Do you Know your ABCDE's?

The month of May is Skin Cancer Awareness month so I thought it only fitting, as an advocate of healthy skin, that we talk about the basic kinds of skin cancer and go over the ABCDE’s of skin cancer detection in moles. First, let’s explore some of the different types of skin cancer.

Basal Cell Carcinoma is the most common form of skin cancer making up 80% of the more than 3 million skin cancer diagnoses each year. Basal Cell Carcinoma develops in the basal cell layer or lowest part of the epidermis. It is most commonly found in areas that are exposed to the sun frequently. It is diagnosed through lab testing completed by a dermatologist. It is treated in one of several ways including topical creams or chemotherapy, tissue removal, and surgery. Mohs surgery is often recommended for cancerous lesions. This type of surgery involves removing thin layers of skin until only non-cancerous tissue remains. Each layer undergoes laboratory testing while the patient waits to ensure that complete removal of malignant tissue is achieved. Basal cells are not usually metastatic which means that they do not tend to spread. Those who have had basal cell carcinomas in the past are more likely to develop new malignancies in the future, so good preventive care and frequent mole checks are advised.

Squamous Cell Carcinomas are slow growing cancer cells originating from the flat squamous cells that make up most of the epidermis. They are often found in areas that experience more sun exposure but can also be found in scar tissue, skin ulcers, and the genital region. Lesions that are rough and scaly that come and go may be Actinic Keratosis. These dry flaky patches are made up of precancerous cells and without treatment can develop into Squamous Cell Carcinomas. Squamous Cell Carcinoma can be treated with chemotherapy, radiation photodynamic therapy and in some cases Mohs surgery. Treatment should begin as soon as it is diagnosed to prevent advancement which can lead to spread in the lymph nodes, organs, or other distant tissues.

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Melanoma only comprises about one percent of cancer diagnoses per year but is responsible for the most deaths per year from skin cancer. This type of cancer is extraordinarily complex and has several subtypes. Melanoma occurs in the melanocytes or skin cells responsible for pigment production. This is why we look for symptoms in moles. Many of us have had a mole that looked a little suspicious, but do you really know what you’re looking for? The ABCDE rules are easy to remember and a good way to detect early signs of melanoma.

Please note that these are common signs of a melanoma, they are not hard and fast rules. Sometimes a mole has signs of irregularity but is completely benign, and sometimes a mole is seemingly normal but is malignant. Therefore, it is always best to get checked by a dermatologist at least once a year. If you aren't established with a dermatology practice you shouldn't wait to make an appointment as it can take up to 6 weeks to be seen as a new patient. If you have a history of skin cancer or you are high risk for developing skin cancer, your dermatologist may want to see you more frequently. Melanoma is a fast spreading cancer making it more likely to metastasize, but if caught in early stages it can be treated and cured. More importantly, protecting against UV exposure with wide brimmed hats, UPF clothing and window tinting, and wearing SPF of 30 or more every day can help prevent the development of all skin cancers in the first place. Remember to reapply sunscreen every 2 hours or 80 minutes if you are in water or sweating.

Beyond these more frequently mentioned skin cancer types are some that are lesser known. Rare and aggressive Merkel Cell Carcinoma begins in the Merkel cells which along with nerves are responsible for the skin’s sense of touch. This type of cancer is found in areas of the body that have been exposed to UV rays more frequently. Being over the age of 50 and having a compromised immune system means a higher risk for developing this type of skin cancer. Merkel Cell Carcinomas May metastasize to the brain, bones, liver or lungs, but if caught early is highly treatable. Chemotherapy, immunotherapy, radiation and surgery are all treatment options and may require a combination of therapies. Kaposi Sarcoma is an extremely rare form of skin cancer cases by herpesvirus 8. It presents as lesions or tumors on the skin, around or in the mouth, in the lungs, or in the digestive tract. Most of the cases in the United States are associated with HIV patients or severely immunocompromised patients. Cutaneous Lymphoma is a rare Non-Hodgkin's Lymphoma that develops in the lymphoid tissues of the skin, spleen and bone marrow. This cancer may appear as a red scaly plaque that is itchy mimicking eczema or psoriasis which can delay diagnosis. It is a slow growing cancer and is highly treatable.

My posts are almost always a result of my own knowledge and experience but in this case, I needed to look elsewhere to make sure I had complete reliable up-to-date information before posting. I sourced all of my information from the following websites - Cancer Centers of America -The Skin Cancer Foundation and -American Academy of Dermatology. These sites are filled with information should you want to expand your knowledge of skin cancer. Skin cancer is the most common cancer in the United States and worldwide. One in five Americans will develop skin cancer by the age of 70, and more than 2 people die from skin cancer in the United States every hour. As you can see, skin cancer is both serious and complicated, but knowing the facts, protecting from UV exposure, doing self-examination and visiting your dermatologist annually are ways you can stay active in caring for your skin health.

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