Causes Skin Cancer: Ultraviolet (UV) light exposure, most commonly from sunlight, is overwhelmingly the most frequent cause of skin cancer. Other important causes of skin cancer include the following: Use of tanning booths Immunosuppression - This means impairment of the immune system. The immune system protects the body from foreign entities, such as germs or substances that cause an allergic reaction. This suppression may occur as a consequence of some diseases or can be due to medications prescribed to combat conditions such as autoimmune diseases or prevent organ transplant rejection. Exposure to unusually high levels of X-rays Contact with certain chemicals-arsenic (miners, sheep shearers, and farmers), hydrocarbons in tar, oils, and soot (may cause squamous cell carcinoma) The following people are at the greatest risk: People with fair skin, especially types that freckle, sunburn easily, or become painful in the sun People with light (blond or red) hair and blue or green eyes Those with certain genetic disorders that deplete skin pigment such as albinism, xeroderma pigmentosum People who have already been treated for skin cancer People with numerous moles, unusual moles, or large moles that were present at birth People with close family members who have developed skin cancer People who had at least one severe sunburn early in life Basal cell carcinomas and squamous cell carcinomas are more common in older people. Melanomas can occur at any age. It is most commonly diagnosed at between 55 and 75 years of age, but about 1/3 occur before the age of 50. For example, melanoma is the most common cancer in people younger than 30. Symptoms of Skin Cancer: A basal cell carcinoma (BCC) usually looks like a raised, smooth, pearly bump on the sun-exposed skin of the head, neck, or shoulders. Small blood vessels may be visible within the tumor. A central depression with crusting and bleeding (ulceration) frequently develops. A BCC is often mistaken for a sore that does not heal. A squamous cell carcinoma (SCC) is commonly a well-defined, red, scaling, thickened patch on sun-exposed skin. Like BCCs, SCCs may ulcerate and bleed. Left untreated, SCC may develop into a large mass. The majority of malignant melanomas are brown to black pigmented lesions. Warning signs include change in size, shape, color, or elevation of a mole. The appearance of a new mole during adulthood, or new pain, itching, ulceration, or bleeding of an existing mole should all be checked by a healthcare professional. The following easy-to-remember guideline, "ABCD," is useful for identifying malignant melanoma: Asymmetry-One side of the lesion does not look like the other. Border irregularity-Margins may be notched or irregular. Color-Melanomas are often a mixture of black, tan, brown, blue, red, or white. Diameter-Cancerous lesions are usually larger than 6 mm across (about the size of a pencil eraser), but any change in size may be significant. Exams and Tests Diagnose Skin Cancer: If you have a worrisome mole or other lesion, your primary-care provider will probably refer you to a dermatologist. The dermatologist will examine any moles in question and, in many cases, the entire skin surface. Any lesions that are difficult to identify, or are thought to be skin cancer, may then be checked. A sample of skin (biopsy) will be taken so that the suspicious area of skin can be examined under a microscope. A biopsy can almost always be done in the dermatologist's office. If a biopsy shows that you have malignant melanoma, you will probably undergo further testing to determine the extent of spread of the disease, if any. This may involve blood tests, a chest X-ray, and other tests as needed. Treatment for Skin Cancer: Treatment for basal cell carcinoma and squamous cell carcinoma is straightforward. Usually, surgical removal of the lesion is adequate. Malignant melanoma, however, may require several treatment methods, including surgery, radiation therapy, and chemotherapy or immunotherapy or both. Because of the complexity of treatment decisions, people with malignant melanoma may benefit from the combined expertise of the dermatologist, a cancer surgeon, and a medical oncologist. Self-Care at Home for Skin Cancer 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. Prognosis for Skin Cancer? 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, new targeted agents or older approaches 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 70,000 malignant melanomas diagnosed in the United States in 2007, the vast majority were cured. Still, thousands of people die of melanoma each year.
