What is Skin Cancer?

Cancer develops when DNA, that encodes genetic information, becomes damaged and the body cannot repair the damage. These damaged cells begin to grow and divide uncontrollably. When this occurs in the skin, skin cancer develops.

Scope of the problem

The most common cancer in South Africa is skin cancer. Everyone should learn how to recognize the signs of skin cancer, perform regular examinations of their skin, and see a dermatologist annually (more frequently if at high risk) for an exam. Skin cancer is highly curable with early detection and proper treatment.

Causes

Sun exposure is the leading cause of skin cancer. In some cases, skin cancer is an inherited condition. Between 5% and 10% of melanomas develop in people with a family history of melanoma.

APPOINTMENT
The different types of skin cancer:

Basal cell carcinoma (BCC) - the most common skin cancer.

Commonest skin cancer – about 80% of all skin cancers. Appears as a pearly nodule, non-healing ulcer, a pink elevated growth, red patch, or a waxy scar.



Squamous cell carcinoma (SCC) - About 15% of all skin cancers.

About 15% of all skin cancers. Commonly found on sun-exposed areas of the body however, it may occur anywhere. Appears as crusted/scaly lesions on an inflamed base, often with non-healing ulceration. Has the potential to metastasize (spread) to organs and can be lethal if not treated.



Melanoma - accounts for about 5% of all diagnosed skin cancers.

Accounts for about 5% of all diagnosed skin cancers.

Melanoma has been coined “the most lethal form of skin cancer” because it can rapidly spread to the lymph system and internal organs.

It causes the greatest number of skin cancer related deaths worldwide. With early detection and proper treatment, the cure rate for melanoma is about 95%.

Melanoma most often develops in a pre-existing mole or looks like a new mole, which is why it is important for people to know what their moles look like and be able to detect changes to existing moles and spot new moles. Regular self-examinations of your skin and mole mapping play a key role in early detection. Should you spot a suspicious lesion, contact a dermatologist immediately.



Actinic Keratosis - caused by years of exposure to the sun.

Appears as scaly, red lesions or hard fibrous horn-like growths on your skin. Can progress to Squamous cell carcinoma, therefore important to have them treated.



Anyone can develop skin cancer.

However, the likelihood of developing skin cancer increases with age and when you have one or more of the risk factors on this checklist:

  • History of exposure to UV rays from the sun, tanning beds, or sun lamps – whether intermittent or year round, even if the exposure was years ago
  • Had several sunburns or experienced severe, especially blistering, sunburns
  • Fair skin, blonde or red hair and blue, green, or grey eyes
  • Sun sensitive or tendency to burn or freckle rather than tan
  • Family history of melanoma or other skin cancers
  • Previous personal history of skin cancer
  • Changing mole
  • Large number of moles (> 50)
  • Diagnosed with actinic keratoses
  • Overexposure or long-term exposure to x-rays
  • Long-term treatment with immunosuppressive medication, such as those used to prevent organ rejection or treat severe arthritis
  • Weakened immune system caused by a disease, such as lymphoma or human immunodeficiency virus (HIV)
If you have any of the above risk factors, it is important that you:
  • Perform regular self-examinations of your skin to check for suspicious moles and other lesions that may be skin cancer
  • Practice sun protection
  • See a dermatologist for regular examinations
APPOINTMENT
Dr Ramkisson recommends that everyone protect their skin by following these sun protection practices :

 

Apply sunscreen generously to exposed skin daily.

Avoid deliberate tanning.
Tanning may result in premature aging (wrinkles, blotchiness, and sagging skin) as well as increasing chance of developing skin cancer. Tanning beds are just as dangerous because they, too, emit enough UV radiation to cause premature aging and skin cancer.

Get vitamin D safely through a healthy diet that includes vitamin supplements.

Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, where possible.

  • Clothing protects your skin from the sun’s harmful rays. The tighter the weave, the more sun protection provided. In fact, clothing plays such an important role in sun protection that clothing is now being designed specifically to protect against the sun.
  • A wide-brimmed hat shades your face and neck from the sun’s rays. Wide-brimmed means the brim circles the entire hat and shades both the face and neck.

Seek shade when appropriate. The sun’s rays are strongest between 10 a.m. and 3 p.m.

Use extra caution near water and sand as they reflect the damaging rays of the sun. This can increase your risk chance of sunburn.

Check your skin regularly.
If you notice anything changing, growing, or bleeding on your skin, consult a dermatologist. Skin cancer is very treatable when caught early.

APPOINTMENT
More Good Reasons to Practice Sun Protection:

Aside from skin cancer, the sun’s UV rays also cause:

Premature aging: Signs of premature aging include wrinkles, blotchiness, and loss of skin’s firmness.

Immunosuppression (weakening of the body’s ability to protect itself from cancer and other diseases).

ABCDE rule of Melanoma Detection:

Asymmetry. If you can fold the lesion in two, the two halves would not match.

Border. Melanomas often have uneven or blurred borders.

Colour. Melanoma typically is not one colour; rather it contains mixed shades of tan, brown, and black. It can also show traces of red, blue or white.

Diameter. While melanomas are usually greater than 6 millimeters when diagnosed, they can be smaller. If you notice a mole different from others, or which changes, itches, or bleeds even if it is smaller than 6 millimeters, you should see a dermatologist.

Evolving. A mole or skin lesion that looks different from the rest or is changing in size, shape or colour.

APPOINTMENT
It is important to realize that a mole may have some of the characteristics described above and not be a melanoma.

A biopsy is often necessary to distinguish an atypical mole from a melanoma. Other warning signs of melanoma include:

Change in the appearance of a mole, such as the spreading of the pigment from the border of the mole into the surrounding skin.

A mole that looks scaly, oozes, or bleeds.

Itching, tenderness, or pain in a mole or lesion.

Brown or black streak that appears underneath a nail or around the nail.

Bruise on the foot that does not heal.

Sunscreens

Sunscreens should have a Sun Protection Factor (SPF) of at least 30+ and be broad-spectrum (provides protection against UVA and UVB rays).

A shot glass full of sunscreen is considered adequate amounts to cover exposed skin properly. Here are a few more tips:

  • Don’t forget your ears, nose, neck, hands, and toes. Many skin cancers develop in these areas. Protect your lips, another high-risk area, with lip balm that offers sun protection with an SPF of 30 or higher.
  • Sunscreen should not be used to prolong sun exposure. Some UV light gets through sunscreen.
  • Sunscreens should be applied to dry skin 15-30 minutes before going outdoors, and reapplied approximately every two hours.
  • Be sure to reapply sunscreen after being in water or sweating.
  • Sunscreen does not make sunbathing safe.
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