Skin cancer is the most common form of cancer in the United States.
1.3 million Americans will be diagnosed with skin cancer this year—over 99% can be cured if treated early enough. Exposure to the ultraviolet (UV) rays from the sun and a history of childhood sunburns are the main causes of many skin cancers. In some cases, skin cancer may be prevented. Skin cancer that is detected and treated early is very curable. North County Dermatology Clinic feels that skin cancer prevention and early detection are so important that they offer a thorough skin and mole check for every patient.
Please visit North County Dermatology Clinic’s Patient Education Library to learn more about skin cancer, skin cancer types, and skin cancer treatments.
- Skin Cancer Types
- Skin Cancer Risk Factors
- Clinical Examination
- At Home Self-Examination
- Prevention
- Treatment
Skin Cancer Types
There are many types of skin cancers.They are classified as nonmelanomas or melanomas. Basal cell carcinoma and squamous cell carcinoma are common nonmelanoma skin cancers. If left untreated, basal cell and squamous cell skin cancers can grow quite large and cause disfigurement when they grow on or near the eyes, nose or ears. Occasionally, these nonmelanoma skin cancers can be fatal if left unchecked. Malignant melanomas are fast growing and aggressive cancers which often originate in pre-existing moles. However, they also can arise in previously normal skin tissue. They can quickly spread to vital organs in the body and are more likely to cause death than nonmelanomas. More than 8,000 Americans die annually from malignant melanoma and the incidence continues to increase.
Actinic keratoses are pre-cancerous skin lesions commonly found on chronically sun exposed skin and appear as rough, scaly areas on the skin. They may be skin colored, pink, or red and may have a white crust. Actinic keratoses usually feel and look rough. Because actinic keratoses represent the early stages of squamous cell carcinoma, they need to be removed in a short simple in-office procedure. Once these pre-cancerous lesions progress to a squamous cell carcinoma, a more involved surgical procedure will be required.
Rest assured that Dr. Timothy Knight and his professional staff are experts at diagnosing and treating skin cancer. Fortunately, most skin cancers that are diagnosed and treated early are curable. We encourage you to contact us when you notice any suspicious change in your skin, even if it is not “bothering” you. Most skin cancers will not “bother” you with itching, discomfort, pain, etc. However, it is important to realize that although the cancers cause no symptoms they are nonetheless a threat to your health.
We are happy to set you up with a regular skin cancer screening schedule based on your individual history and needs.
Please visit our North County Dermatology Clinic’s Patient Education Library to learn more about skin cancer, skin cancer types, and skin cancer treatments.
Skin Cancer Risk Factors
Risk factors may increase your likelihood of skin cancer, although some people that experience skin cancer may not have any risk factors. People with all of the risk factors may never develop skin cancer; however, the likelihood increases with the more risk factors you have. Make sure to tell Dr. Knight about the risk factors that you have. He is happy to discuss your concerns.
Risk factors for skin cancer:
- Light colored skin, blue or green eyes, blonde hair, and red hair (People with darker complexions may get skin cancer as well, but they have a lower risk.)
- Spending a lot of time in the sun, such as construction workers, farmers, lifeguards, sunbathers, and outdoor enthusiasts
- Receiving multiple severe sunburns in childhood or as a teenager
- History of skin cancer
- Cigarette smoking
- Exposure to cancer causing chemical agents, such as oils, tars, and arsenic (used in some herbicides)
- Skin injuries from burns or friction
- Suppressed immune system, such as organ transplant recipients or people with HIV/AIDS
- Not wearing a sunblock for UVA and UVB rays
- Increased age (Most cases of skin cancer develop in older adults, but it can certainly develop in younger people.)
- Easily sunburned
- Multiple moles
- Freckled skin
- Use of artificial tanning lights or booths
- Genetic predisposition to skin cancer. If your close relatives have skin cancer, you have an increased risk for developing it
- Excessive exposure to X-rays or other forms of radiation
- People with the human papilloma virus (HPV) have an increased risk of developing squamous cell carcinoma
- Receiving radiation treatment in the 1950s for acne
- Actinic keratoses (pre-cancers)
- Exposure to psoralen and ultraviolet light used to treat psoriasis
Clinical Examination
North County Dermatology Clinic is committed to preventing and diagnosing skin cancer early. Our highly trained specialists offer a thorough skin examination for new patients and established patients on a regular basis. We will carefully look for changes in your skin, moles which appear suspicious and other lesions (growths) that are indicative of skin cancer.
At Home Self-Examination
Try to exam your skin at home on a regular basis to look for signs of changes in moles and any new growths or lesions. Also, any “sore” which does not heal within three weeks should be seen by your dermatologist.
Most skin cancers will not “bother” you with itching, discomfort, pain, etc. However, it is important to realize that although the cancers cause no symptoms, they are nonetheless a threat to your health.
The ABCD method is useful when examining growths or moles on your skin for cancer related changes. Look for:
A- Asymmetry: One half does not match the other half
B- Border Irregularity: There are uneven, notched, ragged, or irregular edges
C- Color: There may be different shades of tan, brown, black, red, blue, or white
D- Diameter: Larger than ¼ inch across. However some melanomas begin smaller
E- Evolving or Enlarging: any change in appearance.
If you notice a suspicious area of skin or have any concerns about changes in your skin, it is important that you call our Polk County, Florida dermatology office promptly to schedule an examination. In most cases, skin cancer that is diagnosed and treated early is associated with the best outcomes.
Prevention
North County Dermatology Clinic offers these tips:
- Perform a full body skin examination each month. Report any concerns to our office promptly.
- The American Cancer Society recommends a yearly skin examination by a qualified professional every year after the age of 40, and every three years for people ages 20-40. If you have a history of skin cancer or actinic keratoses, we may recommend more frequent skin examinations.
- Wear sunblock that blocks both UVA and UVB rays and has an SPF of 30 or greater. Dr. Knight recommends the new generation of physical sunblocks containing micronized titanium dioxide and zinc oxide. EltaMD and Solbar Gel suncreens are available for purchase in the office.
- Limit the amount of time you spend in the sun. Wearing sunblock and sunscreen may reduce your risk of skin cancer.
- Try to avoid being in the sun between the hours of 10 AM and 4 PM, when the sun’s rays are the strongest.
- Wear sunblock and sunscreen even in the winter months.
- Wear sunglasses that block UVA and UVB rays since malignant melanoma can also occur on the colored part (iris) of the eye or other parts of the eye.
- Avoid tanning from sunlight or tanning lamps or booths. Remember, tanning is a response to damage of the DNA in your skin cells by ultraviolet light. There is no safe tan.
- Teach children to protect their skin from the sun.
- Wear a broad brimmed hat. The brim needs to be at least four inches wide. There are a wide variety of hats on the market today made especially to block the sun. Catalogs for sun protective hat and clothing are available in the office.
Treatment
Most skin cancers that are detected and treated early have very good cure rates. If a skin cancer is suspected, a small piece of tissue (biopsy) will be removed and sent to a laboratory for microscopic examination to confirm the presence and type of skin cancer. If the biopsy shows skin cancer (malignancy), the goal of treatment is to remove all of the cancer cells. The type of treatment that you receive depends on the type, size, location, and stage of your cancer.
The following skin cancer treatments can take place at North County Dermatology Clinic:
- Excision is the preferred method for the removal of all skin cancers and offers the highest cure rate. After the skin cancer is removed, the specimen is sent for pathology examination to determine if all cancer cells have been removed. All skin cancer surgeries are performed under local anesthesia in our office.
- Curettage is another surgical procedure where the skin cancer is scraped out without the use of sutures. In certain situations, this method may be necessary but it is not ideal because there is no way for the pathologist to check if the margins are clear and the resultant scar is not as cosmetically appealing.
- Prescription chemotherapy creams may be applied to the skin daily to treat pre-cancers and certain superficial skin cancers.
- PDT (Photodynamic Therapy) is an in office procedure involving application of a chemical (levulenic acid) and exposure to either red or blue LED light.
If the biopsy shows pre-cancerous cells only, then cryosurgery using liquid nitrogen can be used to freeze and kill pre-cancer cells. This method is not recommended for treating skin cancer, except in rare instances. Actinic keratoses may also be treated with 5-flurouracil cream (Efudex, Carac) especially if the AKs are very numerous. This treatment requires special instructions, precautions and frequent follow-up at the clinic.
