Each year more than 600,000 people learn that they have some form of skin cancer. (National Cancer Institute [NCI] , 1993) Skin cancer is the most common type of cancer in the United States.(NCI, 1993) It is estimated that 40 to 50 percent of Americans that live to the age of 65 will have skin cancer at least once.(NCI, 1993) One-third of all new diagnosed cancers are skin cancer. (Siegel, 1990, p.77) Skin cancer is now almost 100 percent curable if detected early and treated properly. (NCI, 1993)
Healthy cell in the body’s tissues grow, divide, and replace themselves in a orderly way. (NCI, 1993) Sometimes normal cells lose their ability to limit their growth; too much tissue is formed and a tumor begins to form. (NCI, 1993) Tumors can be either benign or malignant. (NCI, 1993) Benign tumors do not spread to other parts of the body and are seldom deadly. (NCI, 1993) Malignant tumors invade and destroy nearby healthy tissues and organs.(NCI, 1993) Cancerous cells for malignant tumors can spread to other parts of the body by way of blood vessels and the lymph nodes. (Microsoft Encarta, 1995)
Skin Cancer has one known and easily avoidable risk factor: exposure to ultraviolet rays from the sun. (Reid, K. ; Vikhanski, L, Medical World News, 1992) People with the highest risk of getting skin cancer are those that have fair skin and sunburn easily.(Siegel, 1990. p 78) The risk of developing skin cancer is also effected by where a person lives. People living closer to the equator ands people living in high altitudes have a increased risk of developing skin cancer. (Siegel, 1990, p 78) Exposure to artificial sources of UV radiation can increase a person’s risk.(NCI, 1993) It is also a good idea to try to avoid prolonged exposure to the midday sun. (NCI, 1993)
80 percent of skin cancers occur on the face, head or neck of the person; another 10 percent occur on other exposed areas of the body. (Siegel, 1990, p 80) Men’s shoulders, backs, and chests and women’s lower legs have become more common sites of skin cancer in recent years. (Siegel, 1990, p 80) In the United States, people are more likely to develop skin cancer on their left arm and face; this is because people sit on the left side of their car when they are driving. (Siegel, 1990, p. 80)
The epidermis consist of several different types and layers of cells. (Siegel, 1990, p 76) The bottom row of cells is composed of basal cells; the middle layer consist of squamous cells and Melanocytes are interspersed between them. (Siegel, 1990, p 77) The three kinds of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma.
Basal cell carcinoma is the most common of all cancers, including skin cancer. (Siegel, 1990, p. 86) Basal cell is a slow growing cancer that seldom spreads to other parts of the body. (NCI, 1993) Basal cell carcinoma is found most often on people with white skin, particularly of north European descent. (Siegel, 1990, p 86) Basal cell carcinoma if left untreated can badly damage and destroy underlying structures and tissues. (Siegel, 1990, p86) Basal cell carcinoma usually begins on areas of the body exposed to the sun. (Siegel, 1990, p 86) Their are a number of warning signs for Basal cell carcinoma.Appearance of the cancer can usually be seen, as well as felt. (Siegel, 1990, p 87) The growth may have pearly or shiny edges with a reddish or purplish color to it. (Siegel, 1990, p 87) In dark skinned people, the bump may appear to look like a mole. (Siegel, 1990, p 87) Another sign of Basal cell carcinoma is an open sore that does not heal and/or begins to bleed, ooze, or crust. (Siegel 1990 p 87) Sometimes a reddish patch or irritated area may persist, itch, hurt, or crust. (Siegel, 1990, p 87) Basal cell carcinoma has many variations in size, color, and shape; thus making it very difficult for a nonphysician to do a self-diagnose. (Siegel, 1990, p.87)
The second most common skin cancer is squamous cell carcinoma; which effect around 100,000 people or 20 percent of all skin cancers. (Reid, K. & Vikhanski, L, Medical World News, 1992) Squamous cell carcinoma not only grows faster than Basal cell, but has a greater potential to invade and destroy underlying structures and to metastasize to other parts of the body. (Siegel, 1990, p.88) Between 1,500 and 2,000 people die each year from Squamous cell carcinoma. (Siegel, 1990, p.88) Squamous cell carcinoma most often arises on the ear, the face, mouth, or the back of the hand. (Siegel, 1990, p.88) Squamous cell carcinoma usually begins as a slightly raised pink opaque papule or as a red scaly patch. (Siegel, 1990, p.88) Like basal cell carcinoma, squamous cell carcinoma is difficult for a nonphysician to diagnose. (Siegel, 1990, p.88)
The third and most deadly form of skin cancer is melanoma. Approximately three fourths of all skin cancer-associated deaths are caused by melanoma. (JAMA, 1995) Of all deaths associated with melanoma, 98 percent of the deaths occurred among whites. (JAMA, 1995) In 1989 about 6,000 melanoma-related deaths occurred. (Siegel, 1990, p.93) It is estimated that by the year 2000, one in ninety people will develop melanoma(Vitolins,C , Berkeley wellness letter, 1993) A main reason that the number of cases of melanoma is increasing is because the sunburned youth of the ’50s and ’60s are now reaching middle age.
Melanoma is chiefly caused by exposure to ultraviolet radiation. (Siegel, 1990, p.95) Melanoma can develop even in people who have avoided the sun, especially if they have moles. (Siegel, 1990, p96) Their are four main warning signs of melanoma: (Siegel, 1990, p.101)
A. Asymmetry: one half of the mole unlike the other
B. Border Irregularity: edges are ragged, notched, or blurred
C. Color: shades of tan, brown and black. May be spots of red, blue and
D. Diameter: any mole larger than 6mm or a sudden increase in size.
Along with moles, other risk factors include a family history of melanoma, fair skin, and a large number of moles. (Reid, K. & Vikhanski, L, Medical World News, 1992)
When a doctor is treating any kind of skin cancer, the main goal is to remove or destroy the cancer with as little a scar as possible. ( NCI, 1993) To plan the best treatment for a patient, the doctor considers the location, size, age of the person, and the person’s general health. (NCI, 1993) Treatment for skin cancer usually involves some type of surgery. (NCI, 1993) Many skin cancers can be cut from the skin easily and are sometimes completely removed at the time of the biopsy. (NCI, 1993) Their are many different ways to get rid of a cancer.
Doctors commonly use a type of surgery called curettage. (NCI, 1993) After a local anesthetic is applied, the cancer is scooped out with a curette, an instrument with a sharp, spoon-shaped end. (NCI, 1993) An electric current is used to control bleeding and destroy any remaining cancer cells. (NCI, 1993) Another technique is Mohs’ surgery. Mohs’ is a special type of surgery used for large tumors and hard to reach places.(NCI, 1993) In Mohs’ surgery, the cancer is shaved off one thin layer at a time and examined under a microscope until the entire tumor is removed. (NCI, 1993)
Other techniques include cryosurgery (freezing of the cancer), laser therapy, radiation and topical chemotherapy. When your doctor tells you that you have skin cancer, it might be a good idea to seek a second opinion. (NCI, 1993)