Skin Cancer

Introduction

Many people, especially those who have fair coloring or have had extensive sun exposure, should periodically check their entire body for suggestive moles and lesions.

Have your primary health-care provider or a skin specialist (dermatologist) check any moles or spots that concern you.

See your health-care provider to check your skin if you notice any changes in the size, shape, color, or texture of pigmented areas (such as darker areas of skin or moles).

If you have skin cancer, your skin specialist (dermatologist) or cancer specialist (oncologist) will talk to you about symptoms of metastatic disease that might require care in a hospital.

Self-Care at Home

Home treatment is not appropriate for skin cancer. These conditions require the care of a dermatologist or specialist in skin cancers.

Be active in preventing and detecting skin cancer on yourself and others. Perform regular self-examinations of your skin and note any changes. Avoid unnecessary exposure to direct sunlight. Wear sunscreen daily.

Follow-up

Most skin cancer is cured surgically in the dermatologist's office. Of skin cancers that do recur, most do so within three years. Therefore, follow up with your dermatologist (skin specialist) as recommended. Make an appointment immediately if you suspect a problem.

If you have advanced malignant melanoma, your oncologist may want to see you every few months. These visits may include total body skin examinations, regional lymph node checks, and periodic chest x-rays. Over time, the intervals between follow-up appointments will increase. Eventually these checks may be done only once a year.

Prevention

You can reduce your risk of getting skin cancer.

• Limit sun exposure. Attempt to avoid the sun's intense rays between 10 a.m. and 2 p.m.
• Apply sunscreen frequently. Use a sunscreen with sun protection factor (SPF) of at least 15 both before and during sun exposure. Select products that block both UVA and UVB light. The label will tell you.
• If you are likely to sunburn  , wear long sleeves and a wide-brimmed hat.
• Avoid artificial tanning booths.
• Conduct periodic skin self-examinations.

Skin self-examination

Monthly self-examination improves your chances of finding a skin cancer early, when it has done a minimum of damage to your skin and can be treated easily. Regular self-exam helps you recognize any new or changing features.

• The best time to do a self-exam is right after a shower or bath.
• Do the self-exam in a well-lighted room; use a full-length mirror and a handheld mirror.
• Learn where your moles, birthmarks, and blemishes are, and what they look like.
• Each time you do a self-exam, check these areas for changes in size, texture, and color, and for ulceration. If you notice any changes, call your primary-care provider or dermatologist.

Check all areas of your body, including "hard-to-reach" areas. Ask a loved one to help you if there are areas you can't see.

• Look in the full-length mirror at your front and your back (use the handheld mirror to do this). Raise your arms and look at your left and right sides.
• Bend your elbows and look carefully at your palms, your forearms (front and back), and upper arms.
• Examine the backs and fronts of your legs. Look at your buttocks (including the area between the buttocks) and your genitals (use the handheld mirror to make sure you see all skin areas).
• Sit down and examine your feet carefully, including the soles and between the toes.
• Look at your scalp, face, and neck. You may use a comb or blow dryer to move your hair while examining your scalp.

Outlook

Although the number of skin cancers in the United States continues to rise, more and more skin cancers are being caught earlier, when they are easier to treat. Thus, illness and death rates have decreased.

When treated properly, the cure rate for both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) approaches 95%. The remaining cancers recur at some point after treatment.

• Recurrences of these cancers are almost always local (not spread elsewhere in the body), but they often cause significant tissue destruction.
• Less than 1% of squamous cell carcinomas will eventually spread elsewhere in the body and turn into dangerous cancer.

In most cases, the outcome of malignant melanoma depends on the thickness of the tumor at the time of treatment.

• Thin lesions are almost always cured by simple surgery alone.
• Thicker tumors, which usually have been present for some time but have gone undetected, may spread to other organs. Surgery removes the tumor and any local spread, but it cannot remove distant metastasis. Other therapies, such as radiation therapy or chemotherapy, are used to treat the metastatic tumors.
• Malignant melanoma causes more than 75% of deaths from skin cancer.
• Of the approximately 100,000 malignant melanomas diagnosed in the United States in 2007, the vast majority were cured. Still, thousands of people die of melanoma each year.