Melanie Wilson spent her younger years as many people do: lounging on the beach and tanning herself to achieve an attractive golden hue. On Jones Beach in New York, Wilson would rub herself with body oil while soaking up the rays and even sunbathed in the driveway of her home and at school using sun reflectors. She ended up paying the price for a temporarily bronzed body with multiple skin cancer surgeries. “The biopsies they did on me were so very deep and large that I felt for sure they must have gotten all the cancers. I have had the surgery on my right arm and both of my lower legs,” Wilson says. Despite the many surgeries, she still gets skin cancer symptoms. She often notices spots “of interest” all throughout her arms, legs, and face. Fortunately, most require little work to remove. “The ones that I can identify always turn out to be ‘pre-basal cell,’ (superficial benign lesions) and they can be addressed either with a simple excision or by using Aldara cream,” she says. But they pop up every few months, even though the sun damage happened decades ago. Wilson, with fair skin, light eyes, and a history of sun worshipping, is the perfect storm for skin cancer.
Skin Cancer Facts
“Skin cancer is the most common type of cancer worldwide, more than lung, breast, cervix, colon, and prostate,” says dermatologist Alberto de la Fuente, MD. But the good news, he notes, is that skin cancer is the easiest to cure.
Sunscreen is not just about preventing sunburns. It is your best defense against premature signs of aging, and skin cancer. It's never too late to start wearing it!
— AcneSkinSite (@AcneSkinSite) March 21, 2018
To demonstrate how common it is, the Skin Cancer Foundation provides compelling statistics:
- In the U.S., each year, more than 3.3 million people receive treatment for non-melanoma, a less serious type of skin cancer.
- More than 5.4 million cases of non-melanoma skin cancer are treated each year (some people receive multiple diagnoses).
- One in five Americans will develop skin cancer at some point in their life.
- One person with melanoma, the most serious type of skin cancer, passes away every 54 minutes.
- Women ages 49 and younger have a higher probability of developing melanoma than breast or thyroid cancer.
- The cost of treating melanoma in the U.S. is $8.1 billion each year.
“When caught early, skin cancer is highly treatable,” says David Lortscher, MD, dermatologist and founder of Curology. “Although the vast majority of skin cancer deaths are from melanoma, the five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 98 percent.” So, what can you do to not become a statistic? De la Fuente says the most important advice he can give is to get any new or changing lesions examined by a medical professional.
Symptoms to Watch
Staying hyper-vigilant on skin awareness is your best defense, as is staying away from the sun’s harmful ultraviolet rays. Symptoms you should look out for include:
A Growth on the Skin Found by Touching It
These growths are often overlooked and, if left untreated they can become cancerous. “[They] often form very small in shape and can really only be detected through touch, as they are often rough and/or raised,” explains dermatologist Gary Goldfaden, MD. He says you find them in areas often exposed to the sun, and some can disappear and then reappear bigger in shape. One of the more common versions of this is a small, slightly red spot, particularly on the forehead or nose. “If this spot feels quite rough, almost like sandpaper, there could be cause for concern,” says Lorna Thomas, MD, dermatologist at Detroit Medical Center and Detroit Receiving Hospital. She says that patients often treat these lesions with moisturizer, assuming they are just dry skin.
Lumps and Bumps in Places Unseen by the Sun
Skin cancers like mucosal melanoma can occur in places such as the nasal cavity or genital region, says Brenda Busby, program coordinator of pediatric and mucosal melanoma at the Melanoma Research Foundation. (Busby works for the organization but is not a medical professional).
This is me then and now. I nearly lost my life to mucosal melanoma thanks to the expert care I received, I’m here to fight another day. Please check your moles & look out for any unusual lumps or bumps & get them checked, it might save your life #cancerrightnow #melanoma #CR_UK pic.twitter.com/GhUjauFniq
— Melanomamagnet (@queenbonsai1) February 5, 2018
Mucosal melanoma is rare, making up 1 percent of skin cancer cases. But incidence rates are higher among women due to genital tract melanomas, according to research published in the International Journal of Clinical & Experimental Pathology. Despite its overall rarity, Busby says, mucosal melanoma “is one of most aggressive forms of the disease because it is often caught late. People do not know to check for it and doctors may even misdiagnose it.” JB Ward was diagnosed with vaginal mucosal melanoma in 2016 and says that mucosal melanoma primary tumors “are more of the lump and bump nature and can be painful or not painful at all, and frequently don’t have a discoloration or tint to them.” In short, it is hard to find.
Reoccurring Shiny Spots That Almost Heal
These are commonly found on the face and upper body, says Tsippora Shainhouse, MD. These persistent patches or bumps are typically pink or translucent. Occasionally, they may bleed before appearing to heal. Before they totally heal, however, they bleed again, in a process that can take place over months or years. “If you have a sore that won’t completely heal up after a few months,” Shainhouse says, “get it checked out by your dermatologist.”
Moles That Change Shape and Color
“The most obvious change is enlargement over time,” says dermatologist Mark Gray, MBChB. The change can even happen slowly and subtly—so keep your eye on them. Malignant moles “tend to be asymmetric and are varying shades of brown, black, gray, and sometimes pink,” he says. He recommends looking with a critical eye at any lesions greater than six millimeters. Of course, not all moles are easy to see. You need to check more than just your arms and neck. According to dermatologist Sam Hetz, MD, the deadliest type of skin cancer is most common in women on their back and legs. “I always make sure that patients keep an eye out for odd looking moles in these areas,” he says.
Skin Cancer Treatments
If a doctor finds squamous cell carcinomas (a non-melanoma skin cancer) at an early stage, you are in luck. Most medical professionals can conduct treatments on an outpatient basis at their office. A few such treatments include:
- Moh’s micrographic surgery—Considered one of the most effective techniques to treat basal cell carcinomas (with a 99 percent success rate), the surgery removes skin cancer layer by layer. Doctors examine the tissue under a microscope until they get to the healthy skin around a tumor.
- Radiation—For large tumors or tumors in locations more challenging for doctors to reach, radiation therapy might become a suitable alternative. In this treatment, doctors use a type of radiation called “electron beam radiation.” According to the American Cancer Society, “It uses a beam of electrons that don’t go any deeper than the skin.”
- Topical therapy—Ointments and creams are rubbed on the skin to treat visible and invisible lesions. Wilson uses topical therapy with Aldara cream, but she finds the experience less than pleasant.
- Photodynamic therapy—Drugs called photosensitizing agents are used with light to kill cancer cells. Wilson had this done approximately five times throughout years; she even has an upcoming appointment for it on her chest. “It is a good way to treat pre-basals when you don’t want surgery or to go through the horrible Aldara cream, particularly when there are many in an area.”
- Excisional surgery—A doctor uses a scalpel or a sharp razor to remove all the growth by cutting or shaving it off the skin. The wound is then closed up with stitches.
To take a hands-on approach to skin cancer, you should always get a yearly wellness check by your primary care physician. A good way to remember to do so is to schedule it around your birthday or the first of the year. This way the doctor can check out any potential moles/lesions you might miss. In addition, you should perform monthly self-checkups. “Once every month or so, look at your entire body and check your moles for any new lesions and any changes in shape, border, size, color,” says Shainhouse. She suggests doing this before you get in the shower. “Examine all of your skin, including your face, ears, neck, chest, under and on breasts, abdomen, back, armpits, arms, legs, hands, feet, nails, and genitals; use a hand mirror, if necessary.” For the harder to see places, she recommends enlisting the help of a friend to check the scalp and back of your ears and neck. And always, follow sun care best practices. Find shade, stay covered up, and apply sunscreen that’s SPF 15 or higher 30 minutes before you head outdoors and again every two hours. Hearing the word “cancer” can make you feel scared and powerless at best. Fortunately, when detected early, skin cancer is highly treatable and curable. You cannot change the sun damage you experienced in the past, but you can always change the quality of the future by practicing conscious, preventive sun care, and examining your body for any changes.