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Weekend doctor: Skin cancer

By Jay Alammar, MD
Surgical Associates of Northwest Ohio
The skin is the largest organ of the body, and skin cancer is the most common cancer in the United States regardless of age, race or skin color.

The disease incidence is reaching an epidemic level. Over 5.5 million cases of skin cancer are diagnosed each year, and approximately 15,000 people die each year from this disease. The current estimate is that 1 in 5 Americans will develop skin cancer in their lifetime.

The US average annual cost of treating skin cancer is about $8 billion. Considering this enormous cost in lives and health care dollars, increasing awareness about prevention, early detection and prompt treatment of skin cancer is crucial.

Skin cancer has two major categories:

Melanoma: This type is the cause for 4 percent of skin cancers, making it the least common. However, it is the most aggressive type and is responsible for the most deaths from skin cancer. 85 percent of melanoma cases are related to exposure the sun UV radiation. 

Non-melanoma: This type causes 95 percent of skin cancers, 90 percent of which are cases related to exposure to UV radiation.

There are two main types of non-melanoma cancers:

Basal cell cancers: These account for 75 percent of cases, and that number is slow growing Fortunately, basal cell cancers are easily treated, and the majority are curable if detected early and never metastasize.  

Squamous cell cancers: These account for 20 percent of cases and are more aggressive than basal cell cancers. Squamous cell cancers could involve lymph nodes and may metastasize if not treated promptly.

Those who have blue or green eyes, red or blond hair, fair skin that freckles or burns easily, a history of sunburns at any age, a history of excessive sun exposure, and/or a history of tanning bed use are at greater risk for skin cancer.

Those who possess these risk factors should be diligent in performing a monthly skin self-exam and a yearly clinical exam by a physician, and they should be familiar with the ABCDE of skin cancers.

A= Asymmetry (any irregularly shaped mole)

B= Borders (moles with jagged edges)

C= Color (moles with color variation)

D= Diameter (moles with diameter greater than the third of an inch or 7 mm)

E= Evolution (moles that have changed in size, shape or color)

Knowing the ABCDE of skin cancers may save your life or the life of a loved one. If you or anyone you know has a skin growth that matches any of the above criteria, show it to a primary care provider.

In the summer, many people look forward to spending time under the energizing sunrays. However, please remember that UV light secondary to sun exposure is the greatest modifiable skin cancer risk factor. Seek shade when the sunrays are strong, cover up when there is no shade, always wear sunscreen (greater than SPF 15), wear sunglasses and wide brim hats, do not forget to protect children, and avoid tanning beds and tanning supplements.

Fortunately, skin cancer is one of the most preventable and easiest to treat of all cancers. Raising awareness about the harms of unprotected sun exposure and encouraging sun-safe habits will undoubtedly save many lives. In addition, raising awareness about early detection makes treatment more curative and less disfiguring.