Skin cancer is the most commonly diagnosed cancer in the United States. (Glanz, Shoenfeld, &
Steffen, 2010) Skin cancer is more common than lung, pancreas, or prostate cancer with more
than 1 million cases diagnosed every year. According to Fulmore, Geiger, Warner, Talbott &
Jones (2009), the American Cancer Society (ACS) reported in2007 that 1 out of 5 Americans
will develop skin cancer in their lifetime.
Cancer occurs when cells in the body start to grow out of control. There are several different kinds of cancer that can occur, but they are all caused by this uncontrolled growth of abnormal cells. These cancer cells quickly multiply into new cancer cells rather than dying out. Cancer cells can form tumors, which is what happens with skin cancer. These cells can metastasize, or invade other parts of the body. If the cancer is not detected, and treated in time it can result in death. (“What is cancer”, ACS, 2010)
There are three main types of skin cancer, basal cell carcinoma, squamous cell carcinoma, and melanoma. Each type is named for the type of skin cell where it originates. (“Skin cancer”, Wikipedia, 2010) The most common risk factor for skin cancer is Ultra Violet (UV) light exposure, which is estimated to be responsible for 90% of skin cancers. (Roberts & Black, 2009)
In addition to being classified based on the specific cells they affect, skin cancers are also classified by the general type of skin cell that they invade. The two general groups of skin cancer classifications are keratinocyte carcinoma and melanoma.
Keratinocyte carcinomas are the first group. These cancer cells are so named because they arise from keratinocyte cells. The two most common types of keratinocyte cancer are basal cell carcinoma and squamous cell carcinoma. (“What are basal and squamous cell skin cancers?, ACS, 2010)
Basal cell carcinoma begins in the lowest layer of the skin, the basal cell layer. About 80% of skin cancers are Basal cell carcinomas. “They usually begin on skin exposed to the sun, such as the head and neck.” (ACS 2010 What Are Basal and Squamous Cell Skin Cancers) Historically, basal cell carcinoma was usually found in middle age or older people but recently more and more young people are being diagnosed with basal cell carcinoma. This is likely due to young people having increased exposure to the sun with little or no protection. . Basal cell carcinoma tends to grow very slowly and is rare for it to metastasize, or spread to other parts of the body. If left untreated, however, it can metastasize. Even after treatment, basal cell carcinoma can recur in the same area of the skin. New basal cell cancers can occur on other parts of the body as well. Nearly half of basal cell carcinoma patients will get a new skin cancer diagnosis within five years. (“What are basal and squamous cell skin cancers?, ACS, 2010)
Squamous cell carcinoma occurs in the upper part of the epidermis where the squamous cells are located. About 20% of skin cancers are squamous cell carcinoma. Squamous cell carcinoma most often occurs in the area of the skin most exposed to the sun, such as the head, neck, ears, and arms. It can also occur in the within skin ulcers or scars, or, rarely, in the skin of the genital area. Squamous cell carcinoma is more likely than basal cell carcinoma to metastasize to other parts of the body or lymph nodes, although this is still fairly uncommon. (“What are basal and squamous cell skin cancers?, ACS, 2010)
Melanoma begins in the melanocytes, which are the skin cells that produce melanin. Melanin is the pigment in the skin that makes skin tan or brown. Most melanoma tumors are brown or black because the melanoma cells produce melanin. This is not always true, however, as melanomas can sometimes be non-pigmented, the same color as the surrounding skin. Unlike keratinocyte carcinomas that occur on sun-exposed areas of the skin, melanomas can occur anywhere on the body. In men, the most common sites are the chest and back, while in women, the most common site is the legs. Melanoma is much less common than basal cell and squamous cell carcinoma, but is far more dangerous. Although melanoma has a high rate of cure when caught early, it is much more likely to metastasize to other areas of the body than basal cell or squamous cell carcinomas. (What is melanoma?, ACS, 2010)
Having dark pigmented skin lowers your risk of developing melanoma, but even people with dark skin can develop melanoma on the palms of their hands, under their nails, or on the soles of their feet. In rare instances, melanoma can even form in parts of the body such as the mouth, eyes, and vagina. (What is melanoma?, ACS, 2010)
Risk factors for developing skin cancer include age, sun sensitive phenotypes, such as people with blue eyes, fair skin, and light-colored hair. Other risk factors include family history, personal history of precancerous lesions, or a history of excessive sun exposure such as multiple sunburns. (Glanz et al., 2010).
North America, Europe, and Australia have all seen increases in skin cancer rates in the past thirty years. “During this period, melanoma incidence rates more than doubled, and nonmelanoma skin cancer rates exceeded those of all other cancers combined”, (Roberts & Black, 2009). Many countries have started skin cancer awareness campaigns to make people aware of the dangers of prolonged UV exposure. The Centers for Disease Control and Prevention (CDC) and the ACS have recognized a need to educate children and adolescents about skin cancer awareness and prevention. These programs enhance awareness and prevention of the risks of UV radiation and skin cancer. (Fulmore et al., 2009)
Simple steps can be taken to lessen UV exposure, such as lessening the amount of time spent in the direct sun, wearing long sleeves, hats, and sunglasses when outside, and frequent application of sunscreen. UV radiation levels are the highest from 10am to 2pm. Skin damage can occur in as little as 30 minutes of sun exposure. Studies have shown that high levels of childhood sun exposure are linked to increased risk of skin cancers later in life. It is important to protect children from sun exposure and to teach them about protecting themselves, as they get older. (Fulmore, Geiger, et al., 2009)
Although it isn’t possible or practical to avoid sunlight completely, but too much sunlight can be harmful, but there are simple ways to limit the amount of exposure to UV rays. “Slip! Slop! Slap!… and Wrap” is a catch phrase that the ACS uses to help people remember four key methods to reduce sun exposure. The first method is to “slip” on a long-sleeved shirt when going outside to protect your arms from excess UV radiation. The second method is to “slop” on sunscreen, and remember to reapply the sunscreen every two hours when outside. The third method is to “slap” on a hat when going out side to protect your head, ears, and face from excess UV radiation. The final method is to “wrap” sunglasses around your face to protect your eyes from the sun. (“Skin cancer prevention and early detection”, ACS, 2010)
There are several different ways to treat skin cancer. The type of progression of the cancer determines the treatment. Often, skin cancer can be treated with minor surgery. In these instances, the skin tumor is cut out of the skin. In some instances topical medicine for the skin can be used. Currently, imiquinod cream is used in early stage melanomas to help the body fight back against the cancer cells. In skin cancers with a high risk of spreading, surgery may be followed by radiation or chemotherapy. (“How is melanoma skin cancer treated?”, ACS, 2010)
New vaccines have been developed to fight skin cancers. Weakened melanoma cells can be given to a patient to try and make the body’s immune system kill the cancer cells. BCG (Bacille Calmette-Guerin) is a bacterium related to the germ that causes tuberculosis (Tb) it is sometimes used to help treat stage III melanomas via a shot (injection) right into the tumors. (“How is melanoma skin cancer treated?”, ACS, 2010)
Throughout the world skin cancer has been increasing. Several countries have started awareness and detection programs such as free skin cancer screenings. Many new treatments and options for care and prevention are now available and are increasing everyday with advanced research. There may not be a cure for cancer as of yet but prevention is the best medicine and skin cancer is preventable.
REFERENCES
American Cancer Society. (March 29, 2010). How Is Melanoma Skin Cancer Treated?. In Skin Cancer-Melanoma. Retrieved April 25, 2010, from http://www.cancer.org/docroot/CRI/content/CRI_2_2_4X_How_Is_Melanoma_Skin_Cancer_Treated_50.asp?sitearea=.
American Cancer Society. (March 23, 2010). What Are Basal and Squamous Cell Skin Cancers?. In Overview: Skin Cancer - Basal and Squamous Cell. Retrieved April 25, 2010, from http://www.cancer.org/docroot/CRI/content/CRI_2_2_1x_What_Is_Nonmelanoma_Skin_Cancer_51.asp?sitearea=.
American Cancer Society. (n.d.). What Is Cancer?. In Overview: What Is Cancer?. Retrieved April 25, 2010, from http://www.cancer.org/docroot/CRI/content/CRI_2_2_1x_What_Is_Cancer.asp?sitearea=.
American Cancer Society. (March 5, 2010). What Is Melanoma?. In Skin Cancer-Melanoma. Retrieved April 25, 2010, from http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_melanoma_50.asp?sitearea=.
Anonymous. (n.d.). Skin Cancer. In Skin Cancer. Retrieved April 24, 2010, from http://en.wikipedia.org/wiki/Skin_cancer.
Fulmore, J.S., Geiger, B.F., Werner, K.A., Talbott, L.L.& Jones, D.C. (2009). Sun protection education for healthy children. Childhood Education, 85 (5), 293-299.
Glanz, K., Schoenfeld, E.R., & Steffen A. (2010). A randomized trial of tailored skin cancer prevention messages for adults: Project SCAPE. American Journal of Public Health, 100 (4), 735-741.
Roberts, D.C., & Black, D. (2009). Comparison of interventions to reduce sun exposure. Behavioral Medicine, 35 (2), 67-76.
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