As we enter into the summer months of the year in the United States, the sunshine can feel wonderful, lift spirits, and be relaxing to enjoy. As time marches on for each of us, so do the effects of our time in the sun. May marks Skin Cancer Awareness Month; are you armed with the tools and information you need to prevent, identify, and be informed about skin cancer?
According to the Skin Cancer Foundation, more than 5 million people in the United States (US) are diagnosed with skin cancer each year. This is also the most common type of cancer in the US. The very painful part of this diagnosis is that most often, it is preventable. Nearly 90 percent of non-melanoma skin cancers and 85 percent of melanoma cases are due to ultraviolet radiation exposure, aka. sunlight.
There are a great many efforts underway to educate, raise awareness, and provide resources to encourage individuals to change their behaviors to escape the dangers of this disease.
There are multiple types of skin cancers and even precancer, called actinic keratosis.
Actinic keratosis signs include small crusty or scaly bumps comprised of different color tones within the same bump. Actinic keratoses (plural) can be found on the face, lips ears, scalp, shoulder or neck area, and on the backs of hands or forearms.
Basal cell carcinoma (BCC) is a type of nonmelanoma skin cancer and is also referred to as an epithelial tumor; it accounts for just over 4 million cases and over 3000 deaths annually. BCCs are comprised of uncontrolled basal cells which are found normally in the deepest portion of the epidermis. BCC can appear as open sores, abnormal growths, and almost never spread beyond the original tumor site. It is widely accepted that BCC is caused by intense, but not continuous, sun exposure experiences. The damage done by that UV exposure is cumulative. Affected tissue must be treated and is often excised beyond the margins to eliminate the chance for it to reoccur at that location. These BCCs arise in locations on the body where bad burns occur, like the head and neck. The prognosis in BCC is usually very good because of its limited scope and metastatic inability.
Squamous cell carcinoma (SCC) is another type of nonmelanocytic skin cancer. It is the second most common type of skin cancer with over 1 million cases diagnosed annually in the US. It has a much higher mortality rate than BCC; SCC causes 15,000 patient deaths annually. Squamous cells are found on the outermost layer of the epidermis. It can be confusing because SCC can occur in other tissues of the body, other than skin. Sometimes, SCC of the skin is called cutaneous squamous cell carcinoma (CSCC) to differentiate the location. CSCCs can look like scaly red patches or sores with a central depressed area. These lesions can also bleed. Consistent, longer term sun exposure over one’s lifetime is has become an accepted etiology for the disease. The skin in the potential areas targeted for CSCC can show signs of sun damage including wrinkles, freckles, age spots, and loss of elasticity. It is believed that regular daily use of SPF 15 or higher will reduce the risk of SCC by up to 40 percent.
Melanoma is the last type of skin cancer that will be included here. Melanoma diagnoses have increased annually over the past decade to reach an expected 178,000 cases in 2018. Melanoma can be further categorized into “in situ”/noninvasive or invasive, meaning it has spread into the dermis (second layer of skin). Based on trending data, more than 9000 men and women are expected to die of melanoma this year. Unlike BCC and CSCC, melanoma can metastasize and if it is found in the lymph nodes or other organs, the survival rates decrease dramatically. There is still the belief that melanomas only arise within existing moles but this is incorrect. Studies show that only 20-30 percent of melanomas are found in existing moles with the remainder developing in normal skin without an existing mole. The risk of melanoma doubles if an individual has had more than 5 sunburns. Interestingly, the occurance rates of melanoma are higher in women under age 49 but in men, the diagnosis comes after age 55 and most often in Caucasians.
Indoor tanning is claimed to have contributed to the increase in skin cancers. In addition, we have a decreasing amount of ozone which has long protected humans and animals from damaging UV rays. The average life expectancy has also risen in men and women which can further be a factor in why skin cancer rates are rising.