Tips for prevention, detection, treatment
Skin cancer is the most common form of cancer, with an estimated 5 million cases diagnosed every year in the U.S. It’s also one of the most preventable and treatable if you’re proactive at protecting yourself.
It’s important to identify skin cancer as soon as possible, because even the most dangerous type, melanoma, is highly treatable early on. Melanoma has an estimated fiveyear survival rate of 99 percent if it’s detected before it can spread to other parts of the body, according to the Skin Cancer Foundation.
May is Skin Cancer Awareness Month, a national campaign to educate the public about skin cancer prevention and detection. Aside from wearing sunscreen and avoiding sunburns, it’s also a good idea to check your skin for anything that looks unusual and see a dermatologist if it changes size, shape or color over time, said Dr. Susan Chon, a professor of dermatology at MD Anderson Cancer Center.
“It’s really important for patients to not be alarmed if they see something, to be proactive,” she said. “That’s probably my one word of advice, is to just go see a dermatologist.”
Chon and Dr. Ida Orengo, professor and medical director of the dermatology at Baylor College of Medicine, spoke to the Chronicle to offer tips about how to identify skin cancer and how to protect yourself.
What are the most common types of skin cancer?
There are three major types of skin cancer, and they can be divided into two groups, Chon said.
The first is melanoma, which is the most dangerous type but only accounts for 1 percent of all skin cancer cases, according to the American Cancer Society. Melanoma is particularly dangerous because it can grow quickly and spread to other organs. The ACS estimates that nearly 100,000 new melanomas will be diagnosed in the U.S. in 2022, and it will cause more than 7,600 deaths.
The other group is the nonmelanoma skin cancers, basal cell carcinoma and squamous cell carcinoma. They’re much more common, with an estimated 3.6 million basal cell carcinomas and 1.8 million squamous cell carcinomas diagnosed annually in the U.S., according to the Skin Cancer Foundation. They are highly treatable, though squamous cell carcinomas are more likely to turn deadly if left untreated over a long period of time.
How can you tell if you might have skin cancer?
The most obvious warning sign is anything abnormal that can’t be explained away as something like an injury or an insect bite. If the abnormality is changing in size or shape, itching or there’s a halo of white forming around it, it’s time to go see a dermatologist, Orengo said.
“I kind of tell patients that if it’s unexplainable and after three weeks it’s still there, you need to go have somebody take a look at it,” Orengo said.
Skin cancers generally don’t have any symptoms, but if they do, it will be itching, Orengo said.
Melanoma often appears to look like a mole, but it’s commonly assessed using the ABCDE rule. The acronym instructs people to check if the mole is asymmetrical, has an irregular or jagged border, has an uneven color, has a diameter that’s changing size and is evolving over time.
What are the risk factors for skin cancer?
Skin tone plays a major role in someone’s risk for skin cancer, with those with lighter skin being at higher risk. That’s because melanin, the pigment that’s primarily responsible for skin tone, also protects against the sun’s ultraviolet rays. More melanin generally means a darker skin tone and more UV protection.
However, anyone can develop skin cancer, regardless of skin tone. In fact, in people of color, melanoma often occurs in areas that get little exposure to sunlight, such as the palms of the hands, the soles of the feet and the nailbeds.
Other risk factors include a family history of skin cancer and an occupation that inherently leads to a lot of time spent in the sun. Farmers and construction workers, for example, will be spending more time outdoors than someone with an office job.
How can you protect yourself ?
The easiest way to protect yourself from skin cancer is to avoid spending too much time in the sun, Orengo said. She recommended doing outdoor activities like gardening or yard work before 10 a.m. or after 4 p.m. to avoid being sunburned.
It’s also important to remember that sun exposure is cumulative, Chon said. It’s important to wear sunscreen when you’re going to the beach, but it’s also important if you’re going on a 20-minute run every day.
“All those things kind of add up,” Chon said. “It’s all kind of cumulative.”
If you do need to be out in the sun for an extended period, wear a broad-spectrum sunscreen that’s at least SPF 30 and reapply it every two hours. Long-sleeved shirt and pants, a hat with a brim and sunglasses will also protect you from the sun.
Studies have shown that certain foods and drinks can help protect you, too. The polyphenols in green tea and omega-3 fatty acids in fish such as salmon, mackerel and tuna have been found to help prevent skin cancer.
How and when should you be checked for skin cancer?
Skin cancer can develop at any age. Orengo has seen melanoma in a 4-year-old patient and basal cell carcinoma in a 12-year-old, so she recommends having a pediatrician check your child’s skin during routine checkups.
Anyone with a family history of skin cancer is at higher risk, so they should start seeing a dermatologist beginning in their 20s, Orengo said.
Aside from having a dermatologist check your skin, it’s also a good idea to check yourself every few months, Chon said.
“We really ask patient to become kind of involved in their skin care. They see it all the time, and we see it very intermittently,” Chon said.
How is skin cancer treated?
The good news is that skin cancer is highly treatable if it’s identified early. The vast majority of deaths are from melanoma, but the five-year survival rate is 99 percent if melanoma is identified before it spreads to the lymph nodes.
Treatment typically consists of cutting out the damaged skin, though there are creams that can be used to treat the earliest stages of basal cell and squamous cell carcinomas. But if the cancer has spread, a patient may need radiation therapy.