Skin cancer is the most common of all cancers. The skin changes that result in cancer develop cumulatively and irreversibly in an individual over the years, and so may take decades to produce a malignancy. Men get skin cancer more frequently than women, and it usually shows up in older people, but no one is exempt. In fact, Americans are developing skin cancer at ever-younger ages because of the increasing amounts of time spent in the sun. Prolonged sun exposure is the principal cause of skin cancer.
Exposure to the sun’s ultraviolet radiation is known to promote three kinds of skin cancer.
Basal cell carcinoma is the most prevalent type, striking one out of every eight Americans, including people in their 20s and 30s, women as well as men. The most common site for basal cell carcinoma is the face, especially the nose or ears, but it can appear anywhere. It is painless and slow-growing, and rarely spreads to other parts of the body.
Squamous cell carcinoma typically develops on the face, lips, the rim of the ear, and the back of the hands. If not treated, the lesions can grow in size and spread to other parts of the body, including internal organs.
About 1.3 million new cases of these two types of cancer are reported annually in the United States alone. Fortunately, both basal cell and squamous cell skin cancers have a 95-percent cure rate when detected and treated early.
Melanoma, the least common of the three (47,000 cases annually), is also the most dangerous, though early treatment can result in a cure. Melanoma develops from melanocytescells located in the epidermis that produce melanin, the dark pigment that helps protect the skin from ultraviolet radiation. Melanocytes are scattered throughout the epidermis and can also collect and form benign moles, or nevi. Melanoma occurs when melanocytes begin reproducing uncontrollably to form malignant tumors.
Once rare, the incidence of melanoma has increased five- to sixfold worldwide over the past four decades. Since 1973 the incidence of melanoma has risen about 4 percent a year, even as the use of sunscreen has increased. In 1996 alone the incidence rose by 6 percent and the mortality rate by 2 percent. And whereas melanoma was once a disease of the aging, half of all those who develop it are between the ages of 15 and 50. Many scientists attribute some of this increase to the gradual destruction of the stratospheric ozone layer, which is allowing more ultraviolet radiation to reach the earth’s surface.
Symptoms of Skin Cancer
- Any change in the size, color, shape or texture of a mole or other skin growth
- An open or inflamed wound that won’t heal
Signs of basal cell carcinoma
- A sore that doesn’t heal. Have it checked if it hasn’t healed after three weeks and it crusts, bleeds, or oozes.
- A persistent reddish patch. It may be painful or may crust and itch; or it may not bother you at all.
- A smooth bump indented in the middle. The borders will be rolled, and as it grows you may notice blood vessels on the surface.
- A shiny, waxy, scarlike spot. It may be yellow or white with irregular borders.
Signs of squamous cell carcinoma
- Small, firm lump or patch, initially painless, that develops on the face or back of the hand. May be raised or flat, with a scaly or crusted surface.
- Slowly grows to take on a wartlike appearance; may become painful
Signs of malignant melanoma
- A mole that begins to enlarge, thicken, or change color. (Some 70 percent of early-state lesions are identified because of recent changes in size, color, border contours, or surface texture.)
- A mole that suddenly begins to grow, or one that bleeds or ulcerates
- A mole that has irregular rather than round borders
- A mole with irregular pigmentation—some portions light colored, others almost black
What Causes Skin Cancer?
It is clear that the risk of basal and squamous cell carcinoma rises in proportion to the cumulative amount of time people have spent in the sun. But the sun’s role in the development of melanoma is less clear, and in fact surprisingly little is known about what causes melanoma. People who spend lots of time in the sun (such as farmers) do not have elevated rates of melanoma, though they do have higher rates of squamous and basal cell carcinoma. And melanoma often turns up on parts of the body rarely exposed to the sun (such as the buttocks and soles of the feet).
Genetic factors—including skin and hair color and the number of moles—clearly play a role. But genetics can’t explain the huge increase in melanoma incidence over the past three generations. Some researchers believe that intermittent sun exposure and severe, blistering sunburns, especially early in life, rather than simply years of sun exposure, cause melanoma. However, studies have been inconsistent about the role of sunburn.
The people at highest risk for melanoma are fair skinned—notably people with red or blonde hair, who freckle (especially on the upper back), and/or who have rough red patches on their skin (actinic keratoses) as a result of sunning. If, in addition, you have a family history of melanoma or have had three or more blistering sunburns as a child or teenager, your risk also increases.
Steps to Early Detection
Self-examination is the key to early detection of skin cancer. It isn’t difficult—certainly no harder than the examination for breast cancer many women have learned to do. And it is vital: in many of the most successfully treated cases of malignant melanoma, the patients themselves brought the melanoma to their doctors’ attention early on.
Pay special attention to areas of your body that are habitually exposed to sunlight: your face, neck, and hands. Don’t forget your scalp and the back of your ears. Also check body parts not exposed to sunlight, such as your buttocks and underarms, since melanoma can occur in those places as well. Use a mirror to check areas you can’t easily see or have a partner check them.
Self-examination should be performed once a month. Don’t forgo the procedure even if you habitually stay out of the sun. While it’s certainly protective to avoid excess sun exposure, you cannot undo damage from past exposure, which is cumulative, starting in childhood. In fact, some experts believe that by age 20 the average American has already received 80 percent of the damaging ultraviolet rays that may lead to cancer in later years.
In addition to self-examination, ask your doctor to include a total skin exam as part of your routine checkup. A study in the Journal of the American Medical Association found that physicians were much likelier to find thin, early melanomas, which are most treatable.
What If You Do Nothing?
If untreated, all these forms of skin cancer will ultimately become destructive. Basal cell carcinomas are slow-growing, but it is important that they be found and treated early because they can ultimately invade and destroy nearby tissues. Melanoma that goes untreated may quickly spread to other parts of the body, which is why it is the most dangerous form of skin cancer. Of the nearly 10,000 deaths from skin cancer each year, almost 80 percent are from melanoma.
Home Remedies for Skin Cancer
Skin cancer requires evaluation and treatment by a physician.
Even if the only risk factor you have is fair skin, you still need to be cautious and to protect yourself. One of the major steps you can take to prevent all forms of skin cancer is to reduce your direct exposure to sunlight, use adequate sunscreens, and wear protective clothing. Also avoid other sources of UV light, such as sun lamps and tanning beds.
Beyond Home Remedies: When To Call Your Doctor
Contact your doctor if you develop any of the symptoms listed above. Any new growths, changes in the size or color of existing growths, any sore that doesn’t heal, or any persistent patch of irritated skin are reasons to see your doctor.
If you have had skin cancer, you should be sure to have your skin checked regularly.
What Your Doctor Will Do
Your doctor (or a dermatologist) may perform a biopsy—that is, remove all or part of a growth that doesn’t appear normal. To check for cancer, this sample of tissue is examined under a microscope to detect cancerous cells.
If cancer is detected, the doctor will determine what stage it is in: local (affecting only the skin) or metastatic (spreading beyond the skin). You may need to have additional tests, such as x-rays, to find out whether cancer has spread to other parts of the body and to help plan the best treatment.
When caught in time, basal cell carcinoma can often be removed by a doctor on an outpatient basis, leaving only a minor scar. Once malignant melanoma is detected, you should see a doctor with special expertise in melanomas. The treatment is prompt surgical removal and microscopic examination of a sample.
If melanoma is removed in the early stages, the 5-year survival rate is 95 percent; the 10-year rate, 90 percent. If removal is done during a later stage, when a tumor has begun to invade the surrounding tissues or other areas of the body, the survival rate drops sharply.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media