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How Do You Know Skin Cancer

About 1 In 5 Americans Will Develop Skin Cancer Find Out The Facts About This Common Disease

Skin Cancer – What You Need To Know

Skin cancer is by far the most common cancer in the United States close to 10,000 people are diagnosed every day. Despite public health warnings to wear sunscreen, cases of the most dangerous form of skin cancer melanoma have been rising rapidly over the last few decades. But the news about skin cancer is not all bad: When treated early, even melanoma has a 5-year survival rate of 92%.

Heres what you need to know about your chances of getting skin cancer, the different types of skin cancer and what to expect for treatment.

How To Spot Skin Cancer

Skin cancer is by far the most common type of cancer. If you know what to look for, you can spot warning signs of skin cancer early. Finding it early, when its small and has not spread, makes skin cancer much easier to treat.

Some doctors and other health care professionals include skin exams as part of routine health check-ups. Many doctors also recommend that you check your own skin about once a month. Look at your skin in a well-lit room in front of a full-length mirror. Use a hand-held mirror to look at areas that are hard to see.

Use the ABCDE rule to look for some of the common signs of melanoma, one of the deadliest forms of skin cancer:

AsymmetryOne part of a mole or birthmark doesnt match the other.

BorderThe edges are irregular, ragged, notched, or blurred.

ColorThe color is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.

DiameterThe spot is larger than ΒΌ inch across about the size of a pencil eraser although melanomas can sometimes be smaller than this.

EvolvingThe mole is changing in size, shape, or color.

Basal and squamous cell skin cancers are more common than melanomas, but they are usually very treatable.

Both basal cell carcinomas and squamous cell carcinomas, or cancers, usually grow on parts of the body that get the most sun, such as the face, head, and neck. But they can show up anywhere.

Basal cell carcinomas: what to look for:

Squamous cell carcinomas: what to look for:

There Is Risk In Every Season

Just because it’s not summer and you’re not playing volleyball on a beach doesn’t mean that you’re not at risk of sun damage, which can result in a heightened risk of not only skin cancer but also cosmetic concerns such as fine lines, wrinkles, and discoloration, among others, said Dr. Peebles. Whenever the sun is shining, that risk is there.

Also, dont forget that water, sand and snow reflect the sun really well onto your skin, Dr. Peebles said. Even in the peak of winter after a big snowstorm, its still possible to get a sunburn and its still possible to get those UVA-based aging issues over time.

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The Abcdes Of Melanoma

The first five letters of the alphabet are a guide to help you recognize the warning signs of melanoma.

A is for Asymmetry. Most melanomas are asymmetrical. If you draw a line through the middle of the lesion, the two halves dont match, so it looks different from a round to oval and symmetrical common mole.

B is for Border. Melanoma borders tend to be uneven and may have scalloped or notched edges, while common moles tend to have smoother, more even borders.

C is for Color. Multiple colors are a warning sign. While benign moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. As it grows, the colors red, white or blue may also appear.

D is for Diameter or Dark. While its ideal to detect a melanoma when it is small, its a warning sign if a lesion is the size of a pencil eraser or larger. Some experts say it is also important to look for any lesion, no matter what size, that is darker than others. Rare, amelanotic melanomas are colorless.

E is for Evolving. Any change in size, shape, color or elevation of a spot on your skin, or any new symptom in it, such as bleeding, itching or crusting, may be a warning sign of melanoma.

If you notice these warning signs, or anything NEW, CHANGING or UNUSUAL on your skin see a dermatologist promptly.

A is for Asymmetry

D is for Diameter or Dark

E is for Evolving

E is for Evolving

What Are The Melanoma Stages And What Do They Mean

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Early melanomas

Stage 0 and I are localized, meaning they have not spread.

  • Stage 0: Melanoma is localized in the outermost layer of skin and has not advanced deeper. This noninvasive stage is also called melanoma in situ.
  • Stage I: The cancer is smaller than 1 mm in Breslow depth, and may or may not be ulcerated. It is localized but invasive, meaning that it has penetrated beneath the top layer into the next layer of skin. Invasive tumors considered stage IA are classified as early and thin if they are not ulcerated and measure less than 0.8 mm.

Find out about treatment options for early melanomas.

Intermediate or high-risk melanomas

Localized but larger tumors may have other traits such as ulceration that put them at high risk of spreading.

  • Stage II: Intermediate, high-risk melanomas are tumors deeper than 1 mm that may or may not be ulcerated. Although they are not yet known to have advanced beyond the primary tumor, the risk of spreading is high, and physicians may recommend a sentinel lymph node biopsy to verify whether melanoma cells have spread to the local lymph nodes. Thicker melanomas, greater than 4.0 mm, have a very high risk of spreading, and any ulceration can move the disease into a higher subcategory of stage II. Because of that risk, the doctor may recommend more aggressive treatment.

Learn more about sentinel lymph node biopsy and melanoma treatment options.

Advanced melanomas

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Laser Surgery Is Not Fda

Laser surgery is not currently used as a standard treatment for basal cell carcinoma or squamous cell carcinoma. It can, however, be an effective secondary treatment. Laser treatment is sometimes used after Mohs surgery to complete the removal of cancer cells. Lasers are effective at removing precancerous lesions, but have not been proven effective at treating cancer yet.

Looking For Signs Of Skin Cancer

Non melanoma skin cancers tend to develop most often on skin that’s exposed to the sun.

To spot skin cancers early it helps to know how your skin normally looks. That way, you’ll notice any changes more easily.

To look at areas you cant see easily, you could try using a hand held mirror and reflect your skin onto another mirror. Or you could get your partner or a friend to look. This is very important if you’re regularly outside in the sun for work or leisure.

You can take a photo of anything that doesn’t look quite right. If you can it’s a good idea to put a ruler or tape measure next to the abnormal area when you take the photo. This gives you a more accurate idea about its size and can help you tell if it’s changing. You can then show these pictures to your doctor.

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Less Common Skin Cancers

Uncommon types of skin cancer include Kaposi’s sarcoma, mainly seen in people with weakened immune systems sebaceous gland carcinoma, an aggressive cancer originating in the oil glands in the skin and Merkel cell carcinoma, which is usually found on sun-exposed areas on the head, neck, arms, and legs but often spreads to other parts of the body.

What Are The Symptoms Of Skin Cancer Of The Head And Neck

What You Should Know About Skin Cancer

Skin cancers usually present as an abnormal growth on the skin. The growth may have the appearance of a wart, crusty spot, ulcer, mole or sore. It may or may not bleed and can be painful. If you have a preexisting mole, any change in the characteristics of this spot – such as a raised or an irregular border, irregular shape, change in color, increase in size, itching or bleeding – are warning signs of melanoma. Sometimes the first sign of melanoma or squamous cell cancer is an enlarged lymph node.

Johns Hopkins Head and Neck Cancer Surgery Specialists

Our head and neck surgeons and speech language pathologists take a proactive approach to cancer treatment. Meet the Johns Hopkins specialists who will work closely with you during your journey.

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Regular Skin Checks Are Key

Regular checks by a doctor or nurse specialist, especially if you have a large number of moles or other risk factors, is key.

In addition, The Skin Cancer Foundation recommends that you do a head-to-toe self-examination of your skin every month. See the ABCDEs of skin cancer for information on what to look for. Make sure to tell your doctor if you see any new, unusual or changing moles or growths on your skin.

While these skin checks will not prevent skin cancer from developing, they can help to catch it early when it is most easily treated.

What About Other Treatments That I Hear About

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

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Where Else Does Melanoma Spread To

When melanoma advances to stage 3, it means the tumor has spread to the lymph nodes or the skin around the primary tumor and lymph nodes. In stage 4, the cancer has moved to other areas far beyond the lymph nodes, like your internal organs. The most common places melanoma spreads to are the:

  • lungs
  • brain
  • stomach, or abdomen

These growths will cause different symptoms, depending on which areas it has spread to. For example, you may feel breathless or constantly cough if the cancer has spread to your lungs. Or you may have a long-term headache that wont go away if it has spread to your brain. Sometimes the symptoms for stage 4 melanoma may not appear for many years after the original tumor was removed.

Talk to your doctor if youre feeling new pains and aches or symptoms. Theyll be able to help diagnose the cause and recommend treatment options.

There Are Everyday Things You Can Do To Reduce Your Risk For Skin Cancer

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Although some risk factors for skin cancer, like skin type and family history, cant be controlled, its best to follow best practices for the ones you can. This includes:

  • Minimizing your exposure to ultraviolet rays, by staying out of the midday sun
  • Wearing daily sunscreen with sun protection factor 15 or higher
  • Avoiding indoor tanning

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Treatment For Skin Cancer

The primary goal of skin cancer treatment is to remove all of the cancerous cells. We use a few different types of removal methods depending on multiple factors including the type, extent, and location of your skin cancer. The main types of treatment include:

  • Surgical Excision
  • Electrodesiccation and Curettage

For skin cancers that are in sensitive areas of the body, such as the face and ears or for particularly large skin cancers, we recommend a specialized surgery called MOHS surgery. With this, the surgeon looks at the removed areas under the microscope during the surgery and removes any additional abnormal tissue necessary, until the entire cancer is assured to be completely removed. This is performed at specially-trained surgeons offices.

In some cases, we can use a topical chemotherapy cream to treat the cancer instead of performing a procedure, although this is not common and not considered first-line treatment.

Another, less common treatment treatment method is a procedure that uses a specialized radiation device. There are only a few centers in the area that have this device, and patients have expressed mixed reviews due to the number of treatments required. Additionally, the results are not better than other treatment methods.

But Not All Skin Cancers Are Caused By The Sun

Smokers are more likely to develop skin cancer, particularly on the lips. While areas of the body that have been treated with radiation are more prone to developing skin cancer, conditions that weaken the immune system-such as immune suppression therapy associated with organ transplantation and exposure to certain chemicals like arsenic, industrial tar and coal also increase the risk of skin cancer. And like most cancers, having a family history increases your risk of developing skin cancer.

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I’ve Been Diagnosed With Melanomawhat Happens Next

Doctors use the TNM system developed by the American Joint Committee on Cancer to begin the staging process. Its a classification based on three key factors:

T stands for the extent of the original tumor, its thickness or how deep it has grown and whether it has ulcerated.

What Is Breslow depth?

Breslow depth is a measurement from the surface of the skin to the deepest component of the melanoma.

Tumor thickness: Known as Breslow thickness or Breslow depth, this is a significant factor in predicting how far a melanoma has advanced. In general, a thinner Breslow depth indicates a smaller chance that the tumor has spread and a better outlook for treatment success. The thicker the melanoma measures, the greater its chance of spreading.

Tumor ulceration: Ulceration is a breakdown of the skin on top of the melanoma. Melanomas with ulceration are more serious because they have a greater risk of spreading, so they are staged higher than tumors without ulceration.

N indicates whether or not the cancer has already spread to nearby lymph nodes. The N category also includes in-transit tumors that have spread beyond the primary tumor toward the local lymph nodes but have not yet reached the lymph nodes.

M represents spread or metastasis to distant lymph nodes or skin sites and organs such as the lungs or brain.

After TNM categories are identified, the overall stage number is assigned. A lower stage number means less progression of the disease.

How Common Is Skin Cancer

Skin cancer prevention: what you need to know

Skin cancer is the most common cancer diagnosed in the U.S.

Other skin cancer facts:

  • Around 20% of Americans develop skin cancer sometime in their life.
  • Approximately 9,500 Americans are diagnosed with skin cancer every day.
  • Having five or more sunburns in your life doubles your chance of developing melanoma. The good news is that the five-year survival rate is 99% if caught and treated early.
  • Non-Hispanic white persons have almost a 30 times higher rate of skin cancer than non-Hispanic Black or Asian/Pacific Islander persons.
  • Skin cancer in people with skin of color is often diagnosed in later stages when its more difficult to treat. Some 25% of melanoma cases in African Americans are diagnosed when cancer has spread to nearby lymph nodes.

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The Abcde Rule Of Melanoma

National Cancer Institute

When checking for early signs of melanoma, it’s helpful to use the ABCDE rule. The ABCDE abbreviation stands for:

  • Asymmetry: An irregular shape
  • Border: Ragged, notched, or blurred edges
  • Color: Different colors or shades within the mole
  • Diameter: Diameters over 6 millimeters
  • Evolving: Changes in size, shape, color, or appearance

Where Does Skin Cancer Develop

Skin cancer is most commonly seen in sun-exposed areas of your skin your face , ears, neck, arms, chest, upper back, hands and legs. However, it can also develop in less sun-exposed and more hidden areas of skin, including between your toes, under your fingernails, on the palms of your hands, soles of your feet and in your genital area.

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How Serious Is My Cancer

If you have skin cancer, the doctor will want to find out how far it has spread. This is called staging.

Basal and squamous cell skin cancers don’t spread as often as some other types of cancer, so the exact stage might not be too important. Still, your doctor might want to find out the stage of your cancer to help decide what type of treatment is best for you.

The stage describes the growth or spread of the cancer through the skin. It also tells if the cancer has spread to other parts of your body that are close by or farther away.

Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.

Other things can also help you and your doctor decide how to treat your cancer, such as:

  • Where the cancer is on your body
  • How fast the cancer has been growing
  • If the cancer is causing symptoms, such as being painful or itchy
  • If the cancer is in a place that was already treated with radiation
  • If you have a weakened immune system

Melanoma: The Deadliest Skin Cancer

How Do You Know If You Have A Cancerous Mole

Melanoma is the most serious type of skin cancer, because it tends to spread if its not treated early.

This cancer starts in the melanocytes cells in the epidermis that make pigment.

About 100,350 new melanomas are diagnosed each year.

Risk factors for melanoma include:

  • Having fair skin, light eyes, freckles, or red or blond hair
  • Having a history of blistering sunburns
  • Being exposed to sunlight or tanning beds
  • Living closer to the equator or at a higher elevation
  • Having a family history of melanoma
  • Having many moles or unusual-looking moles
  • Having a weakened immune system

Melanoma can develop within a mole that you already have, or it can pop up as a new dark spot on your skin.

This cancer can form anywhere on your body, but it most often affects areas that have had sun exposure, such as the back, legs, arms, and face. Melanomas can also develop on the soles of your feet, palms of your hands, or fingernail beds.

Signs to watch out for include:

  • A mole that changes in color, size, or how it feels
  • A mole that bleeds

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