| Dr. M. Christine Lee is a board certified Dermatologist by the American Board of Dermatology. Here the doctor has answered some common questions that Bizymoms visitors have about Skin Cancer.
Q. What are the signs that I should be aware of in regard to skin cancer?
A. There is an acronym we use in dermatology called the "ABCDE’s" of recognizing skin cancer. A=Asymmetry. One part of the mole is unlike the other part. B=Borders. The borders may be irregular or notched or scalloped or ill-defined or "fuzzy". C=Color. Changes in color or multiple colors or uneven distribution of color may indicate skin cancer. D=Diameter. Any lesion larger than 6 mm (the size of a pencil eraser) may be at higher risk for cancer. A rapid increase in size over weeks or months may indicate cancer. E=Evolving. Look for changes over time, such as a mole that grows in size or that changes color or shape. Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding.
Just having one or more of these signs doesn’t necessarily mean you have a melanoma but they are tip-offs that you definitely better get them checked by a dermatologist. I tell my patients to check themselves all over at least once a month and look out for either new lesions or changes in pre-existing lesions. When in doubt, have it checked out.
Q. What are pre-cancers and squamous cell carcinoma?
A. There are 3 major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. All 3 have to be treated. Basal cell carcinoma is by far the most common and usually doesn’t kill people but they can spread locally and cause great destruction (such as loss of the eye or ear or nose). Squamous cell carcinoma and melanoma can metastasize (invade thru the blood stream) and can be deadly. Some spread slowly and others can be very aggressive and spread very quickly. Melanoma is the number killer in people under the age of 30. Skin cancer is the most common kind of cancer in the U.S. It also accounts for nearly half of all cancers in the U.S. Early detection is key for curing melanoma and skin cancer.
Pre-cancers are usually called "actinic keratoses" (AK’s)--these are precancers that lead to squamous cell carcinoma. Most people who live long enough and were exposed to enough sun will probably develop some precancers of some kind which can then lead to skin cancer. These can be treated with early detection by various creams (such as Retin-A, Efudex or Carac (5-fluorouracil), or Aldara (imiquimod)) or other treatments such as liquid nitrogen (freezing the lesions off), photodynamic therapy, ablative lasers, chemical acid peels. These treatments are not 100% and the precancers can recur and continue to progress into skin cancer despite treatment but the treatments help to decrease that risk.
There are also "precancerous" moles known as atypical or dysplastic nevi. These moles have a higher risk of turning into melanoma and are usually advised to be removed. Some patients are born with or have a genetic predisposition to developing many moles--the more moles and larger the moles and irregular shaped these moles are, the higher the risk of that patient developing melanoma. (this is called "dysplastic nevus syndrome") These patients need to be carefully monitored by a dermatologist and usually require multiple samplings of moles at regular intervals. There are many factors that contribute to a patient’s risk factors for developing skin cancer: skin type (fair vs. dark), family history of skin cancer, number and size of moles, presence of atypical moles, amount of sun exposure/damage over their lifetime especially in their younger years (80% of the sun damage that eventually leads to a skin cancer forming happens before the age of 18), number of precancers.
Q. How can this be treated before it becomes fully cancerous?
A. I’ve addressed how actinic keratoses (AK’s) are treated in the answer above. The best treatment depends on how extensive the precancers are and how widespread (ie: liquid nitrogen might be the best treatment if someone only has a few isolated treatments whereas a topical cream or photodynamic therapy might be best for a large surface area such as the entire scalp or entire chest).
The best treatment for precancerous moles is to surgically remove them.
Q. What is melanoma?
A. Skin cancer is a disease in which skin cells lose the ability to divide and grow normally. These abnormal skin cells can grow and form a mass or "tumor." Melanoma is one type of skin cancer--it is the most dangerous one. Melanoma starts in the melanocytes (the cells that produce pigment in the skin). Most melanomas usually appear dark but there is a rare form of melanoma called "amelanotic" melanoma that has no color at all and is very difficult to detect. Melanoma is very serious because the cells tend to spread rapidly from the skin to blood stream and lymphatics and then to the internal organs. Melanoma can appear anywhere on the body including the scalp or eyes or even the bottom of the feet or genital area. In women, it most often occurs on the lower legs. In men, it most often occurs on the back. Melanoma can occur suddenly on normal appearing skin or form in an existing mole or freckle.
Q. How can we contact Dr. Lee if we have further questions?
A. The best way for you to reach is by email. The best way for patients (not known to my practice) to reach me is to schedule an appointment at my office at (925) 932-9389. If a patient is already established in my practice I will sometimes answer their questions by email or phone. In general, if there are questions from the public re: the questions I’ve answered for your interview and they would like to contact me about your publication, they can reach me at my email: eastbaylaser@aol.com. They should also be referred to my website: www.eastbaylaser.com |
