May is national melanoma/skin cancer awareness month. It’s a good time to have an annual skin check of your full body if you are due or if you’ve never had one. This is recommended for all adults as prevention and screening for skin cancer. Skin cancer is the most common type of cancer diagnosed: each year, there are more skin cancers than breast, colorectal, prostate and lung cancers combined!
The 3 most common types of skin cancer are: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma. While BCC and SCC are more common in older individuals with sun damaged skin, melanoma can affect anyone regardless of age or sun damage. Having a skin check may also be very important if you have a family history of skin cancer and/or atypical moles.
BCCs often appear on sun exposed areas. They may grow rather slowly as red or pink patches or bumps. They are often pearly or translucent in appearance and may contain visible, fine blood vessels. BCCs may bleed very easily like when toweling off after a shower. Long standing lesions may appear indented or ulcerated in the center. While this cancer will not spread to other areas of the body, its most easily treated when small. So, detecting them early may make them easier to treat surgically or otherwise with less scarring.
SCCs are also usually on sun exposed areas, but may also occur on the genitalia. These cancers tend to grow more quickly, becoming red and scaly patches or plaques. They may even appear as thickened “horns” growing from the skin. While these lesions may not bleed easily, they continue to thicken and increase in size and may seem chronically “inflamed”. Some SCCs appear as very fast growing red, crusty nodules. Again, these cancers rarely metastasize, but are much easier to treat in the earlier stages when they are small.
Melanomas are the most deadly form of skin cancer. They are aggressive and grow very quickly. They can metastasize to other organs in the body which is why early detection is so critical. A person’s lifetime risk of having a melanoma is one in seventy. If you have a relative with melanoma, the risk is 50% higher, so early detection and regular exams are a must. Although rare, it can affect children. Each year, pediatric melanoma accounts for 1% of all melanomas diagnosed. Incidence increases with age: 1-2/million in age less than 10, 4.1/million in 10-14 year olds, and 16.9/million in 15-19 year olds. In this latter age group, melanomas account for 8% of all cancers diagnosed yearly. Some researchers believe that this is further evidence of the damaging effects of indoor tanning, which is common in teenagers and young adults.
Melanomas can appear on sun and non-sun exposed areas, even on digits and the bottoms of the feet. ABCDE is an anachronism to remember what to look for. A is for asymmetry: is one side a mirror image of the other? B is for borders: are they jagged or scalloped? C is for color: is there more than one color or is the color very dark? D is for diameter: is it larger than 6 mm (the size of a pencil eraser)? E is for evolving: is the mole changing in any way? If you answer “yes” to any of these questions when looking at you or your kids’ moles, you definitely need to make an appointment for further evaluation. Early detection leads to easier treatment and may just save your life!