Skin Cancer Awareness

Detection and Self Examination

As well as using a broad-spectrum sunscreen with SPF 15 or higher, a yearly scheduled full-body exam by your dermatologist is key to prevention. Melanoma can occur on parts of the body that are not exposed to the sun.

It takes a trained eye to spot a melanoma in its early stage. You should also examine yourself regularly. The best time to do this is after a bath or shower standing in front of a full-length mirror. Use a hand mirror to help you see difficult to reach areas. Contact your Doctor at once if you see any odd-looking mole.

• Skin Cancer and Melanoma Facts
• High Risk Individuals
• A Guide to Skin Cancers
• ABCD of Skin Cancer
• Self Exam

Skin Cancer and Melanoma Facts

• Over half of all new cancers are skin cancers.
• More than 1 million new cases of skin cancer will be diagnosed in the United States this year.*
• About 79 percent of the new skin cancer cases will be basal cell carcinoma, 15 percent are squamous cell carcinoma, and 5 percent are invasive melanoma. The other 1 percent represents rare types of skin cancer, such as Merkel cell carcinoma, adnexal carcinoma(s), dermatofibroma fibrosarcoma protuberans, etc.
• Both basal cell carcinoma and squamous cell carcinoma have a better than 95 percent cure rate if detected and treated early.
• An estimated 10,590 people will die of skin cancer this year, 7,770 from melanoma and 2,820 from other skin cancers.*
• There will be about 105,750 new cases of melanoma in 2005 - 46,170 in situ (noninvasive) and 59,580 invasive (33,580 men and 26,000 women).* This is a 10 percent increase in new cases of melanoma from 2004. In 2005, at current rates one in 34 Americans have a lifetime risk of developing melanoma and one in 62 Americans have a lifetime risk of developing invasive melanoma.
• One American dies of melanoma almost every hour (every 68 minutes). In 2005, 7,770 deaths will be attributed to melanoma - 4,910 men and 2,860 women.* Older Caucasian males have the highest mortality rates from melanoma.
• The incidence of melanoma more than tripled among Caucasians between 1980 and 2003.
• More than 73 percent of skin cancer deaths are from melanoma.
• Melanoma is more common than any non-skin cancer among women between 25 and 29 years old.
• Invasive melanoma is the fifth most common cancer in men and the sixth most common cancer in women.* **
• 1 in 5 Americans will develop some form of skin cancer during their lifetime.
• Five or more sunburns double your risk of developing skin cancer.

*Source: American Cancer Society's 2005 Facts & Figures
**Excluding basal cell carcinoma and squamous cell carcinoma, which together are the most common cancers in both sexes.
* Information taken from American Academy of Dermatology www.aad.org

High Risk Individuals

Despite the importance for everyone to practice sun safe practices, some individuals are at a higher risk of developing skin cancer. These risks include:

• Light hair color and blue, gray or green eyes.
• Fair complexion and/or freckles.
• Sun sensitivity (skin that burns easily).
• Taking prescription medications that increase sun sensitivity.
• Family history (one or more close relatives with skin cancer).
• Several moles on your body.
• Presence of a congenital mole (since birth).
• One or more large or irregularly pigmented lesions.
• Suppressed immune system.
• Exposure to certain chemicals, such as arsenic, and to radiation therapy.
• Excessive exposure to the sun and repeated blistering sunburns before the age of 15.

*Information taken from the Cancer Research and Prevention Foundation www.preventcancer.org

A Guide to Skin Cancers

Skin cancer is an important issue and one that we should be aware of and educated about. Skin cancer is not only a threat to our appearance but also to our lives. Examining our skin regularly is the best way to detect any early warning signs. Most of the "spots" on our skin-freckles, moles, and birthmarks-are normal, but some may be skin cancers. It is important to look for any new growths or changes when examining our skin.

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common skin cancers, affecting more than 1.3 million people in the United States each year. Both are caused primarily by long-term sun exposure and typically appear in those areas that are exposed to the sun. The rim of the ear and the lower lip are especially susceptible to SCC.

Skin damaged by factors other than the sun may also be vulnerable to both cancers. These factors include burns and scars, open sores that resist healing, inflammatory skin conditions, and areas exposed to radiation or chemicals such as arsenic and petroleum by-products.

BCCs and SCCs are easily treated when they are detected at an early stage. However, the larger a tumor grows, the more dangerous and potentially disfiguring it may become and the more extensive the treatment must be While BCCs seldom spread to vital organs, they can cause major damage-even the loss of an eye, ear, or nose. Certain rare forms can become lethal if not treated promptly.

In general, SCCs are more threatening than BCC's and have a much greater chance of spreading and becoming life threatening if untreated.

Five Signs of BCC

These are the five most typical characteristics of BCC. Frequently, two or more of these features appear in the same tumor.

1. A shiny bump or nodule, that is pearly or translucent and is often pink, red or white. The bump can also be tan, black or brown, especially in dark haired people, and can be confused with a mole.
2. An open sore that bleeds, oozes, or crusts and remains open for 3 or more weeks. A persistent, nonhealing sore is a very common sign of an early basal cell carcinoma.
3. A scar like area that is white, yellow or waxy and often has poorly defined borders. The skin itself appears shiny and taut. Although a less frequent sign than others, it can indicate the presence of an aggressive tumor.
4. A pink growth with a slightly elevated rolled border and a crusted indentation in the center. As the growth slowly enlarges, tiny blood vessels may develop on the surface.
5. A reddish patch or irritated area frequently occurring on the chest, shoulders, arms or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no noticeable discomfort.

Four Signs of SCC

SCCs usually appear as thick, rough, scaly patches that may bleed if bumped. The skin around them typically shows signs of sun damage such as wrinkling, pigment changes, and loss of elasticity. They often appear as:

1. A wart-like growth that crusts and occasionally bleeds.
2. An open sore that bleeds and crusts and persists for weeks.
3. A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds.
4. An elevated growth with a central depression that occasionally bleeds. It may rapidly increase in size.

ABCDs of Melanoma

Melanoma is the deadliest form of skin cancer. It is most often caused by intense, intermittent exposures to the sun-especially exposures that occur before age 18. In the past two decades, as outdoor recreational activities have increased and fashions have left more skin exposed, melanoma incidence rates have more than tripled. In its earliest stages, melanoma is readily treatable. Left untreated, it will spread to vital organs, frequently becoming life threatening.

Most people have some brownish spots or growths. Almost all of these are normal. But growths that change noticeably in size or have irregularities in shape and color could be melanomas.

It is important to check the skin from head to toe every month, staying alert for lesions that have the "ABCD" signs of melanoma: Asymmetry, Border irregularity, Color variability, and Diameter larger than a pencil eraser.

Asymmetry
One half doesn't match the other half.


Border Irregularity
One half doesn't match the other half.


Color
The pigmentation is not uniform. Shades of brown. tan and black are present. Dashes of red, white and blue add to the mottled appearance.


Diameter
The width is greater than 6 millimeters (about the size of a pencil eraser). Any growth of a mole should be of concern.

Reproduced with the permission from the American Academy of Dermatology.

Asymmetry- Most melanomas are asymmetrical: A line through the middle would not create matching halves. Common moles are round and symmetrical.

Border Irregularity- The borders of early melanomas are often uneven and may have scalloped or notched edges. Common moles have smoother, more even borders.

Color Variability- Varied shades of brown, tan or black are often the first sign of melanoma. As melanomas progress, the colors red, white, and blue may appear. Common moles usually are a single shade of brown.

Diameter- Early melanomas tent to grow larger than common moles-generally to at least the size of a pencil eraser

Self Examinations

PRACTICE FREQUENT SELF-EXAMINATIONS
REMEMBER: PROMPT SURGICAL EXCISION OF AN EARLY MELANOMA OFFERS AN EXCELLENT CHANCE OF A CURE. IF YOU HAVE ANY QUESTIONS ABOUT A MOLE, SEE A DERMATOLOGIST.

	Examine your body front and back in the mirror, then right and left sides with arms raised.
	Bend elbows and look carefully at forearms, upper underarms and palms.
	Look at the backs of your legs and feet, the spaces between your toes and on the sole.
	Examine the backs of your neck and scalp with a hand mirror. Part hair for a closer look.
	Finally, check your back and buttocks with a hand mirror.

* Information Taken from American Academy of Dermatology www.aad.org