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Skin Cancer
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Skin cancer is the most common of cancers, affecting an estimated 1.3 million Americans each year. With rates of newly diagnosed cases rising at a rate of 4 to 5 percent annually, skin cancer continues to be is a veritable epidemic. Three cancers of the skin comprise this category of sun-induced cancer: the basal cell (BCC), the squamous cell (SCC) carcinoma, and of course malignant melanoma.
Ultraviolet exposure and sun damage is the leading factor to developing skin cancer. Damaging rays create cellular DNA damage and ultimately skin cancer. Under normal circumstances, skin has a repair system that literally cuts out damaged DNA and replaces it with new, healthy code. Genetics play a role in one’s ability to repair the damage. But too much ultraviolet damage may simply overwhelm the system.
Obviously lighter skin is more prone to becoming sun burned. Red heads and fair blondes with blue eyes are notorious for developing skin cancer. A lifelong history of sun exposure places one at higher risk. Take for instance those raised on farms, veterans of WWII who were stationed in the South Pacific, construction workers and basically anyone who spent a lot of time outdoors. In addition, patients who are immunosuppressed, especially transplant patients, are quite likely to see rapid and early development of skin cancer (particularly squamous cell carcinoma). Regardless of race, anyone can develop skin cancer.
Basal Cell Carcinoma
The most common skin cancer, newly diagnosed cases of BCC will affect an estimated 800,000 Americans this year. That said, most have never heard of this form of skin cancer. Basal cell carcinomas earn their name from the location deep within the epidermis in which they form, the basal (or basement) layer. Basal cell carcinomas are traditionally slowly growing tumors of the skin. While they can grow quite large and invade spaces to which they’re adjacent, they rarely metastasize to other areas of the body.
BCCs often look pearly. Pink or flesh-toned bumps (papules) slowly rise above the skin’s surface. It’s the pearlescent quality that gives them away. Given enough time, a basal cell carcinoma may go on to form a central ulceration (sore). Early basal cell carcinomas (superficial spreading basal cell aka SSBCC)
resemble reddish dry skin patches that simply won’t heal over months or even
longer. They may also develop a pearly quality. It’s not unusual for patients
claiming a longstanding “acne” bump that’s been present for months, or years to
find out it’s really a BCC. Acne resolves spontaneously, skin cancer does not.
Diagnosis of a BCC involves a skin biopsy. Whether performed as a simple shave
biopsy or a deeper punch, the basal cell carcinoma has easy diagnostic features.
There is no concern about the spread of a BCC if cut through during the biopsy,
unlike melanoma. Treatment of a basal cell carcinoma is relatively
straightforward. Simple Excision The skin is numbed with a local anesthetic and
the visible area of skin cancer with a small margin of normal skin is excised
and sutured closed. This allows the pathologist to determine if the entire skin
cancer was removed. ED&C x 3 An abbreviation for electrodessication and
curettage, the affected area is cauterized and scraped 3 times after being
numbed with a local anesthetic. A quick, simple method, ED& C x 3 is ideal for
larger skin cancers on the torso (less excised skin), and for handling skin
cancer on elderly or infirm patients unlikely to be able to care adequately for
a large sutured area. The downfall is that no pathological confirmation
certifying 100% eradication of the skin cancer exists.
Next
Thank you for taking the time to read through this important information. I hope you have found this article informative.
Audrey Kunin, M.D.
(Any topic discussed in the this newsletter is not intended as medical advice. If you have a medical concern, please check with your doctor.)
Article updated July 16, 2002.
http://www.dermadoctor.com
Copyright © 2000-2002, All Rights Reserved.
DERMAdoctor.com
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Bio
Dr. Kunin is a board certified dermatologist in Kansas City, Missouri. She
received her dermatology training at the Medical College of Virginia. She has
been featured on several local television and radio news and talk shows for her
expertise in her field. She also holds a position as Associate Clinical
Instructor at the University of Kansas Medical School Department of Dermatology.
In addition to general dermatology, her interests in cosmetic dermatology
include non-surgical approaches to skin rejuvenation, including chemical peels,
Botox, Isolagen, skin care products and sclerotherapy.
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