Skin Cancer Prevention and Early Detection - Part - I

Skin cancer is the most common of all cancer types and the number of skin cancer cases has been on the rise for the past few decades. Currently, more than 1 million skin cancers are diagnosed each year in the United States. That's more than cancers of the prostate, breast, lung, colon, uterus, ovaries, and pancreas combined.

The good news is that there is a lot you can do to protect yourself and your family from skin cancer, or to catch it early enough so that it can be treated effectively. Most skin cancers are caused by too much exposure to ultraviolet (UV) rays. Much of this exposure comes from the sun, but some may come from manmade sources, such as tanning beds.

This document discusses how skin cancer develops and some simple steps you can take to help protect yourself from getting it. It also describes how to look for signs of possible skin cancer on your body. Finding possible skin cancers doesn't require any x-rays or blood tests -- just your eyes and a mirror. If skin cancer does develop, finding it early is the best way to ensure it can be treated effectively.

Understanding Skin Cancer

Types of Skin Cancer

Skin cancers are divided into 2 general types: nonmelanoma and melanoma. Nonmelanoma skin cancers are the most common cancers of the skin. They are called nonmelanoma because this group of cancers includes all skin cancers except one -- melanoma. Cancers that develop from melanocytes (the cells that make the brown pigment that gives skin its color) are called melanomas. Melanocytes can also form benign growths called moles.

There are many types of nonmelanoma skin cancers, but 2 types are most common -- basal cell carcinoma and squamous cell carcinoma. These 2 types are also known as keratinocyte carcinomas. It is important for doctors to tell these apart, because they are treated differently. It is also important for you to know what melanomas and non-melanomas look like. That way, you can find them at the earliest possible stage, when skin cancers are cured most easily.

Basal and Squamous Cell Cancers

Basal cell cancers and squamous cell cancers are the most common cancers of the skin. They develop from skin cells other than melanocytes. Both basal cell and squamous cell cancers are found mainly on parts of the body exposed to the sun, such as the head and neck, and their occurrence is related to the amount of sun exposure over a person's lifetime.

These cancers rarely spread elsewhere in the body and are less likely than melanomas to be fatal. Nonetheless, they are important to recognize. If left untreated, they can grow quite large and can cause scarring, disfigurement, or even loss of function in some parts of the body.

Melanomas

Melanomas can occur anywhere on the body, but are more likely to develop in certain locations. The trunk is the most common site in men. In women, the legs are most commonly affected. Some experts think that melanomas develop more often in these spots because these areas are exposed to sun off and on and are more likely to get sunburned. .Rarely, melanomas can also develop in other areas, such as the eyes.

Melanoma occurs much less often than basal cell and squamous cell skin cancers, but it can be far more serious. Like basal cell and squamous cell cancers, melanoma is almost always curable in its early stages. But if left alone, melanoma is much more likely than basal or squamous cell cancer to spread to other parts of the body, where it can be very hard to treat successfully.

Understanding Ultraviolet (UV) Radiation

Ultraviolet (UV) rays are a form of invisible energy given off by the sun. Ultraviolet radiation is divided into 3 wavelength ranges:

• UVA rays help age skin cells and cause some damage to cells' DNA (the genetic "blueprint" found in the nucleus of each cell that holds the genetic information on cell growth, division, and function). UVA rays are mainly linked to long-term skin damage such as wrinkles, but are also thought to play a role in some skin cancers.


• UVB rays are mainly responsible for direct damage to the DNA, and are the rays that cause sunburns. They are also thought to cause most skin cancers.
  
  
• UVC rays don't penetrate our atmosphere and therefore are not present in sunlight. They are not normally a risk factor for skin cancer.

Although UVA and UVB rays make up only a very small portion of the sun's wavelengths, they are mainly responsible for the harmful effects of the sun on the skin. UVB radiation can damage the DNA of skin cells. If this damage affects the DNA of genes that control skin cell growth, skin cancer may be the result. Recent research has found that UVA also contributes to skin cancer formation. Scientists now believe that both UVA and UVB rays damage skin and cause skin cancer. There are no safe UV rays.

Skin cancers are one result of getting too much sun, but there are others as well. The short-term results of unprotected exposure to UV rays are sunburn and tanning. Long-term exposure causes prematurely aged skin, wrinkles, loss of skin elasticity, dark patches (lentigos, sometimes called "age spots" or "liver spots"), and pre-cancerous skin changes (such as the dry, scaly, rough-textured patches called actinic keratoses).

The sun's UV rays also increase a person's risk of cataracts and certain other eye problems and can suppress their immune system. Although dark-skinned people are generally less likely to get skin cancer than light-skinned people, they can still get cataracts and immune system suppression.

What Is the UV Index?

To increase awareness of the damaging potential of UV radiation, the Environmental Protection Agency (EPA) and the National Weather Service have developed the UV Index. The UV Index number, on a scale from 1 to 11+, is a measure of the amount of UV radiation reaching the earth's surface during an hour around noon. The higher the number, the greater the exposure to UV radiation.

The UV Index is given daily for regions throughout the country. Many newspaper and television weather forecasts now include the projected UV Index for the following day. Further information about the UV Index, as well as predictions for the following day's UV Index by zip codes, is available on the EPA's Web site at www.epa.gov/sunwise/uvindex.html. As with any forecast, local changes in cloud cover and other factors may change the actual UV levels experienced, but the UV index reminds the public to take precautions against too much exposure.

Are Some People More Prone to Sun Damage?

Everyone's skin and eyes can be damaged by the sun and other UV rays. Although people with light skin are more likely to have sun damage, darker-skinned people, including African Americans and Hispanic Americans, also can be affected.

People with darker skin tan more easily than others. But tanning is a form of skin damage. Tanning occurs when UV radiation is absorbed by the skin, causing an increase in the activity and number of melanocytes, the cells that make the pigment melanin. Melanin helps to block out damaging rays up to a point, which is why darker-skinned people burn less easily.

Those with lighter skin are more likely to burn. Sunburns are thought to increase your risk of skin cancer, especially melanoma. But UV exposure can raise skin cancer risk even without causing sunburn.

Aside from skin tone, other factors can also affect your risk of damage from UV light. You need to be especially careful in the sun if you:

• have lots of moles, irregular moles, or large moles


• have freckles and burn before tanning
• have fair skin or blond, red, or light brown hair
• were previously treated for skin cancer
• have a family history of skin cancer, especially melanoma
• live or vacation at high altitudes (UV radiation increases 4% to 5% for every 1,000 feet above sea level)
• live or vacation in tropical or subtropical climates
• work indoors all week and then get a tan on weekends
• spend a lot of time outdoors

• have certain autoimmune diseases, such as systemic lupus erythematosus (SLE, or "lupus")

• have had an organ transplant

• take medicines that lower your immunity
• take oral contraceptives (birth control pills)
• take tetracycline, sulfa drugs, or certain other antibiotics
• take naproxen sodium or certain other nonsteroidal anti-inflammatory drugs



• take phenothiazines (major tranquilizers and anti-nausea drugs)
• take tricyclic antidepressants
  
• take thiazide diuretics (medicines used for high blood pressure and some heart conditions)


• take sulfonylureas (a form of oral anti-diabetic medication)

Ask your doctor, nurse, or pharmacist about the risk of any medicines you may be taking that could increase your sensitivity to sunlight.

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