Dr. Jacqueline Gerhart: Recurrence Of Skin Cancer Depends On Many Factors
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I recently was diagnosed with skin cancer, and it was removed by a dermatologist. I don't consider myself a sunbather, so I was surprised by this. Am I likely to get another cancer?
Dear Reader: The answer to your question depends on what type of cancer it was, how large it was and how it was removed. Also, your prior sun exposure and your future sun exposure will have an effect on whether you will get a skin cancer again.
There is more than one type of skin cancer. The three main types are melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). To protect yourself from future cancers you will need to understand how to check your own skin, when to see a physician and how to prevent further sun exposure — which is the main cause of skin cancers.
First, how to check your skin. Melanomas are often detected by patients or physicians using an "ABCDE" approach. "A" stands for asymmetry. This means if the mole is not round, oval, or proportional — for example, it looks like a paint splotch — then it may be concerning for cancer. "B" stands for border. If you notice that a mole has an irregular border, or a variation in the color of the border, you should get it checked. "C" stands for color. If you notice a mole changes in color, is speckled or is different from your other moles, get it checked. "D" stands for diameter. If your mole is greater than 6 millimeters — which is about the size of a pencil eraser — or is growing, get it checked. "E" stands for evolution. If there is anything that seems to be changing quickly (such as the mole is enlarging, becoming more scaly, or starting to bleed), you should see your physician. To detect early squamous cell cancers, look for scaly white spots that don't flake off, especially on the face, ears and arms. To detect early basal cell carcinomas, look for shiny or pearly-looking bumps that may have a central "dot" and may have small red blood vessels in or around them.
Next, when to see your doctor. The general rule of thumb: If in doubt, check it out. If you notice a mole has any of the "ABCDE" qualities, see your doctor. Your primary care physician can determine if this is a concerning mole, or if it may be normal. One normal type that is often confused with cancer is called seborrheic keratosis, which is like an "age spot" and can mimic the appearance of a skin cancer.
Prevention: The younger you are when you get a peeling sunburn, or repetitive sun exposure, the greater your risk of skin cancer. Try to encourage your teens not to use tanning beds, and help kids remember to wear sunscreen when playing in the park, practicing sports or mowing the lawn. While baseball caps are more fashionable than broad brimmed bonnets, they don't protect the back of the ears — which are common places for skin cancer.
Remember, just because you aren't a sunbather, and just because you live in Wisconsin, doesn't mean you can't get skin cancer. Melanomas are actually most common on men's backs and women's legs — which are areas of intermittent sun exposure. Wearing sunscreen has been proven to protect against squamous cell and basal cell skin cancers. Be sure to find a sunscreen that is at least 30 SPF, and apply it often.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 01/31/2012