SKIN CANCER PREVENTION & IDENTIFICATION

Why is skin cancer important?  the most common type of cancer in the United States  about 40 to 50 % of Americans who live to age 65 will be diagnosed with it  …. and it is largely preventable

What is skin cancer?  An abnormal malignant overgrowth of certain types of skin cells in the epidermis  May metastasize (spread) to other parts of the body

What causes skin cancer?  Solar ultraviolet (UV) radiation  Artificially-produced UV radiation, such as from sunlamps and tanning booths  Predisposition (genetics)  Chemicals (e.g. arsenic)

Ultraviolet radiation  UVB rays ( nm, shorter wavelength) are more likely than UVA rays ( nm, longer wavelength) to cause sunburn

UV exposure varies by day, time of day (10-3), latitude, and weather

Main skin cancer types: -Basal cell carcinoma -Squamous cell carcinoma -Melanoma

Basal Cell Carcinoma  A type of skin cancer that arises from the stratum basale of the epidermis

Basal Cell Carcinoma  78 % of all skin cancers  It is a slow-growing cancer that seldom spreads to other parts of the body and generally is treatable  Generally seen in areas not protected by clothing (ears, nose, chest, arms, neck)

Basal Cell Carcinoma Three common presentations: Small, smooth, pale, or waxy shiny lump Firm, red lumpA lump that bleeds or develops a crust

Squamous Cell Carcinoma  20% of skin cancers  Cancer that begins in squamous epithelial cells (nonmelanoma)  Usually on the face

Squamous Cell Carcinoma  Similar in appearance to basal cell carcinoma

Melanoma  2% of skin cancers  A form of skin cancer that arises in melanocytes  Melanomas usually begin in a mole, which is a benign cluster of melanocytes and other tissue Normal moles:

Melanoma  Melanoma is the deadliest form of skin cancer, causing more than 75% of all skin cancer deaths  Can occur in the colored part of eye (iris) (originates from melanocytes), usually occurs near existing moles

Melanoma (the A-B-C and Ds) A symmetry -- The shape of one half does not match the other

Melanoma (the A-B-C and Ds) B order -- The edges are often blurred; the pigment may spread into the surrounding skin

Melanoma (the A-B-C and Ds) C olor -- The color is uneven; shades of various colors

Melanoma (the A-B-C and Ds) D iameter -- There is an increase in size; melanomas are usually larger than the eraser of a pencil (5 mm or 1/4 inch)

Who is at highest 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

dysplastic nevi – more likely to become cancerous

Sunburns are common It is estimated that 32% of all adults & 40% of children in the US sunburn each year Basal cell carcinoma – increased odds with repeated exposure, the accumulation over years Squamous cell carcinoma – increased odds with a single blistering sunburn

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  chemotherapy  radiation

Excess UV Light Exposure Excess UV exposure leads to:  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

What else?  Don’t try to self diagnose!  Be sure your physician does a skin examination when you have a physical

References  National Cancer Institute (  Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (  Fitzpatrick, Thomas B., et.al., Dermatology in Medicine, 1971, McGraw-Hill Book Company, St. Louis  Saraiya M, Hall HI, Uhler RJ, Sunburn prevalence among adults in the United States, 1999, Am J Prev Med 2002 Aug; 23(2):91-7  Environmental Protection Agency (