In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to marylou@newfalconherald.com. It’s your chance to ask the doc.QUESTION:I have several spots on my skin that have changed recently. How do I know if I have skin cancer?ANSWER: Skin cancer is the most common form of cancer in the United States, with more than 1 million new cases diagnosed each year. One in five people will be diagnosed with a skin cancer in their lifetime. Skin cancer is one of the most preventable of all cancers, as over 90 percent of cases are caused by sun or tanning bed exposure. Skin cancer has traditionally been more common in men over age 50, likely because men over 40 spend more time in the sun than any other group. However, the rate of skin cancer in women under age 40 has quadrupled in the last 30 years, as young women are spending more time in the sun and tanning beds.Skin cancer can generally be divided into two groups: melanoma and non-melanoma skin cancer. Melanoma is less common but more serious. In 2006, there were approximately 60,000 new cases of melanoma, with about 8,000 deaths.Melanomas arise from moles and are more common in light-skinned people (although they are more deadly in dark-skinned people, as they are usually detected later). If caught early, melanomas are nearly always treatable, but survival can drop to as low as 15 percent if they are not treated. In addition to light skin, people with more than 100 moles and a family or personal history of skin cancer are at higher risk for developing melanoma. Above all else, sun or tanning bed exposure increases one’s risk of skin cancer. It is estimated that one blistering sunburn doubles the risk of melanoma, and those who use tanning beds are seven times more likely to develop melanoma than those who don’t. Contrary to popular belief, there are no safe light rays, and ultraviolet (UV) radiation from tanning beds is as likely to cause skin cancer as UV radiation from the sun.To check moles for signs of cancer, one should look for the “ABCDE” of melanoma. First, look for asymmetry, or a different appearance of the two halves of a mole. If you draw a line through a mole, the two sides should look about the same. Second, the borders of the mole should be smooth and even. Irregular or notched borders may be a sign of an abnormal mole. Third, check to see if the color of the mole is the same shade throughout. If a mole has several different colors in it, it may be abnormal. Next, look at the diameter of the mole. Normal moles should be less than one-fourth inch across or about the size of a pencil eraser. Finally, a mole that evolves, or changes, may be abnormal and should be checked. If any of these features occur, see your doctor to discuss testing and treatment options. Moles that have concerning features can be easily removed and biopsied, and if cancer is found, the surrounding area can be surgically excised.Non-melanoma skin cancers are much more common and typically less dangerous than melanomas. There are two main types of non-melanoma skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Both arise from the top layers of skin and are almost always caused by sun exposure. They can appear as small reddish bumps or sores or as scaly or flaky spots . They often are accompanied by other signs of skin damage, such as peeling or wrinkled skin. They often are confused for other non-cancerous skin spots, so any spot that doesn’t go away should be checked for cancer. These cancers are typically easily treated with either freezing (cryosurgery) or a simple surgical excision.The key to treating skin cancer is prevention. It is best to protect yourself by avoiding being outside in the mid-day sun, wearing long sleeves and pants and regularly wearing a wide brimmed hat. Sun screen should be used liberally and should be at least SPF 15. Keep in mind that one is exposed to UV radiation even on cloudy days, so the same precautions should be followed during all seasons.To prevent skin cancer, it is very important to avoid tanning beds, as even occasional use will damage the skin. Unfortunately, the myth that tanning will protect one from sunburns, and therefore prevent skin cancer, has been proven false. Both tanning and burning damage the skin, and both can lead to skin cancer. If you develop a concerning mole or a sun-damaged area, see your doctor as soon as possible, as precancerous and cancerous skin spots are often very treatable if detected and treated early.Kent S. Herbert, M.D.Board-Certified Family PhysicianFalcon Family Medicine7641 McLaughlin Rd.Falcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
