February 15, 2013                  Issue #6

Skin cancer is one of the most common types of cancer. There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Risk of all types of skin cancers increases with more sun exposure.

Basal cell and squamous cell are the most common types and they also tend to be the easiest to treat. In general, they don’t spread. They mostly grow locally and infiltrate the surrounding tissue. They should be removed as soon as possible to avoid destruction of the nearby structures. Basal cell carcinoma and squamous cell carcinomas tend to occur in sun exposed areas of skin (i.e. face, neck, ears, arms, hands). Basal cell and squamous cell carcinomas generally don’t require chemotherapy or anything, they just need to be removed. Most skin lesions that are smaller than an inch or so in size can be removed in the office easily and quickly.

Basal cell carcinomas tend to look like a raised bump that is purple or pearly in color compared to the nearby skin. They grow relatively slowly (compared to other cancers) and will oftentimes scab and bleed for seemingly no reason. They can look like “sores” that just never fully heal up.

Squamous cell carcinomas tend to be flatter and might look like an inflamed scar. They can be quite irregular and hard to discern their edges from the nearby normal skin. They also tend to scab over and bleed for seemingly no reason.

Melanoma is the really bad type of skin cancer. It does tend to spread far and fast and it carries a high mortality rate. It usually looks like a dark, flat mole that rapidly grows/changes. Unlike Basal cell and squamous cell cancers, melanomas don’t always occur in sun-exposed areas. I have seen or heard of cases where melanomas have occurred between the toes, in the genitalia or even in the eyes. They can occur anywhere on your body, so if you see a rapidly-changing mole anywhere, please don’t hesitate to have it evaluated by a physician. It’s better to be safe than sorry because the survival rate for melanomas is strongly correlated with early detection and removal.

To prevent skin cancer you should avoid tanning beds, avoid repeated sunburns and when you do go out in the sun for prolonged periods of time, protect the exposed skin with a 30 spf or higher SunBlock.

So what should you look for? The warning signs for skin cancer are as simple as ABCD:

A: Asymmetry- a lesion is suspicious if it appears asymmetric in color or shape. Benign skin lesions tend to be oval or round and symmetric with uniform coloration.

B: Border- a lesion is suspicious if it has an irregular border or it’s difficult to tell exactly where the lesion ends and normal skin begins. Benign skin lesions tend to have very sharp and regular borders and it’s easy to tell where the mole ends and normal skin begins.

C: Color- a lesion is suspicious if it has variations in color or asymmetric color. For instance, if it is mostly brown but has a dark blue circle in it, or if it is very black in color, these are warning signs. Benign lesions tend to be very uniform in color and tend to be light brown or tan in color.

D: Diameter > 6mm- a lesion is suspicious if it is larger than 6mm in size (approx. ¼ of an inch). Benign lesions tend to be smaller than 6mm in diameter.

There are no hard-and-fast rules when it comes to skin lesions. It’s always best to have a trained eye look at any lesion you think is changing/growing or any lesion that has one or more of the above ABCD features.