By: Dr. James Lee
Last month we discussed Melanoma Awareness, but May was also Awareness month for other skin cancers and safe sun. Skin cancer is the most common of all human cancers. Skin cancer is diagnosed in 3 million Americans each year. The number of skin cancers annually is estimated to be 5.4 million, indicating that many people are diagnosed with more than 1 skin cancer in a year. However, if caught early can be easily treated and only accounts for less than 1% of all cancer deaths. The two most common types of non-melanoma skin cancers are basal cell carcinoma and squamous cell carcinoma.
Basal Cell Carcinoma is the most common, accounting for 80% of these cancers. They arise from the basal layer of the epidermis (skin) and usually develop on sun-exposed areas like the face, head, and neck. They grow slowly and rarely spread to other parts of the body. However, if left untreated basal cells can grow into nearby areas and invade bone and other tissues beneath the skin. The treatment is surgical removal with a margin of normal tissue where there are no residual cancer cells (negative margin).
Squamous cell carcinoma arises from the outer part of the epidermis. These also occur on sun-exposed areas of the body including the neck, ears, face, lips, and the back of hands. They can also develop from actinic keratosis, which is a rough, scaly area on the skin related to sun-damage. Squamous cell carcinoma may also develop in chronic wounds or areas of the body exposed to other types of radiation. Like basal cell carcinoma, squamous cell carcinoma is treated with excision with negative margins. However, squamous cell carcinoma has a greater tendency to grow into deeper layers of the skin and can spread to lymph nodes and other parts of the body if left unchecked.
The primary risk factor for basal and squamous cell carcinoma is, of course, UV exposure, either natural sunlight or tanning beds. Older individuals are more at risk due to the buildup of UV exposure over time. Light colored skin that freckles, blue or green eyes, and naturally red-or blond-haired individuals have greater risk because melanin, the dark skin pigment, is protective in people with darker skin. Traditionally males are at greater risk, presumably due to more sun exposure. Exposure to coal tar, petroleum products, and arsenic also increased the risk. Other risk factors include prior skin cancers, radiation treatment, severe skin inflammation, psoriasis, and Human papillomavirus (HPV) infections.
As with other cancers, early detection is associated with better outcomes and survival. Skin surveillance monthly at home to identify any skin lesions that are new, getting larger, or otherwise changing is key. Any concerning lesion should be brought to the attention of your doctor. For those with a history of skin cancer, regular physician examinations for recurrence or new skin cancers are important and should occur every 6 to 12 months.
Prevention is primarily to limit exposure to UV rays. “Slip! Slop! Slap! . . .and Wrap” is an easy reminder of ways to protect yourself from sun exposure. Slip on a shirt. Slop on Sunscreen, at least SPF 30, but 45 and 50+ are better. Slap on a hat, especially a wide-brimmed hat that protects your ears and neck as well as your face. Wrap around sunglasses will protect your eyes and the sensitive skin around them. Children require special consideration because they spend more time outdoors and burn easily. The risk of later skin cancer increases with each sunburn before the age of 18. Sunscreen should be reapplied every 2 hours and if possible, avoid the sun between 10-2:00 when the UV index is highest.
Dr. James Lee serves as the Coroner of Winn Parish. He is a General Surgeon and Surgical Oncologist who has been practicing in Winnfield for over ten years. Dr. Lee attended the University of Colorado for his medical degree. He completed his residency in Surgery at the University of Oklahoma before completing a fellowship in Surgical Oncology and Endoscopy at Roswell Park Cancer Institute in Buffalo, NY. Dr. Lee and his wife Scarlett live in Winnfield with their son and are active in the community.