May is Skin Cancer Detection and Prevention Month
Skin cancer is the most common cancer. More than 2 million cases of skin cancer will be diagnosed this year and that’s just in the United States, according to the Centers for Disease Control and Prevention. While these statistics are staggering, there is good news: when caught early, skin cancer has a 98 percent cure rate, which is why it is imperative for people to know the warning signs and see a dermatologist for proper diagnosis.
“Skin cancers develop primarily on areas of sun-exposed skin, but can also form on areas that rarely see the light of day,” explains Dr. Larry Bishop, Health First board certified dermatologist.
More than 90 percent of skin cancers result from excessive sun exposure. Much of the damage to DNA in skin cells results from UV radiation found in sunlight, as well as in commercial tanning lamps and tanning beds.
Health First Dermatology’s Dr. Anita Saluja and Dr. Larry Bishop are on the front lines in the battle against skin cancer. Both physicians are board certified, award-winning dermatologists.
“Every time you get sunburned, you damage your skin cells and increase your risk of developing skin cancer. Having multiple sunburns as a child increases the risk of developing skin cancer as an adult,” says Dr. Bishop.
Although the damage that occurs during your younger years may not become apparent until you’re older, skin cancer is not limited just to older people. It can occur at any age. In fact, studies have found that the incidence of melanoma among adults under age 45 has risen six-fold in recent years.
Monthly, examine your whole body for any changes in your skin. Make an appointment with your dermatologist’s office to report a changing mole or if you notice any changes that worry you. A skin lesion that is bleeding, itching or crusting can be an indication of a serious problem.
Understanding Skin Cancer
Dermatologists can classify skin growths as either benign (non-cancerous) or malignant (cancerous). In addition, Actinic keratoses (AKs for short), commonly develop after repeated exposure to the sun. They are precancerous lesions of the outer layer of skin, caused by this long-term exposure to sunlight.
“I am a big fan of Levulan topical solution with BLU-U Light (photodynamic therapy) for the treatment of precancerous lesions,” said Dr. Anita Saluja, Health First board certified dermatologist.
“The Levulan topical solution is applied to the affected skin, usually the face, and it incubates for 90 minutes. After, the patient sits in front of a specialized BLU-U light for just over 16 minutes. This activates the Levulan to destroy the AKs. Some of my higher risk skin cancer patients do this treatment annually.”
Melafind is a new device that aids in the detection of worrisome pigmented lesions. This non-invasive and painless medical device sees into and analyzes the skin, providing more information and immediate results in a few easy steps so patients don’t have to wait and worry.
“Ours is the only practice in Brevard County that utilizes Melafind to aid in the detection of melanoma,” said Dr. Saluja.
Physician assistants and nurse Practitioners utilize a handheld tool to help diagnosis skin cancer called a Dermatoscope, which allows for closer inspection of skin lesions without being obstructed by surface reflections.
Most Americans will have one of these skin cancers:
- Basal cell carcinoma is easily treatable, and occurs in sun-exposed areas of the body as a pearly or waxy bump, or as a flat, flesh-colored or brown scar-like lesion.
- Squamous cell carcinoma also occurs on sun-exposed areas of the body in the form of a firm, red nodule or as a flat lesion with a scaly, crusted surface.
- Melanoma the most serious form of skin cancer, most commonly occurs on sun-damaged skin, but can also occur on skin that hasn’t even been exposed to the sun. It can affect people of any skin tone. Melanoma may appear as a large brownish spot with darker speckles or as a mole that changes in color, size or feel, or that bleeds. It may also be a small lesion with an irregular border with portions that appear red, white, brown, blue or blue-black.
Treatment for skin cancer varies according to the location, size, aggressiveness of the cancer, and the patient’s health. In most cases, the dermatologist will take a small piece of the abnormal growth for an evaluation (biopsy). These sections of tissue are then assessed under a microscope. Forms of treatment include surgical excision, Mohs micrographic surgery, chemotherapy or perhaps radiation.
Mohs Surgery is reserved for the more aggressive skin cancers that have a high risk of recurrence. The Mohs procedure involves the surgeon taking a section of tissue, which is then frozen by a technician, cut into microscopic slides, stained and prepared for reading.
Then, the Mohs surgeon examines the prepared slides for cancer cells. “Should there be more cancerous tissue present, it is removed at that time. If the tissue is all clear, at that time we perform a cosmetic closure.”
Another option is frozen section surgery when rapid analysis of removed cancer tissue is warranted. Immediately, after removal, the tissue is sent for pathology reading and then, the pathologist calls me with his or her findings. I, then, know to remove more tissue or to start cosmetic repair of the skin. The good news is often times, skin cancers are caught early and we have time to have the tissue processed for final pathology results.
“Immediately, after removal, the tissue is sent for pathology reading and then, the pathologist calls me with his or her findings. I, then, know to remove more tissue or to start cosmetic repair of the skin.”
“The good news is often times, skin cancers are caught early and we have time to have the tissue processed for final pathology results,” says Dr. Saluja.
A patient of Dr. Bishop’s for 19 years, Becky Quinn, has had an extensive history of skin cancer. After an “inkling” that some of her moles were abnormal, she made an appointment to have her skin checked.
“He saved my life,” Becky said. “All my trust is with him and the care he takes with his patients.” Dr. Bishop was able to remove cancer, including melanoma, from several places in her body, including her face, without extensive scarring.
Part of the treatment process for both doctors is an extensive education and understanding for patients. “He’s educated me so well I feel like I could be on his staff,” Becky said.
Lisa Cooke, 58, went in for a skin check with Dr. Saluja. When biopsies came back positive for squamous cell carcinoma, Dr. Saluja’s team began removing the skin cancer surgically. Since then Lisa has over a dozen spots removed. Though she never considered herself a “sun worshipper” a medication that Lisa was on made her more susceptible to skin cancer. Throughout her numerous procedures, Lisa didn’t find herself dreading visits to the office. “You do what you have to do,” Lisa said. “I have a good time, her staff is personable and I enjoy seeing them.”
As a way to raise awareness of melanoma and other types of skin cancer, and to encourage early detection through self-exams, the American Academy of Dermatology designates the first Monday in May as Melanoma Monday®.
- Current estimates indicate that one in five Americans will be diagnosed with skin cancer in their lifetime.
- Melanoma, the deadliest form of skin cancer, is the most common cancer for 25- to 29-year-olds.
The American Academy of Dermatology aims to paint the nation orange by asking the public to wear orange in support of skin cancer awareness on Melanoma Monday, May 6. The day is being designated as SPOT Orange to heighten awareness of the prevalence of skin cancer and motivate people to detect the early warning signs.
Dr. Larry Bishop
Dr. Anita Saluja
- Generously apply sun screen with a Sun Protection Factor (SPF) of 30 or greater to all exposed skin. It is critical to reapply approximately every two hours, even on cloudy days, and after swimming or sweating. Both doctors agree. “Good skin care is a must!” Dr. Saluja recommends those with active ingredients zinc oxide or titanium dioxide. “I like the use of topical anti-oxidants such as medical grade vitamin C serums.”
- A great thought for a long golf, boating, or other outdoor activity is an OTC supplement called Heliocare. It is derived from a fern native to Central/South America and it is used in addition to topical sunscreen because it benefits skin over your entire body.
- Wearing protective clothing, such as shirts with sleeves, pants, hat and sunglasses, whenever possible. “I like sun protective clothing (such as those made by Coolibar or Columbia) in high risk skin cancer patients,” Dr. Saluja said. “I also advise patients who drive a lot to have sun film on their car windows.”
- Seeking shade and remembering that the sun’s rays are strongest between 10 a.m. and 4 p.m.
- Using extra caution near water, snow, and sand because the damaging rays of the sun are reflected and intensified, increasing your chances of sunburn.
- Avoiding tanning beds. Ultraviolet light from the sun and tanning beds cause skin cancer and wrinkling. Consider using a self-tanning product instead.
Learning the Skin Cancer Alphabet
When examining moles, follow the ABC’s of detection:
A – Asymmetry (if you were to cut it in half and fold it over, it is not identical, neither side matches)
B – Borders that are irregular (jagged, scalloped or notched borders)
C – Color that varies within the same mole (having a variety of colors, even red or blue, or different shades of brown, tan or black)
D – Diameter greater than 6mm (larger than a pencil eraser)
E – Evolving mole that is changing over time (any change in size, shape, color)