As the days are getting longer in the springtime, we are starting to emerge from the winter shadows to warm up after a cold winter. But as we do, how many of us are thinking about the impact of the sun relating to our increased risk of cancer? Over time, we accumulate the long term effects of our solar exposures with an increasing risk to develop skin cancers.
The most common and widespread of cancers in the United States are those of basal cell and squamous cell carcinomas. There are about four million and one million respectively diagnosed annually. Generating from the layers that make up skin structures, these skin cancers usually develop as a response to repeated exposure to ultraviolet (UV) light. The most common source of UV light is sun exposure. Not to be forgotten is the risk associated with the use of tanning beds.
A basal cell cancer commonly presents as a skin colored, pearly looking bump or growth that does not go away. Sometimes it may develop as a pink or red scaly patch or have a waxy surface. A squamous cancer may be a thick, rough scaly patch that sometimes bleeds and refuses to heal. They may look initially like a wart, and sometimes have a crusty surface. Both cancers may grow over time, but usually grow slowly. With early intervention, both of these cancers can be usually cured with medication or surgery. With delay of treatment, these treatments may become expensive, prolonged and disfiguring.
A much less frequent but much more deadly form of skin cancer is melanoma. Originating from the melanocytes (the cells that give skin its pigment or color), this type is also associated with UV exposure. About half of these cancers on discovery are surface level. The other half likely have already penetrated into deeper levels of the skin, requiring more extensive treatment. Lesions of this type typically may show up earlier in life as compared to the basal and squamous cancers, but all kinds may also show up as we mature. Melanoma is responsible for over 9000 deaths annually in the US, about one out of every ten of these cancers once diagnosed.
To help tell a melanoma from a common mole, use the ABCDE:
“A” is for asymmetrical. Does the mole have an irregular shape with different looking parts?
“B” stands for border. Is the border jagged or irregular?
“C” is for color. Is the color uneven shades of brown, or with any black or bluish color?
“D” stands for diameter. Is the spot larger than the size of a pea?
“E” is for evolving. In the past few weeks or months, has the spot changed?
Actinic keratosis are changes to skin that indicates sun damage, but has not yet evolved to a cancer diagnosis. These scaly patches on a reddish base also have treatments available, the earlier the better. Although sun protection is the keystone to healthy skin, many of us in the Southwest get unintentional exposure. It is likely you may have developed some spots and patches over time you wonder about. Should you have skin lesions of question, the earlier you seek a professional opinion with your primary care provider or dermatologist, the better your outcome likely will be.
Bradford Croft, DO
East Flagstaff Family Medicine