Keeping Skin Cancer at Bay

There are many measures you can take to protect yourself from skin cancer.

When John's wife first noticed an unusual patch of skin on his scalp, he and his wife did not think much of it. But after seeing photos of skin cancer in a magazine, she took another look.

"She handed me the phone and forced me to call the doctor right then," recalls John, 45. It is a good thing she was so insistent. That patch turned out to be basal cell carcinoma, a rarely fatal, but common type of skin cancer.

According to the American Cancer Society (ACS), skin cancer is the most common type of cancer. The most common types of skin cancer are basal cell or squamous cell carcinoma. Another type is melanoma, which is a rare, but more deadly form of skin cancer.

How Aging Influences Skin Cancer Risk

Skin cancer is a particular concern for older adults, who have had more years of sun exposure. Men are also more likely to develop skin cancer because they are more likely to have worked and played outside than their female counterparts. The skin cancers we see today are often due to sun exposure many years or decades ago.

Basal and squamous cell cancer tend to result from years of prolonged exposure to the sun. Melanoma, on the other hand, can be found in both sun-exposed and non-exposed tissue. In rare cases, it can form in the eyes or mouth. More commonly, this type of skin cancer affects the chest and back in men and the legs in women. Unlike basal cell and squamous cell carcinomas, melanoma is much more likely to spread to other parts of the body. That is why it is so important to detect this type of skin cancer early.

Because skin cancer, like all cancers, takes a long time to develop from the single mutated cell to the changes we can actually see, skin cancer is a disease most often seen in older adults. Skin cancer seen in children is particularly worrisome because it may indicate that a genetic defect predisposes them to all types of cancers.

While melanoma may be the most frightening variation of the disease, the majority of skin cancers are found to be either basal cell or squamous cell carcinoma. Both of these types affect older people at higher rates, and both have excellent survival rates if an early diagnosis is made and treatment is started early.

Treatment Options

After being diagnosed, patients are typically referred to a dermatologist who will remove the lesion. From there, it is sent to a lab for testing. If cancer is present, a treatment plan will be worked out.

During his initial visit, John's dermatologist examined his whole body, surgically removed the patch on his head using local anesthesia, and used liquid nitrogen to treat several other pre-cancerous areas on his scalp, face, and chest. These pre-cancerous lesions may also be treated with certain creams.

After the lab biopsy confirmed that John had basal cell carcinoma and that the entire lesion had been removed, his dermatologist asked him to return in 6 months.

Surgical removal is the common approach for skin cancer. It is most often handled on an outpatient basis by a dermatologist or a surgeon. However, larger lesions or those found to be melanoma may require additional treatment. Melanoma, for example, may be treated with chemotherapy, other drug therapies, or radiation therapy.

Skin cancers around particularly sensitive structures—the fold of the nose, the eyelid, the corner of the mouth, and the lining of the ear—can lead to a poor cosmetic outcome if removed by surgery. Radiation therapy can be as successful as surgery in preventing the tumor from returning while sparing the removal of tissue and the scarring that occurs.

Prevention

Although skin cancer is rarely fatal, even the nonfatal forms can result in pain and scarring. They also often occur on the face, the last place on the body you want to have a large—or even small—area of skin removed. That is why it is so important to practice preventive measures.

The ACS recommends the following steps to prevent skin cancer:

• Wear clothes, like long-sleeved shirts and long pants, that will protect you from the sun. Some companies even design clothes that have a high sun protection factor.
• Wear a hat that has a 2-3 inch brim.
• Wear wrap-around sunglasses that block ultraviolet rays (UVA and UVB).
• Use sunscreen that has a sun protection factor (SPF) of 30 or more. Follow the directions for applying the product. It may need to be reapplied every 2 hours. Also, use a lip balm that protects you from the sun.
• Limit outdoor activities between 10:00 am and 4:00 pm, when the sun is strongest.
• Do not go to tanning salons or use sunlamps to darken your skin.

You can also take a proactive role by checking your skin for any changes. If you notice a new lesion or mole, or one that looks different in any way (size, shape, texture, or color), call your doctor for an evaluation.

Revision Information

• Reviewer: Michael Woods, MD
• Review Date: 10/2016
• Update Date: 10/21/2016