Skin cancer is a problem that many of its sufferers do not expect themselves to get.
While we have been subjected to believe that it’s all “fun in the sun” – the truth is that being overexposed to the sun without adequate protection can be extremely harmful to our skin.
It is not just those whose work or lifestyle revolves around the sun that needs to be aware about skin cancer – but anyone who leaves their home and wants to protect their skin in the long term.
So, without further ado, here are 12 frequently asked questions to help you understand more about this often-neglected, yet most preventable type of cancer.
What is skin cancer?
All cancers are caused when the DNA inside our cells are damaged.
In the case of skin cancer – the DNA inside the skin cells specifically are damaged –resulting in a malignant growth that develops on the outermost layer of the skin.
Thankfully, this means that the tumors are often noticed and quickly diagnosed; although this is not always the case. Skin cancer can also present itself in a pre-existing mole, or a new mole that appeared out of the blue.
There are varying types of skin cancer that differ in their potency as well as potential to spread and worsen.
What are the different types of skin cancer?
The three most common types of skin cancer that doctors see are Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and melanoma. They each have specific characteristics and effects on the skin:
BCC: Most common type of skin cancer that develops in the deepest layer of the epidermis. Often mistaken for a sore that does not heal – it shows up as a raised, smooth, and shiny bump on the skin that can crust or bleed. This form of skin cancer is the least deadly type and does not spread anywhere else in the body.
SCC: The second most common type of skin cancer that develops in the upper layers of the epidermis. It appears as a red, scaly, and thickened patch on the skin that looks similar to an ulcer. Usually the result of prolonged sun exposure over the course of someone’s life – it can develop into a large mass that has the potential of spreading into the lymph nodes and other organs.
Melanoma: The most aggressive type of skin cancer that develops in pigment-producing cells. It appears as a mole or pigmentation that spreads beyond the borders of a typical mole or growth that can appear anywhere on the skin – even in areas that do not see regular sun exposure. It is most likely to spread to other parts of the body such as the lymph nodes – and thus requires early diagnosis and treatment.
On top of BCC, SCC, and melanoma – there are also rarer forms of skin cancer, including Merkel Cell Carcinoma, Kaposi Sarcoma, and Cutaneous T-Cell Lymphoma.
What causes skin cancer?
The dominant cause that underlines all skin cancer cases is due to extensive and cumulative ultraviolet (UV) exposure – a proven human carcinogen.
In fact, a UK study found that 86% of all melanoma cases is attributed to the exposure of UV radiation from the sun!
When our skin is constantly being exposed to harmful UV radiation without protection – there comes a point when it is unable to sufficiently repair the damage; causing the cells to grow and divide in an uncontrolled manner and eventually developing into a tumor.
Because it is hard to see or feel UV radiation – skin cancer can quickly develop without you knowing.
Who is at risk of skin cancer?
Remember: skin cancer can happen to anyone.
However, there are certain people who are at a higher-risk of getting skin cancer, and they are:
- People who are fair skinned
- People who have a history of extensive sun exposure
- People who have a tendency to freckle or sunburn easily
- People who have numerous moles on their face and body (typically more than 50)
- People who have a family medical history of skin cancer (which doubles your risk)
- People who have had skin cancer before
- People with a weakened immune system (due to previous organ transplants, HIV patients etc.)
Thus, it is safe to say that skin cancer is caused by a combination of genetic, external, and environmental factors.
Can dark-skinned people get skin cancer?
While it is true that people with darker skin tones are less likely to get skin cancer – due to the fact that they produce more melanin that helps to protect the skin – there is always still a possibility.
In fact, it has been shown that melanoma tends to be more deadly in people of color – with multiple studies showing that as compared to fair-skinned people, dark-skinned people are more likely to die from skin cancer2.
What is the best way to diagnose skin cancer?
There are several actions that a doctor can take in order to assess your skin for any suspicious lesions. One of them is a simple physical examination using a dermascope; however, a visual inspection is simply not enough to ensure an accurate diagnosis.
By far the most precise way of detecting skin cancer is via a biopsy – whereby a doctor uses a thin, sharp blade to shave off either part or all of an abnormal growth. A shave or excisional biopsy can be performed; depending on whether melanoma is suspected. The removed skin is then examined under a microscope and tested to rule out any skin cancer.
If the lesion is confirmed to be malignant – your doctor will then discuss with you the next best steps to take in terms of treatment.
Can skin cancer be cured?
In short, the answer is yes.
A range of treatments are available to patients; including topical creams, cryotherapy, photodynamic therapy, and radiotherapy in an effort to destroy cancer cells – although they aren’t usually recommended if surgery is done.
Generally, majority of skin cancers are treated by surgical removal in order to completely remove the growth and prevent recurrence. Once the growth is completely removed, as in the case of BCC – the cancer is considered to be “cured”.
While a standard excision works well for majority of BCC and SCC cases – skin cancer that develops on sensitive areas such as on the eyelids and face, lesions that have clinically less well-defined margins, more aggressive subtypes, and recurrent skin cancers are best treated using MOHS micrographic surgery.
Currently the gold-standard for treating complex non-melanoma skin cancers – MOHS surgery works to remove skin tissues one layer at a time and testing it for cancerous cells – continuing the process until only healthy tissues are left.
This surgical method achieves the highest cure rate of skin cancer (up to 99%) to date, and a 95% cure rate for recurrent skin cancers where other treatments have failed.
MOHS micrographic surgery also offers optimal skin tissue preservation and minimal scarring – and is often performed as a single-day outpatient procedure.
As every patient is different and not all skin cancers are the same – the best skin cancer treatment for you depends on your specific diagnosis and needs. Thankfully, with early detection, the 5-year survival rate of even the most aggressive form of cancer, i.e., melanoma is roughly 99%3.
At Angeline Yong Dermatology, we offer a range of skin cancer detection and treatment options to accurately diagnose, treat and manage a variety of skin cancers, including the powerful MOHS micrographic surgery!
How do I check for skin cancer symptoms by myself?
About half of melanoma cases are self-detected – and the best way you can protect yourself is to regularly check your body for moles utilizing the ABCDE method:
A: Asymmetrical – does your mole have an irregular shape?
B: Border – does your mole have undefined or jagged borders?
C: Colors – does your mole have a mix of two or more colors?
D: Diameter – is your mole larger than 6mm in diameter?
E: Evolution – does your mole change in appearance or size overtime?
Ideally, you should be conducting frequent self-examinations to catch any changes and abnormalities in your skin – especially if you are a highly active person who enjoys being outdoors.
Doing so increases the chances of early detection, which subsequently increases your chances of overcoming the disease.
How often should I get a skin cancer checkup?
Unfortunately, individuals who have been diagnosed and treated for skin cancer have about a 50% risk of getting another one within the next 5 years – which is why it is highly recommend that patients continue to take preventative measures and schedule regular follow-up visits with their doctor.
Depending on your personal risk for skin cancer – a yearly skin cancer check is sufficient for majority of people. Otherwise, a visit to the doctor every 6 months is ideal.
When is it time to see a doctor?
Skin cancer doesn’t always appear on skin that has been exposed to the sun and can sometimes look like benign or malignant moles – which is why it is vital to get diagnosed by a doctor as soon as you notice any suspicious lesion(s).
At the end of the day, prevention is key – every individual holds the responsibility to protect themselves on a daily basis. Your skin is your biggest defence against not just dangerous UV radiation, but harmful bacteria as well – so never take it for granted.
An integral member of both the skin cancer division and MOHS micrographic surgery service at the National Skin Centre – Dr. Angeline Yong has 15 years of precious medical practice and experience under her belt – equipping her with the right skills and knowledge needed to successfully treat one of the most preventable cancers. She is also a member of the American College of Mohs Surgery – which is the leading body that regulates fellowship-trained Mohs micrographic surgeons.
If you have done the ABCDE test at home and have checked off at least one of the symptoms – do not hesitate to book an appointment with us to conduct a thorough skin cancer screening for you!
References
1.Parkin DM, Mesher D, Sasieni P. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. Br J Cancer 2011; 105:S66-S69.
2.Merrill SJ, Subramanian M, Godar DE. Worldwide cutaneous malignant melanoma incidences analyzed by sex, age, and skin type over time (1955-2007): Is HPV infection of androgenic hair follicular melanocytes a risk factor for developing melanoma exclusively in people of European-ancestry? Dermatoendocrino. 2016;8:121539.
3.Cancer Facts and Figures 2020. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf. Accessed February 26, 2020.