The Most Common Cancer Can Be Prevented

Peter K. Lee, M.D., Ph.D.

Skin cancer, the most common type of cancer, will affect more than one million Americans this year. The incidence of skin cancer, generally grouped into non-melanomas and melanomas, has been increasing over the past few years. When detected in its earliest stages and treated properly, however, it is highly curable.

There are many types of non-melanoma skin cancers, but two types are most common: basal cell carcinoma and squamous cell carcinoma.

Basal cell carcinoma accounts for about 80 percent of all skin cancers. A slow growing cancer that does not tend to spread, it can badly damage the skin. If left untreated, moreover, basal cell cancer may spread to nearby cartilage or bone. Basal cell carcinoma typically begins as a pink or pearly white area, which may later form an ulcer or bleed.

Squamous cell carcinoma is more aggressive and is more likely to spread beneath the skin, particularly to the lymph nodes and internal organs. Squamous cell cancers begin as raised red scaly areas that persist over months.

Melanoma, the least common but most deadly type of skin cancer, originates in skin cells that produce the dark, protective pigment called melanin. Melanin makes skin tan and acts as partial protection against the sun. Melanoma cells usually continue to produce melanin, which explains why melanomas appear in shades of tan, brown, and black. Usually melanomas have an irregular shape and ill-defined borders. The disease may begin in a pre-existing mole or may arise as a new brown lesion. It tends to spread to other parts of the body. Like basal cell and squamous cell carcinomas, melanoma is almost always curable when detected in its early stages.

Most people have moles and almost all moles are harmless. But it is important to recognize changes in a mole. Do self-exams and tell the physician or dermatologist about new moles or changes in the size, color, texture, or shape of existing moles or other dark pigmented areas.

The risk of developing skin cancer appears to be directly related to a person's exposure to the sun's ultraviolet (UV) radiation. To reduce risk, wear a sunscreen with a sun protection factor of at least 15 that protects against ultraviolet A and B light. Sunscreen should be used daily on exposed skin of the head, neck, hands, and arms. Wearing protective clothing like hats with a wide brim and clothing with a sun protective factor while outdoors can also reduce your UV radiation exposure.

Other risk factors for skin cancer include exposure to artificial UV radiation from indoor tanning beds or X-rays, having fair skin that burns or freckles easily, previous severe sunburns, and prolonged exposure to pesticides or other chemicals. Also, a person who has had one skin cancer is more likely to develop a new skin cancer. People with a history of skin cancer should be examined by a dermatologist at least once a year. The American Cancer Society also recommends a skin examination every three years for people between 20 and 40 years of age, and every year for those age 40 and older.

Most skin cancers can be effectively treated with surgery. Other treatments include radiation therapy, chemotherapy, and immunotherapy. Researchers continually look for ways to improve skin cancer treatment. For example, my colleagues and I are among a small number of surgeons who have been professionally trained to perform a new kind of surgery unique to skin cancer. Mohs Surgery, which uses smaller incisions than traditional surgery, treats aggressive skin cancer and cancer in sensitive areas, such as the nose, eyelids, or anywhere on the face. Other University researchers are also testing a promising new therapy that uses a patient's own cancer cells to create a vaccine in order to prevent skin cancer recurrence.

Peter K. Lee, M.D., Ph.D., is an assistant professor of dermatology, director of the Melanoma and Pigmented Lesion Clinic, director of the Cutaneous Surgery and Laser Center, and a member of the University of Minnesota Cancer Center.To learn more about skin cancer, visit www.cancer.umn.edu or call the toll-free information line at 1-888 CANCER MN (1-888-226-2376) or 612-624-2620 in the metro area. This column is an educational service and advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalkandyou.com/.