Skin Cancer: Prevention and Early Detection James M. Eddy Texas A&M University

Skin Cancer: Facts and Figures Most common type of cancer in the US 1 million new cases diagnosed annually 1 out of 3 cancers diagnosed is skin cancer 40 to 50% of people who live to age 65 will have skin cancer at least once Melanoma is the most common cancer for year olds Since 1981 the incidence of melanoma has increased 7.1% annually Almost 100% curable if found early and treated properly

Your Skin The skin protects us against heat, light, injury, and infection Regulates body temperature and stores water, fat, and vitamin D Skin is the body’s largest organ The epidermis (outer layer of the skin) is mostly made up of flat, scale-like cells called squamous cells; and under these lie round cells called basal cells. The deepest part of the of the epidermis also contains melanocytes, which are the cells that produce melanin (which gives the skin its color).

Your Skin

What is Cancer? Cancer is a disease of some of the body's cells. Healthy cells that make up the body's tissues grow, divide, and replace themselves in an orderly way. Cancer is the result of normal cells losing the ability to limit and direct their growth. They divide too rapidly and grow without any order. Too much tissue is produced, and tumors begin to form.

Types of Tumors Benign tumors are not cancer. They do not spread to other parts of the body and are seldom a threat to life. Often, benign tumors can be removed by surgery, and they are not likely to return. Malignant tumors are cancer. They can invade and destroy nearby healthy tissues and organs. Cancer cells also can spread, or metastasize, to other parts of the body and form new tumors.

Types of Skin Cancer Carcinoma is cancer that begins in the cells that cover or line an organ. Basal cell carcinoma accounts for more than 90% of all skin cancers in the U.S. It is a slow-growing cancer that seldom spreads to other parts of the body. Squamous cell carcinoma rarely spreads, but does so more than basal cell carcinoma Both types are mainly found on areas of the skin that are exposed (head, face, neck, hands, and arms).

Types of Skin Cancer Malignant melanoma is heavily concentrated in moles Majority are black or brown, but may be skin colored, pink, red, or purple Most frequent locations are on the trunk, legs, arms, and on the scalp of men.

Symptoms Most common warning sign is a change on the skin, especially a new growth or a sore that doesn’t heal

Characteristic Feature Ordinary Moles Have ALL of these features Atypical Moles Have one or more of these features SHAPERound or OvalIrregular BORDER W/ SKINSharp. EvenUneven and/or fuzzy COLORUniform brown Two or more shades of brown or pink DIAMETERLess than 1 inch¼ inch or more SURFACE TEXTURE Smooth or Cauliflower Pebbled or bumpy IF MOLE IS RAISEDEven dome shape Flat edges with fried egg center

ABCDs of Melanoma Detection A – Asymmetry: one half unlike the other half. ABCDs of Melanoma Detection B – Border irregular: scalloped or poorly circumscribed border. C – Color: varied from one area to another; shades of tan and brown; black; sometimes white, red or blue. D – Diameter: larger than 6mm as a rule (diameter of a pencil eraser).

Cause and Risk Ultraviolet (UV) radiation from the sun is the main cause of skin cancer. UV is an invisible form of light that can penetrate and change the structure of the skin cells. Artificial sources of UV radiation, such as sunlamps and tanning booths, can cause skin cancer.

Increased Risk Regardless of race, the risk of developing skin cancer is elevated if you have ANY of the following risk factors: 50 or more ordinary moles Any atypical moles, even one History of any blistering sunburns, especially under age 20 Sun-sensitive skin which burns or freckles easily Personal or family history of any type of skin cancer Sporadic exposure of normally covered skin to strong sunlight Use of tanning salons

Skin TypeTanning and Sunburn History I Highest Risk Always burns Never tans Sensitive to sun exposure II Burns easily Tans minimally III Burns moderately Tans gradually to light brown IV Burns minimally Always tans to moderate brown V Rarely burns Tans profusely to dark VI Lowest Risk Never burns Deeply pigmented Least sensitive Skin Types

Protection Whenever possible, people should avoid exposure to the midday sun. Beware of reflective surfaces (eg. sand, water, concrete) which reflect more than half of the sun’s rays onto your skin. Sunglasses protect the eyes from UV rays, reduce the risk of cataracts, and protect the skin around the eyes.

Protection Apply sunscreen a MINIMUM of 30 minutes prior to sun exposure Use an SPF of 15 or higher Reapply every 2 hours (don’t forget the lips) Don’t forget to use on cloudy days Wear a wide-brimmed hat, long-sleeved shirt, and long pants when in the sun Tighter the weave = higher the SPF When wet garments lose 1/3 of their sun-protective ability You can purchase laundry additives that increase the SPF of your clothing

Guidelines for Outdoor Workers If possible move the outside job inside or to a shady location. Try to perform jobs that do not offer shade before 10am or after 3pm. Locate a shady spot for lunch breaks. Wear protective clothing that covers your skin. Long sleeved, closely woven, long pants Avoid clothes that you can see through. Bring along an extra shirt in case yours becomes wet. A collar will protect the back of the neck.

Guidelines for Outdoor Workers Wear a wide-brimmed hat and sunglasses. Wear at least a 3 inch wide brim that encircles the hat Use a hat with a flap in the back if your job requires a lot of bending. Hard hats can have a flap or extra brim fitted to them Wear sunglasses that filter out UV rays Apply sunscreen liberally to your entire body Reapply at morning break, lunch, and afternoon break You especially need sunscreen if your shadow is shorter than you are tall.

How to Do a Skin Self-Exam What you’ll need: Bright light, full-length mirror, hand mirror, two chairs, a blow dryer Examine the head and face, using one or both mirrors. Use blow dryer to inspect scalp. Check hands, including nails. In full length mirror, examine elbows, arms, and underarms. Focus on neck, chest, torso. Women: check under breasts.

How to Do a Skin Self-Exam What you’ll need: Bright light, full-length mirror, hand mirror, two chairs, a blow dryer With back to the mirror, use hand mirror to inspect back of neck, shoulders, upper arms, back, buttocks, legs. Sitting down, check legs and feet, including soles, heels, and nails. Use hand mirror to examine genitals.

Questions to Ask the Doctor Your doctor is the best person to ask any important questions you have about cancer. Some questions include: What types of treatment are available? Are there any risks or side effects of treatment? Will there be a scar? Will I have to change my normal activities? How can I protect myself from getting skin cancer again? How often will I need a checkup?

For More Info on Skin Cancer Contact GHM$ at or American Cancer Society at 800-ACS-2345 or American Academy of Dermatology – Cancer Information Service – CANCER Centers for Disease Control and Prevention – National Cancer Institute -