Skin Cancer Screenings
Because skin cancer is the most common type of cancer in the U.S., it is essential that we all protect ourselves as much as possible from developing the disease. We should all having regular skin cancer screenings by a qualified dermatologist to detect skin
cancer at the earliest possible time when there is the best possibility of a complete cure.
It is worth noting that while light-skinned individuals are much more prone to skin cancer, dark-skinned people are more likely to die from it. Clearly, then, everyone, regardless of skin tone, should have regular skin cancer screenings.
Reasons Skin Cancer Has Become So Prevalent
There are several reasons that skin cancer is being diagnosed at an increasingly alarming rate. Not only are global warming and the depletion of the ozone layer resulting in increasing exposure of our skin to ultraviolet (UV) rays. Many individuals are also using tanning salons or sunlamps, exposing themselves to ultraviolet rays even while they are indoors. It should be remembered that even “gorgeous tans” are the result of damaged skin cells. Popular misconceptions to the contrary, tans do not indicate good health, but rather demonstrate that skin cells have been harmed.
Risk Factors for Skin Cancer
Although anyone can develop skin cancer, the following factors put you at a higher risk of developing some form of the disease:
● Fair complexion
● Blue or green eyes
● Naturally blond or red hair
● Skin that burns, freckles or reddens easily
● Personal history of skin cancer
● Family history of skin cancer
● Exposure to sunlight during work or recreation
● History of sunburns, particularly early in life
● History of indoor tanning
● Having a large number of moles, especially of certain types
Smoking also puts you at higher risk of developing squamous cell carcinoma, one variety of skin cancer.
Classifications of Skin Types
People with the greatest likelihood of developing skin cancer are those with the fairest skin, though it must be remembered that even very dark-skinned people can develop, and even die from, skin cancer, so everyone requires skin check-ups.
Skin types are classified by numbers one through six, according to tone and sensitivity to UV rays, number one being the most sensitive:
1. Always burns, never tans
2. Burns easily, tans minimally
3. Burns moderately, can tan to light brown
4. Burns minimally, always tans well to moderately brown
5. Rarely burns, tans profusely to a dark shade of brown
6. Deeply pigmented, never burns
Individuals with type 1 or 2 skin are most susceptible to damage by UV exposure.
Why Skin Cancer Screenings Are Necessary
Even if you don’t have a special risk factors for skin cancer, it is important to have your skin checked periodically for suspicious lesions. This is necessary because: [1] dermatologists have the training and expertise to detect skin cancers at their earliest stages [2] dermatologists can most often distinguish suspicious skin lesions from other skin conditions and, if unsure, can do further testing [3] dermatologists can examine parts of your body that you cannot see, or are less likely to examine, such as your back, scalp, groin, or the soles of your feet and [4] dermatologists are able to detect precancerous regions and treat them before they become cancerous.
Signs of Skin Cancer or Precancerous Lesions
Many patients come into our office because they have discovered spots they are afraid may be cancerous. Signs that signal potential skin cancers should always be evaluated by a professional. Different types of cancers and precancerous cells have varying discernible patterns as follow:
Actinic Keratosis
The precancerous patches of actinic keratosis are typically smaller than an inch in diameter, and present as rough, dry or scaly areas, flat or slightly raised. Sometimes they may have a hard surface, like a wart, and they may itch. Color varies from pink to red or brown. Usually these patches appear on areas exposed to sunlight — face, ears, hands, neck, scalp, and forearms. A related precancerous condition, known as actinic cheilitis typically appears as scaly patches or ongoing roughness on the lips. Less commonly, actinic cheilitis can
present as swelling of the lip, loss of the sharp border between the lip and skin, or prominent lip lines.
Basal Cell Carcinoma
Signs of basal cell carcinoma may include two or more of the following:
● Open sore that bleeds, crusts, or oozes for several weeks
● Shiny, translucent pearly white, pink or red bump
● Raised reddish patch that crusts or itches
● Pink growth with elevated border and crusted indented center
● Scar-like white, yellow or waxy area with poorly defined border
Squamous Cell Carcinoma
Squamous cell carcinoma often announces itself by a crusty surface that may, left alone, begin bleeding. It may appear as:
● A wart-like growth with a rough texture
● A scaly, persistent, red patch with irregular borders
● An open sore that persists for weeks
● A raised growth with a rough surface and a central depression
Melanoma
Melanoma is the most serious type of skin cancer because of its ability to metastasize rapidly. This is why it is extremely important to detect melanomas at their earliest stage. The alphabet of melanoma detection is important to commit to memory:
● A is for asymmetrical
● B is for a border that is irregular of jagged
● C is for uneven color
● D is for diameter (larger than a pea)
● E is for evolving (changing over a period of days or weeks)
Although all types of skin cancers or precancers mentioned should be examined and treated by a skilled dermatologist, they are listed here in order from the least to most serious. Even so, since skin cancers are often difficult to distinguish from benign skin irregularities, as well as from one another, it is crucial to have a trained and experienced dermatologist, like Dr. Dyan Harvey-Dent, examine and evaluate your skin as part of your normal health routine.
What Exactly Occurs During a Skin Cancer Screening
Dr. Harvey-Dent is as careful and concerned about her skin cancer screenings as about all of the other procedures she performs. She will first ask you whether you have any particular areas you suspect are problematic. Then she will examine your entire body, including your scalp and
the soles of your feet, for suspicious lesions. She will, of course, focus especially on the areas you have brought to her attention.
If she finds any region she feels deserves further action, in terms of being watched and re- evaluated, frozen, or biopsied, she will first measure the designated spot with a precise ruler, not just to record its size, but to compare whether it has grown when she performs a subsequent examination. She will also record its exact location and may take a photograph of it to remember its appearance in detail.
Procedures that May Be Performed during a Skin Cancer Screening
If the doctor detects an actinic keratosis, she can freeze it with a special spray to keep it from developing into a skin cancer. If she tentatively diagnoses any type of skin cancer, she will biopsy the tissue — remove a bit of it and send it to a laboratory for microscopic examination. It may take 1 to 2 weeks for the pathology results to be completed. Once the doctor knows the pathology results, she will determine the next step.
There are several types of biopsies she may perform. The most common is an excisional biopsy during which the doctor uses a small scalpel to remove an area of abnormal skin. The other two most common types of biopsies are a shave biopsy, in which she uses a razor-type tool to remove layers of skin, or a punch biopsy, in which she uses a circular tool to remove a small section of deeper skin tissue.
Typically, if the pathology report comes back as positive for a skin cancer, Dr. Harvey-Dent will perform a larger excision in order to remove all of the malignant tissue. She may also, depending on the pathology results and the location of the skin cancer, send you on to a MOHS surgeon.
Our office is set up to treat all types of skin problems, both health-related and cosmetic, from acne and rosacea to enlarged pores and wrinkles. Nevertheless, one of the most important jobs we perform is protecting your skin from skin cancer. Please come in to have Dr. Harvey-Dent perform a skin cancer screening at least annually, or more frequently if you are at especially high risk or already have a history of skin cancer. Reach us today through the contact us page.
