Skin Cancer Q & A
Experts estimate that 1 in every 7 Americans will experience skin cancer, the most common malignancy known to humans, during their lifetimes.
A UW Health dermatologist and Mohs micrographic surgeon offers some sensible tips to help prevent sunshine from causing serious health problems.
Are you seeing in increase in the incidence of skin cancer?
With the depletion of the ozone layer, increased ultraviolet light and people's different styles of leisure, we are seeing it increase. On the other hand, the public is more aware of the changes that occur on the skin. They're concerned about making sure their families are protected, so they're coming in earlier to check out skin lesions.
What are the risk factors?
The first thing is genetic disposition. If you're blond, blue-eyed and have fair skin, you're probably at a higher risk than someone who is more pigmented. But skin cancer occurs in all races and is associated with sun exposure. It's also associated with altitude, and how close you live to the equator.
Children are actually the most susceptible, since most sun exposure occurs between birth and age 16. Unless you have a lifestyle like a farmer, golfer or sailor, you're not going to get too much sun exposure after that. People who are most prone to develop skin cancer are the office workers who stay indoors and then suddenly loll out in the sun during a vacation.
Are pregnant women more at risk?
There are some anecdotal reports that pigmentation can occur during pregnancy. Overall, the incidence of melanoma has not increased in young women, but we try to make sure that any change in pigmented lesions or development of lesion should be investigated or at least followed by a physician.
How can a person determine whether he or she may have skin cancer?
There are two things to watch for. One is a change in a pre-existing mole. It could be anything - a growth, bleeding, itching or a change in color. The second is the appearance of pigmented lesion that's dark brown and/or black - that's usually a melanoma, a type of skin cancer that's less common but a little more threatening.
About 10 years ago, we said that any lesion larger than an adult aspirin tablet was something we'd be interested in examining. Now we're saying that any lesion that is new, even if it's small, is something to discuss with your physician - especially if it's dark. If the lesion is the size of a split pea or a tiny baby aspirin, if it's dark or changing in any way, get it checked.
How much sun damage does it take to trigger skin cancer?
An acute burn can be associated with the development of melanoma, but chronic damage from a low amount of radiation over 10-20 years can also trigger a basal or squamous cell carcinoma, which is more common. If you develop this - and there are about a million cases per year - your chances of developing a melanoma would be about twice as great.
What does the treatment of skin cancer involve?
The first thing we do is to take a biopsy to determine what the thickness of the melanoma or lesion is. If the lesion is thinner than a playing card, the cure rate is nearly 100 percent. If it's thicker than 1 millimeter, we sometimes need to conduct additional scans and blood work.
Are skin cancer screenings something you'd encourage?
Screening is a good idea, especially if you don't have a physician who can look over the areas of your body you cannot see - like on your back and legs. In cases where medical economics are an issue, this is an excellent way to have a free screening to see that there are no lesions that need immediate attention.
What kinds of things can we do to protect ourselves from developing skin cancer?
Take a self-assessment of yourself and your family. Most people will have some changes already on their skin, a brown lesion or a freckle. Those are signs that you've already had enough sun exposure to change your skin. We encourage people to reduce sun exposure between 10am and 2pm, wear sunscreen that's rated at least SPF 30 and wear protective clothing. It's important to remember that having a glorious tan may be favorable for photographs, but it's not favorable for living a long life.