Skin Cancer 101: What You Need to Know

Skin cancer is usually a result of too much exposure to the sun.  While skin cancer is the most common form of cancer, many types are both preventable and treatable.  There are five different types of skin cancer:

• Actinic Keratosis is a precursor to Squamous cell carcinoma. It typically appears as rough, red, or pink scaly patches on sun-exposed areas of the skin.  Up to 1% of these lesions can develop into a squamous cell carcinoma.
• Basal cell carcinoma is the most common form and accounts for 90% of all skin cancers. It starts in the basal cells, at the bottom of the outer skin layer and is caused by long-term exposure to sunlight. It is most easily treated.
• Squamous cell carcinoma is the second most common type. It starts in the outer skin layer, eventually penetrating the underlying tissue if not treated. It is easily treated when found early, but in a small percentage of cases, this cancer spreads to other parts of the body.
• Malignant melanoma is the most serious type of skin cancer and is responsible for most deaths. However, it can be cured if it is diagnosed and removed early. Melanoma starts in moles or other growths on normal skin.
• Kaposi's sarcoma (KS) is caused by a virus in the herpes family. An aggressive AIDS-related form affects about one-third of people with AIDS. A more slow-growing form occurs in elderly men of Italian or Jewish ancestry.

Symptoms of Melanoma

Often the first sign of melanoma is a change in the shape, color, size, or feel of an existing mole. Melanoma may also appear as a new mole.  Thinking of "ABCDE" can help you remember what to look for:

• Asymmetry: The shape of one half does not match the other half.
• Border that is irregular: The edges are often ragged, notched, or blurred in outline.  The pigment may spread into the surrounding skin.
• Color that is uneven: Shades of black, brown, and tan may be present.  Areas of white, gray, red, pink, or blue may also be seen.
• Diameter: There is a change in size, usually an increase.  Melanomas can be tiny, but most are larger than the size of a pea (larger than 6 millimeters or about 1/4 inch).
• Evolving: The mole has changed over the past few weeks or months.

Melanomas can vary greatly in how they look.  Many show all of the ABCDE features.  However, some may show changes or abnormal areas in only one or two of the ABCDE features.

In more advanced melanoma, the texture of the mole may change.  The skin on the surface may break down and look scraped.  It may become hard or lumpy.  The surface may ooze or bleed. Sometimes the melanoma is itchy, tender, or painful.

What Causes It?

Exposure to ultraviolet radiation from the sun is the main cause of skin cancer.  Skin cancer may also be due to genetics or radiation treatments.  A virus causes Kaposi's sarcoma.

Who's Most At Risk?

People at risk for developing skin cancer may have the following conditions or characteristics:

• Fair skin
• Spend a lot of time outdoors in work or leisure activities
• History of sunburn
• Family history of skin cancer
• Many moles
• Are over age 40
• Large dark-colored birthmark known as congenital melanocytic nevus
• Pre-cancerous skin lesions, such as actinic keratosis
• HIV-positive – a risk for Kaposi's sarcoma specifically

What to Expect at Your Provider's Office:

Your doctor will examine your skin for new, changed, or unusual moles.  Your doctor may use a dermatoscope, which is for close examination of skin growths.  If your doctor suspects cancer, you will have a biopsy (sample of the skin).  A biopsy can confirm whether or not you have skin cancer.

Prevention

In most cases, you can prevent skin cancer.  If you are at high risk, stay out of the sun.  When you have to be in the sun, protect yourself by covering up, wearing a hat, and applying sunscreen with an SPF of at least 30.  You should also have regular skin cancer screenings with your primary health care provider or dermatologist.

To find a primary care provider near you, visit a location near you.