Skin cancer identification, treatment, prevention

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As much as everyone loves the sunshine and long summer days at the beach, the sun is not always our friend. Combined with familial tendencies for skin cell mutations, the risks of skin cancer increase with sun exposure. Abnormal skin cells occur when errors happen in the skin cell DNA. Cells grow out of control in the epidermis. We continually shed and replace our skin cells; it is when they mutate that there is a problem. 

The three main types of abnormal cells are squamous, basal and melanoma. Squamous cell cancers or pre-cancerous lesions occur as a firm red nodule or as a flat scaly lesion. Basal cell cancers appear as a pearly or waxy bump or flat flesh colored or brown scar like lesion. Melanomas, the most serious form of skin cancer, appear as a change in an existing mole or a new mole or growth on the skin. Usually dark in color, they can also be tinged with red or blue colorations.

Although anyone can acquire skin cancers, including those with darker skin, there are risk factors. These include fair skin that freckles; light eyes; red/blond hair; history of sunburns; excessive time in sun or tanning booths; large number of moles; family history of skin cancers; precancerous lesions called actinic keratoses which are rough scaly patches; a weakened immune system; exposure to radiation; environmental toxins and chemicals; and a personal history of previous skin cancers. Other risk factors are alcohol use, poor diet, smoking, low Vitamin D levels, sedentary lifestyles and certain viruses. Note that even darker pigmented skins can and do get skin cancers and they are harder to detect.

Detecting skin cancer is all about being observant of changes in your skin. Remember the ABCDE guidelines:  Asymmetry—lesion is an irregular shape; Border—edges are ragged, not smooth; Color—dark or multi colored, red/blue tinges, or pearly; Diameter—bigger than a pencil eraser; Evolving—lesion or mole is changing. See your dermatologist with any concerns. Skin cancer detected early is the key to successful treatment.

Treatment options are based on the location, size and overall health of the individual. Freezing is used most often for superficial lesions using liquid nitrogen. Laser and photodynamic therapies are light based beams which destroy precancerous cells. Curettage is when the lesion is removed and the edges are treated. Moh’s Surgery is when a larger area is removed for a complete margin clearance of cancerous cells. If a cancer returns in the same place, Moh’s is the chosen type of treatment. Radiation is used in sensitive skin areas on the face to avoid scarring. Topical treatments in a chemotherapy cream can remove top layer abnormal cells. If hesitating to have a lesion checked, simply know that it is better to have it removed and be safe.

Prevention Tips:  Seek shade especially between 10 a.m. and 4 p.m.; avoid sunburns; never use tanning booths; use sunscreen daily all year on exposed skin, 15 SPF for daily use and 30+ for extended exposure. Examine your skin monthly, using ABCDE to identify any concerns. See a dermatologist/MD yearly for a skin check. And finally remember: we do need to be exposed to the sun directly without sun screen at least 20 minutes several times a week to maintain adequate Vitamin D levels.

On Thursday, July 19, at 1 p.m., Jean Pickens, RN at Farmington Valley Visiting Nurse Association, will speak at the Granby Senior Center on A Guide to Skin Cancer Awareness.  There will be personal stories shared as well.

Editor’s Note: Frodermann is RN MSN for FV VNA . Information obtained from Mayo Clinic, Skin Cancer Foundation, American Society of Clinical Oncology and