HOW TO DETECT AND AVOID THE "MONSTERS" OF SKIN CANCER.
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HAPPY HALLOWEEN SUMMIT COUNTY!
It’s shaping up to be a beautiful October, and you are probably looking forward to partaking in the many festivities that make this time of year special.
In fact, I’m thinking about those ooey-gooey caramel apples already, yummm!
But as I was pondering all the different costumes and characters that I grew up with, the classic monsters came back to mind. Remember Dracula, The Wolf Man, The invisible man, The Swamp Creature, and of course Frankenstein? So freaky and somewhat creepy, right?
That’s when I thought about how creepy and freaky the different types of skin cancer can be. Yep, a real-life Frankenstein...that could be living on your body without you even knowing it! :-0
NO TRICK OR TREAT WHEN IT COMES TO YOUR SKIN
Although Halloween and the associated activities can be fun, the dangers of skin cancer and its short and long-term consequences are NOT kids play.
Look, I am not writing this article to be a fear-monger or as a scare tactic. Rather, I want to provide this information as a warning and an opportunity to educate yourself and those around you to be proactive when it comes to your health, especially your overall skin wellness.
TIME TO GET A LITTLE TECHNICAL
Skin Cancer in general has been occurring with increased frequency for the past several decades due to the fact that skin cancer detection techniques have improved, people are living longer, and that the overall population is getting more sun exposure than they did in the past. In fact, according to the Skin Cancer Foundation, in the past 30 years there have been more cases of skin cancer diagnosed EACH YEAR than ALL OTHER TYPES OF CANCER COMBINED! :(
Lets first take a look at the two most common types of non-melanoma skin cancer:
1. SQUAMOUS CELL CARCINOMA. Okay, that is definitely a mouthful. SQUAMOUS is pronounced [skwey-muh s].
Also means "scale-like".
Approximately 20% of all non-melanoma skin cancers.
Associated with metastasis to other areas of the body if not treated early enough.
Approximately 1 million cases of squamous cell carcinoma are diagnosed in the US each year.
So what’s the big deal about Squamous Cell Carcinoma?
First, we will refer to Squamous Cell Carcinoma from now on as SCC.
SCC can develop from rough scaly sun spots that you may have had for years which are precancerous (also known as "actinic keratoses"). SCC can also develop within old wounds or previously normal growths on your skin. In addition, some SCC lesions develop due to a weakened immune system, whether from certain medications you are on, in transplant patients, or other medical conditions that make you more susceptible.
The challenge of being fair skinned, having blue or green eyes and blonde or red hair is that these individuals have increased susceptibility to developing skin cancer. Of course, if your work or play habits expose you to prolonged amounts of SUN (um, hello Summit County residents and visitors)....well then you fit into this category also unless you have an extremely diligent sunscreen and sun protection regimen.
As you have probably already guessed, SCC is mainly caused by prolonged, cumulative exposure to the sun and it’s DANGEROUS UV light. Stay tuned for me to go full force "Derm-Nerd" on you in a later blog about UV.
In addition, that tanning bed that you hopefully stopped using many years ago also provides the UV exposure that can lead to SCC (and your skin still remembers the damage you did during those short intervals, even if you haven't exposed yourself to tanning beds in years!).
LETS TALK ABOUT THE SIGNS & SYMPTOMS...
RED AND SCALY:
Those red bumps or wart-like growths that especially develop on your hands, your ears, your nose, your lips, your face, or the bald spot on your scalp. These usually appear as red, scaly, rough and maybe even scabbed spots.
SCC lesions can also bleed easily if scraped or scratched. If they appear in areas other than areas exposed to the sun, they may be larger patches or growths that hurt...
MENTAL NOTE: YOUR ENTIRE BODY IS SUSCEPTIBLE
Note: SCC can appear anywhere on your body including your genital area and mucous membranes like the lips or tongue.
HOW TO TREAT SQUAMOUS CELL CARCINOMA
As with anything, the earlier you detect a potentially harmful spot, the better the chances of a healthy and positive outcome. The good news is that this type of skin cancer is absolutely treatable if caught early. In fact, an estimated 95% of patients treated have no long term effects of SCC.
Treatment options obviously depend on many variables, including but not limited to the type or aggressiveness of the SCC, size, location, and whether or not it has penetrated to the underlying layers of skin or deeper.
Types of treatment include:
Outpatient excisional surgery
Localized therapy with topical destructive treatments
Mohs' Micrographic Surgery
Liquid Nitrogen Cryosurgery
Electrodessication and Curettage (scraping and burning the involved area to remove the SCC)
Basal Cell Carcinoma
- The most common type of skin cancer
* Over 4 million individuals are diagnosed in the US every year with Basal Cell Carcinoma or BCC.
WHAT CAUSES BASAL CELL CARCINOMA?
I’ll give you two guesses for the most common cause....go ahead, I’ll wait here. ;)
Yep, you scored an A+ if you said any or all of the following: SUN. UV. TANNING BEDS/SUN LAMPS.
Again, and I cannot overstate this point, when you work and/or play in the sun frequently, especially at altitude - you are more susceptible to developing skin cancers. This is a major contributing factor as to why I am so passionate about detecting these early and being your resident Summit County “Derm-Nerd.”
But let's not forget that sometimes genetics and other causes (i.e radiation, exposure to arsenic and other caustic chemicals, etc) can play a key role in the development of BCC. These are important to consider when a BCC shows up on a sun-protected area of the body. And, in some cases, it is not always possible to identify the cause.
WHAT TO BE AWARE OF
According to Cancer.org - “These cancers usually develop on sun-exposed areas, especially the head and neck. These cancers tend to grow slowly. It’s very rare for a basal cell cancer to spread to other parts of the body. However, if a basal cell cancer is left untreated, it can grow into nearby areas and invade the bone or other tissues beneath the skin."
And, as with most cancers in general, if the BCC growth is not removed completely, it can recur (come back) in the same place on the skin or possibly grow deeper/wider underneath the skin without you realizing it. People who have had basal cell skin cancers are also more likely to get new ones in other places.
* Often BCC lesions appear as small, red or clear bumps on the most sun-exposed areas of your body.
* These lesions can look like a cyst or pimple that never seem to resolve but instead keep growing larger.
* Some aggresssive tumors can grow so large that they cause significant disfigurement.
MENTAL NOTE: CATCH IT EARLY, WATCH FOR NEW OR CHANGING SPOTS
BCCs are easily treated in their early stages. Almost 95% of all cases are curable if detected early enough.
OPEN SORE OR WOUND:
* Another sign of BCC is a persistent open sore or wound that bleeds or oozes, and does not heal.
* A not so obvious sign of BCC is a scar-like area that appears yellowish and waxy.
What you need to know about all skin cancers is that they can grow deep and wide beneath the surface of the skin so they are usually much larger than what they appear to be on the surface of the skin. If it helps, think of a skin cancer like an iceberg...the tip is easily seen and deceptively makes you think it is one size, but once you put on your scuba gear and get beneath the water line, you see the whole beast in all of it's glory. Skin cancers are a similar type of beast.
Based on this information, it is important to have these spots checked regularly and call for an immediate appointment if a new spot appears, an old spot changes, or any spot is rapidly growing. Better to be safe than sorry...
WHAT TO DO ABOUT BASAL CELL CARCINOMA
Again, this blog post isn’t to scare you into thinking that every little bump, pimple, scar, sore or abnormality is a skin cancer.
On the contrary, as with anything that is important to you, a good dose of knowledge just makes you aware and more likely to have an optimal outcome if something abnormal does develop.
* Treatment can be localized if treated early enough, and a full recovery with minimal to mild scarring is possible for the majority of these cases.
* Similar treatments to Squamous Cell Carcinoma are also used to treat BCC's.
PREVENTION IS THE BEST MEDICINE
Okay, allow me to get a little preachy here. Like my soapbox pic?
Prevention. Precaution. Preemptive. Get the idea? PRE. “The KEY is in the PRE.”
The good news is that science, technology, and more advanced education is allowing Derm-Nerds like me to know more about what's going on with your skin while also having that information sooner and more in-depth than we have had access to before. And, skin specialists can not only detect problems earlier now since patients are more educated about the importance of routine full body exams, but we can also provide tips on some cool ways to prevent skin cancer and pre-cancerous lesions.
But, here's the great news: You are more than likely already smart enough to be mastering the basics. Way to go you kindred nerds! But just keep reading to humor me....
NO NEED TO LIVE LIKE A VAMPIRE OR THE MUMMY, BUT THERE IS A REASON THEY LIVE SO LONG
The simple act of putting on sunscreen (or covering up with UV protective clothing) may not only prevent pre-cancer or skin cancer, it may also save your life. Go SPF 50 or more here in high altitude. In fact, look for broad spectrum (UVA/UVB) sunscreen and be liberal, even getting the "water-resistant" type if you plan on doing physical activity, water sports, or sweating excessively. Check the bottle to see how long before you should reapply, which should be at least every 1.5 hours or so, but may be sooner depending on the specific type of sunscreen you buy. Then set an alarm so you don't forget.
And stay away from the tanning salon and tanning beds! The UV from tanning beds has been proven to be a known human carcinogen (cancer-causing). Studies have shown that if you use a tanning bed before the age of 35, you have a 75% increased risk of developing melanoma---Yikes!
Cover up when you're outside playing and working (no matter if it is cloudy or sunny).
Wearing BIG Hats (wide brim with good neck cover also) is a good, wait, GREAT idea.
Examine your skin in a full length mirror regularly so you can detect any changes before your next scheduled visit with a Derm Nerd like me.
THE DERM-NERD'S BOTTOM LINE: YOU DON'T HAVE TO WORK HARDER, JUST BE SMARTER
Just like getting the kids ready for trick or treating or heading to that family fall festival or haunted house, you have to make smart, precautionary decisions. (like making sure costumes are easy to walk around in, or stopping our family members from eating too much candy, or simply adding reflective strips to costumes so no one gets run over by cars).
It’s those small, mindful decisions that enable enjoyment of this wonderful life. The more intentional we are with making good choices, the easier it is to obtain the results we want.
Being intentional with skin care is no different. Thinking ahead, having the right knowledge, and then applying that knowledge simply gives you a better chance of living a long healthy life.
So, for everyone who is reading this, you may have less chance of an encounter with the “Monsters of Skin Cancer” if you make some minor adjustments to your everyday habits to adequately take care of your skin.
Above all, I want you to enjoy this time of year, have crazy amounts of fun out there partaking in all that Halloween and Fall has to offer. Be safe and I look forward to trick or treating with you soon, (more treats, less trick please). :)
Kelly Ballou, PA-C Co-Founder Renew Dermatology
Frisco, Colorado (Summit County)
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