The New Epidemic

Dermatologists are glad that people are now steering clear of the sun, given that skin cancer has reached epidemic proportions in this country over the past several years. More than 1 million new cases of skin cancer were diagnosed in 1998. Even worse, the rate of melanoma, the most dangerous kind of skin cancer, is doubling every 8 to 10 years. The lifetime chance of getting skin cancer is 1 in 5. Faced with these statistics, it is important for everyone to know the three forms of skin cancer, their characteristics, who is at risk, and available treatments.

 

Basal Cell Carcinoma

Basal cell carcinoma is the most common form of skin cancer, accounting for 80% of all skin cancers diagnosed in this country. Last year, some 900,000 cases were diagnosed and treated. If caught early, though, the cure rate is better than 95%. If left untreated, basal cell carcinoma can cause considerable tissue damage resulting in disfigurement.

• What it looks like:
  Pearly growth, sometimes with an area that won't heal. It can be translucent and gradually grow, or can look like a sore that won't heal.
• Potential candidates:
  People who have gotten chronic sun exposure throughout their life.
• Treatment:
  Basal cell carcinomas can be removed by freezing or surgery.

Squamous Cell Carcinoma

Numbering 200,000 cases in 1998, squamous cell carcinoma is the second-most common form of the disease, representing 16% of all skin cancers. Like basal cell carcinoma, this disease is 95% curable if caught early. But squamous cell carcinoma can spread and is potentially lethal of left untreated.

• What it looks like:
  Crusty, scaly patch with a hard, callusy surface.
• Potential candidates:
  People who have gotten chronic sun exposure throughout their life.
• Treatment:
  If caught early, squamous cell carcinomas can be removed by freezing or surgery. If it spreads, radiation or other more aggressive treatments may be required.

Melanoma

Also called "malignant" melanoma, this is the least common, but the most deadly, form of the disease. It accounts for only 4% of diagnosed skin cancers. The odds of getting melanoma are 1 in 79, but if you have a family history of the disease, you are at risk even if you have never been out in the sun.

• What it looks like:
  Usually a pigmented mole, sometimes with an uneven border. The color and diameter may change over time.
• Potential candidates:
  People who have had several blistering sunburns in youth or adolescence, or those with a family history of the disease.
• Treatment:
  Removal of the tumor via surgery. The amount of tissue that needs to be cut out depends on the tumor's thickness, so early detection means less invasive surgery. If the cancer has spread, the patient may need chemotherapy, radiation, or other treatments. Vaccines, and the study of genetics as it relates to melanoma are important advances in helping prevent recurrences.

Sun Safety 101

Skin cancer, if not completely preventable, can at least be successfully treated if caught early. Here are some ways to protect yourself.

• Stay in.
  Avoid the sun between 10 a.m. and 4 p.m., when the sun's rays are strongest.
• Cover up.
  Wear long pants and shirts with sleeves. If the sun can't get to you, it can't damage your skin.
• Wear a hat.
  Wearing a hat with a 4-inch brim will protect your face and neck.
• Make it routine.
  Use a broad-spectrum sunscreen every day and start putting it on your kids at age 6 months.
• Go higher.
  If you'll be outside for any length of time, use a sunscreen with an SPF of 30, but never less than SPF 15.
• Re-apply.
  Even waterproof sunscreens need to be re-applied every two hours for maximum protection in the midday sun.
• Look for changes.
  Growing, bleeding, crusting, or otherwise changing spots on the skin could indicate a problem. These include asymmetry (one half unlike the other half), irregular borders, varied color (shades of brown, black, or even white, blue or red) and spots which are larger than a pencil eraser.
• Get to know your skin.
  Practice skin self-exams to become familiar with your body's "topography." Once a month, examine your body for moles and dark spots, making note of those that appear to have changed and seeing your dermatologist immediately. Change does not necessarily mean skin cancer, but get them checked out to put your mind at ease.

Are You At Risk?

Certain factors may predispose you to getting skin cancer, even if you've never spent time in the sun. Some of these sun- and gene-related risk factors include:

• Fair skin
• Light hair Tendency to freckle
• Tendency to burn easily
• A family history of the disease
• Chronic sun exposure throughout life
• Blistering sunburns as a child or adolescent