SKIN CANCER
PREVENTION & IDENTIFICATION
1
A Look at Normal Skin
(~100 um)
(~1-4 mm)
What Is Skin Cancer?
An abnormal overgrowth (a tumor) of certain
types of skin cells in the epidermis that began as
normal skin structures.
A tumor can be either benign (generally localized
and not life-threatening) or malignant (invasive or
spreading, and may be deadly).
Skin cancer is a malignant tumor, able to invade
surrounding tissues and metastasize (or spread) to
other parts of the body, BUT…..
Is skin cancer deadly?
… it depends on the type of skin cancer,
and how or if it’s treated, as we’ll discuss in
this session.
What causes skin cancer?
Solar ultraviolet
(UV) radiatio may be the
main cause of skin cancer.
Artificially-produced UV radiation, such as
from sunlamps and tanning booths, also can
cause skin cancer.
Predisposition (genetics).
Chemicals (e.g., trivalent inorganic arsenic).
Ultraviolet radiation
UVB rays (290-320 nm) are more likely than
UVA rays (400-320 nm) to cause sunburn.
But, UVA rays pass deeper into the skin.
UVB radiation is thought to be the cause of
melanoma and other types of skin cancer.
UVA radiation may cause skin damage that can
lead to skin cancer and cause premature aging of
the skin.
Primary types
Pre-cancerous
-Actinic keratosis
Cancerous
-Basal cell carcinoma
-Squamous cell carcinoma
-Melanoma
-Others (of the specialized structures of the skin)
Actinic keratosis
A pre-cancerous condition of thick, scaly
patches of sun-damaged skin. Also referred
to as solar or senile keratosis.
Basal Cell Carcinoma
Basal cell carcinoma accounts for more than
90 percent of all skin cancers in the United
States.
It is a slow-growing cancer that seldom
spreads to other parts of the body, and
generally is readily treatable.
May erode into surrounding structures if not
treated.
Basal Cell Carcinoma
Three common presentations:
Small, smooth, pale, Firm, red lump A lump that bleeds or
or waxy shiny lump develops a crust
Squamous Cell Carcinoma
More than 250,000 new cases of squamous
cell carcinoma diagnosed each year.
Often develop from sun damaged areas
called solar or actinic keratosis.
Look similar to basal cell carcinoma, and
even actinic keratosis.
Squamous Cell Carcinoma
Similar in appearance to actinic keratosis
and basal cell carcinoma.
Melanoma
A form of skin cancer that arises in melanocytes,
the cells that produce pigment and also are found
in the epidermis.
Melanomas usually begin in a mole, which is a
benign cluster of melanocytes and other tissue.
Normal
moles:
Melanoma (the A-B-C and Ds)
Asymmetry -- The shape of one half does not match
the other.
Melanoma (the A-B-C and Ds)
Border -- The edges are often ragged, notched,
blurred, or irregular in outline; the pigment may
spread into the surrounding skin.
Melanoma (the A-B-C and Ds)
Color -- The color is uneven. Shades of black,
brown, and tan may be present. Areas of white,
grey, red, pink, or blue also may be seen.
Melanoma (the A-B-C and Ds)
Diameter -- There is a change in size, usually an
increase. Melanomas are usually larger than the
eraser of a pencil (5 mm or 1/4 inch).
Melanoma
May be found when a pre-existing mole changes:
Early changes
- forming a new black area
- newly formed fine scales
- itching in a mole
More advanced changes
- texture changes (becomes hard or lumpy)
- itch, ooze, or bleed
- usually do not cause pain
Who is at risk for skin cancer?
Light skin color, hair color, eye color.
Family history of skin cancer.
Personal history of skin cancer.
Certain types and a large number of moles.
Freckles, which indicate sun sensitivity and sun
damage.
Chronic exposure to the sun.
History of sunburns early in life.
How is it found?
Mostly by self examination of the skin
By observations by family members
By skin examination during visits to the doctor
To catch it early, you have to LOOK for it!…
and then you have to DO something about it!
How is skin cancer treated?
The physician will:
Determine what type it is (medical history,
examination, biopsy)
Determine how localized or extensive it is
Then treat it….
surgery (e.g., Moh’s, cryo, laser, curettage, grafts)
chemotherapy
radiation
How can it be prevented?
Pick your parents very carefully!
While genetics isn’t the primary factor, having your
parents keep you from getting sunburns as a child is
important.
Too late for that? Keep your kids from getting sunburns.
Too late even for that? (Try to) keep their kids from
getting sunburns.
And, limit further overexposure and damage to
your own skin.
Why?
Because ongoing, excess UV light is harmful even
for adults:
Probably leads to more skin cancer, plus….
Skin damage
Cataracts and other eye disorders
Immune system suppression
How to limit sun damage to skin?
Avoid exposure to the midday sun
(10 a.m. to 2 p.m. standard time, or
11 a.m. to 3 p.m. daylight saving time)
Wear protective clothing
(sun hats, long sleeves, long pants)
Apply and renew sunscreens
(those with an SPF of 15 to 30 block most of the
sun's harmful rays)
Use UVA- and UVB-blocking sunglasses
Watch the UV Index for your area
References
National Cancer Institute
(http://www.cancer.gov/cancerinfo/wyntk/skin#3)
Centers for Disease Control and Prevention, National Center for
Chronic Disease Prevention and Health Promotion
(http://www.cdc.gov/cancer/nscpep/skin.htm)
Environmental Protection Agency
(http://www.epa.gov/sunwise/uvindexcontour.html)
