One in five Americans will develop skin cancer in the course of their lifetime. Each year, nearly 5 million people in the US receive treatment for skin cancer, and each year there are more new cases of skin cancer than new cases of breast, prostate, lung and colon cancers combined! Over the past three decades, more people have had skin cancer than all other cancers combined.
There are three common kinds of skin cancer including basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell carcinoma (BCC) is the most common of the three with 2.8 million cases per year. Basal cell cancers usually are easily treated and rarely fatal but can be highly disfiguring if ignored. An estimated 700,000 cases of Squamous Cell Carcinoma (SCC) are diagnosed every year. Cases of SCC have risen up to 200% over the past three decades in the US. Squamous Cell Cancer can spread to lymph nodes and elsewhere and up to 2% of cases can be fatal.
Melanoma accounts for less than 2% of all skin cancers but is responsible for the vast majority of deaths from skin cancer. One person dies of melanoma every single hour in this country. In 2015 there will be an estimated 73,870 new cases of melanoma and 9,940 people will die from the disease. Of the seven most common cancers in the US, melanoma is the only one whose incidence is increasing. Melanoma is the most common form of cancer for young adults 25-29 and the second most common form of cancer for young people 15-29 years old.
The treatment of skin cancers mostly involves surgical removal of the lesion and an additional margin of normal skin. For advanced cases, skin grafts may be required as well as additional surgery to remove affected lymph nodes. In selected cases of later stage disease radiation, chemotherapy and immune therapy may be utilized. The annual cost of treating skin cancers in the US is estimated at $8.1 billion: $4.8 billion for nonmelanoma skin cancers and $3.3 billion for melanoma.
The most significant risk factor for skin cancer is exposure to UV radiation from sunlight and indoor tanning. UV exposure can raise skin cancer risk even without getting a sunburn but blistering sunburns significantly increase one’s risk over their lifetime. Other risk factors include prior skin cancers, family history of skin cancer especially melanoma, having many irregular moles; having fair skin, blue eyes or blond, red or light hair; living or vacationing at higher altitudes or in tropical climates, spending large amounts of time outdoors for your job or recreation and having certain autoimmune diseases or taking drugs to suppress your immune system (transplant patients).
Protection from the harmful effects of UV rays involves staying out of direct sunlight during the peak hours, protecting your skin with clothing and sunscreen, wearing a hat and sunglasses (to protect the eyes) and also avoiding indoor tanning. Skin cancer researchers believe that the dramatic recent rise in melanoma rates in young and middle-aged adults has been caused by the popularity of indoor tanning. At least 170,000 cases of skin cancer each year are linked to indoor tanning. Many states in the US and Europe have banned tanning bed use by minors. Brazil has banned indoor tanning entirely.
Signs of a possible skin cancer include a lesion that is new, dark-colored, irritated, crusty, ulcerated or bleeding. Self-examination can be carried out with the use of a hand-held mirror and a wall mirror.
The most important warning sign for melanoma is a new spot or a spot that is changing in size, shape or color. Another important sign is a spot that looks different from all the other spots on your skin (known as the ugly duckling sign).
The ABCDE rule is another guide to the usual signs of melanoma:
A is for Asymmetry – one half of a mole or birthmark does not match the other
B is for Border – the edges are irregular, ragged, notched or blurred
C is for Color – the color is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white or blue
D is for Diameter – the spot is larger than 6 millimeters across (the size of a pencil eraser), although melanomas can sometimes be smaller than this
E is for Evolving – The mole is changing in size, shape or color
If you have any of these warning signs, have your skin checked by a health care professional.
The websites of The Skin Cancer Foundation and the American Cancer Society have excellent resources for additional information about skin cancer. Further information or a physician referral is also available by calling Bonnie Burns, Cancer Registrar, at the SE Med Cancer Program at 740.435.2980.