Skin Cancer & Precancers (Actinic keratoses)
Skin cancer, which is the most common form of cancer in the United States, is very treatable when detected early. Routine skin exams are a crucial tool in detection of skin cancer and are especially important for us living in Texas, where the mild weather makes it easy for us to be outdoors more of the year. Skin cancer can affect skin anywhere on the body, but most frequently appears on skin that is exposed to the sun. There are more than a million new cases of skin cancer in the United States each year.
Causes of Precancers and Skin Cancer
DNA damage that leads to actinic keratoses (precancers) and skin cancer is usually a result of exposure to UV rays from sunlight or tanning beds. In some cases, skin cancer affects areas of the skin that have not been exposed to the sun often or at all. Certain factors, such as fair skin, many moles, a weakened immune system (for instance due to medications used for organ transplant patients), heredity and age, also increase the risk of skin cancer.
Types of Skin Cancer
There are three major types of skin cancer. They are named for the different types of skin cells that become cancerous.
Basal Cell Carcinoma
Basal cell skin cancer is the most common type of skin cancer. It most often occurs in people with fair skin. It commonly occurs on areas of the skin that have been chronically exposed to the sun, such as the face. It rarely spreads to other parts of the body and is usually very treatable.
Squamous Cell Carcinoma
Squamous cell carcinoma occurs in the squamous cells. In people with fair skin, it usually occurs in sun-exposed areas such as on the face, head, ears, lip and neck. Actinic keratoses are considered precancerous, and if left untreated, may eventually develop into squamous cell carcinoma. Squamous cell skin cancer can rarely spread to other parts of the body.
Melanoma is the most potentially serious type of skin cancer, and the most likely to spread to other parts of the body. Melanoma occurs in the melanocyte (pigment) cells of the skin, and can form on any part of the body (including the scalp and soles!), regardless of past sun exposure. For this reason, regular skin exams are recommended to look at these areas.
Symptoms of Skin Cancer
Skin cancer is often identified as a new or changing growth on the skin of the scalp, face, lips, ears, neck, chest, arms, hands or legs. Although these are common areas for skin-cancer growths to form, they can occur anywhere, and manifest themselves as the following:
- Pearly or waxy bump
- Scaly red bump or nodule
- Firm, red nodule
- Crusted, flat red or brown lesion
- Large brown spot with darker speckles
- A mole that changes shape or color can also indicate skin cancer
Diagnosis of Skin Cancer
Dr. Black and Brooke Smart, FNP have the training and background necessary to identify different types of skin cancer to give you the best chance for a successful and curative treatment. To diagnose skin cancer, Dr. Black or Brooke will check the skin for any unusual growths or abnormal skin spots. If skin cancer is suspected, a biopsy is performed on the growth or area of skin in question. Once the results of the biopsy are reviewed, the type of cancer can be determined, and a treatment plan created. Those who develop new skin lesions or experience changes to existing moles or birthmarks should see a dermatologist as soon as possible; early detection is key in successfully treating skin cancer.
Treatment for Skin Cancer
Treatment for skin cancer depends on the type, size and location of the tumor. Dr. Black and Brooke Smart, FNP focus on prevention and treatment of skin cancers while attaining the best possible cosmetic result. Removal procedures are usually simple, requiring only a local anesthetic in an outpatient setting. Some of the treatment options for precancerous lesions and skin cancer include the following:
- Freezing – often used for precancerous actinic keratoses
- Surgical Excision under local anesthesia
- Curettage (scraping the tumor off the skin with a special instrument) followed by destruction of the skin cancer and a margin of skin with an electrosurgical device. This treatment is often used for small or superficial skin cancers on the trunk, arms and legs.
- Immune modulating topical creams
- Mohs surgery, which involves referral to a dermatologic surgeon trained in precise skin cancer removal with checking of the surgical margins in the same visit, often used for skin cancers on the face or ears.
- Depending on the stage and severity of the skin cancer, in addition to removal of the growth, referral to an oncologist, or chemotherapy, immune therapy or radiation may be recommended.
Prevention of Skin Cancer
Although not every case of skin cancer can be prevented, the best way to avoid it is to protect skin from the sun. Recommendations for preventing skin cancer include the following:
- Limit exposure to the skin, especially between 10 a.m. and 4 p.m.
- Always wear sun screen with an SPF of at least 30 an reapply often
- Wear a hat in the sun
- Wear long sleeves and long pants when possible
- Avoid tanning beds and salons
Performing routine self-exams to spot skin changes, and seeing a dermatologist or dermatology nurse practitioner or physician’s assistant for a full-body screening on a regular basis, is also recommended. Though much of our sun exposure occurs in our childhood and teens, living in Texas provides lots of opportunity for ongoing exposure to the sun, whether from golfing on the weekend, or just getting sun through the car windows every day. Dr. Black and Brooke Smart, FNP are committed to educating our patients about sun protection, which may include reviewing your skin care regimen and suggesting appropriate sunscreens and other topical products to prevent the damage that may lead to skin cancer.
Maintain your healthy skin by scheduling your regular skin exam with Dr. Black or Brooke Smart, FNP now at (972) 432-0300.