a firm red lump. Sometimes, the lump bleeds or develops a crust.

Actinic keratoses are pre-cancerous growths, usually caused by sun exposure. They often appear as red, scaly spots and may later develop a hard, wart-like surface. If untreated, about 1 percent develop into squamous cell carcinoma.

Both basal and squamous cell cancers are found mainly on areas of the skin that are exposed to the sun — the head, face, neck, hands and arms. But skin cancer can occur anywhere.

Melanoma

Melanoma is the most common cause of death from skin cancer. With early diagnosis, however, 85 percent of patients can be cured. The goal is to recgonize malanoma early when it's potentially curable.

Melanoma begins in cells called melanocytes, which are pigment-producing cells. When melanoma starts in the skin, the disease is called cutaneous melanoma. Melanoma also may occur in the eye, a condition called ocular melanoma or intraocular melanoma. Rarely, melanoma may arise in the meninges, the digestive tract, lymph nodes or other areas where melanocytes are found.

It can occur on any skin surface. In men, it is often found on the trunk or the head and neck. In women, the condition often develops on the lower legs as well as the upper back. The chance of developing melanoma increases with age, but it affects people of all ages and is one of the most common cancers in young adults.

When melanoma spreads, cancer cells are found in the lymphatic system. If the cancer reaches the lymph nodes, cancer cells may have spread to other parts of the body such as the liver, lungs or brain. In these cases, cancer cells in the new tumor are still melanoma cells and the disease is called metastatic melanoma rather than liver, lung or brain cancer.

Often, the first sign of melanoma is a change in the size, shape, color or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new, black, abnormal or "ugly-looking" mole. Rarely, melanoma is not pigmented and is more difficult to diagnose. It may appear as a non-healing ulcer or a new scar-like lump in the skin.

The warning signs of melanoma sometimes are referred to as ABCDE:

  • Asymmetry — Two halves of a lesion that are not the same
  • Border — Borders of a lesion are irregular, scalloped or vague
  • Color — Color varies from one area to another, including shades of tan or brown as well as black, blue, red and white
  • Diameter — A lesion that is greater than 6 millimeters in diameter, about the size of a pencil eraser
  • Evolution — Lesions that change or evolve