Skin Pigment And Ability To Tan
Ultraviolet radiation from sunlight affects everybody’s skin to some extent, but the skin’s response varies widely from person to person. Peoples’ sensitivity to the sun varies according to the amount of pigment in the skin and the skin’s ability to tan.
Ultraviolet radiation causes tanning in two different ways: by immediate tanning and by delayed tanning. Immediate tanning causes the skin to darken in response to UVA. This darkening begins during the period of exposure, but fades within a few hours or days. The amount of tanning increases according to the skin’s natural darkness and previous amount of tanning.
Delayed tanning occurs two to three days after exposure to either UVA or UVB. It lasts from several weeks to months, and is maintained by repeated exposure to sunlight. With delayed tanning, the skin increases its production and distribution of dark pigment. The skin also becomes thicker. These changes can follow sunburning or develop gradually over a long period of repeated brief exposures to sunlight.
Some people burn easily after the first hour of sun exposure following winter or any period away from the sun. Other people, especially those with dark skin, rarely burn. This difference in reaction makes it possible to classify skin into one of six different types .
Table adapted from: SunSmart Victoria , Australia
Recurrent Basal Cell Carcinoma
Basal cell carcinomas are the most common type of skin cancer, according to the American Cancer Society. These cancers develop within the basal cell layer of the skin, in the lowest part of the epidermis.
Patients who have had basal cell carcinoma once have an increased risk of developing a recurrent basal cell cancer. Basal cell cancers may recur in the same location that the original cancer was found or elsewhere in the body. As many as 50 percent of cancer patients are estimated to experience basal cell carcinoma recurrence within five years of the first diagnosis.
Basal cell carcinomas typically grow slowly, and it is rare for them to metastasize or spread to nearby lymph nodes or other parts of the body. But early detection and treatment are important.
After completing treatment for basal cell carcinoma, it is important to perform regular self-examinations of the skin to look for new symptoms, such as unusual growths or changes in the size, shape or color of an existing spot. Skin cancers typically develop in areas of the body that are exposed to the sun, but they may also develop in areas with no sun exposure. Tell your oncologist or dermatologist about any new symptoms or suspicious changes you may have noticed.
- Have a history of eczema or dry skin
- Have been exposed to high doses of UV light
- Had original carcinomas several layers deep in the skin
- Had original carcinomas larger than 2 centimeters
Increased Rate Of Aging Of The Skin
Repeated exposure to the sun’s ultraviolet radiation eventually causes skin damage similar to the aging process. Patches of skin become thin and less elastic, and develop blemishes, sun freckles, and wrinkles. These changes may take many years of exposure but when they occur, the damage is irreversible.
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What Is A Melanocyte
Melanocytes are skin cells found in the upper layer of skin. They produce a pigment known as melanin, which gives skin its color. There are two types of melanin: eumelanin and pheomelanin. When skin is exposed to ultraviolet radiation from the sun or tanning beds, it causes skin damage that triggers the melanocytes to produce more melanin, but only the eumelanin pigment attempts to protect the skin by causing the skin to darken or tan. Melanoma occurs when DNA damage from burning or tanning due to UV radiation triggers changes in the melanocytes, resulting in uncontrolled cellular growth.
Naturally darker-skinned people have more eumelanin and naturally fair-skinned people have more pheomelanin. While eumelanin has the ability to protect the skin from sun damage, pheomelanin does not. Thats why people with darker skin are at lower risk for developing melanoma than fair-skinned people who, due to lack of eumelanin, are more susceptible to sun damage, burning and skin cancer.
What Exactly Is Cutaneous T
Cutaneous T-cell lymphoma is a rare type of blood cancer.
It begins in a type of white blood cell called the T-lymphocyte . T-cells help prevent infections and other diseases.
As odd as it sounds, most T-cells are found in our skin. Thats because our skin is the first line of defense against disease. The surface of an adults skin contains about 20 billion T-cells. Thats nearly twice as many T-cells as found in other parts of the body.
There are many types of CTCL. More than half the people who develop CTCL will have one of the following types:
Mycosis fungoides is the most common type of CTCL. This type tends to worsen very slowly. It can stay in its earliest stage, which often looks like rash, for years. In this stage, the cancer is often difficult to diagnose because it tends to looks like eczema or psoriasis. These conditions are much more common than CTCL.
Sézary syndrome is more aggressive. It can also look like eczema. Some people develop red and swollen skin over much of their body. Their skin may feel hot, sore, and extremely itchy.
The other types of CTCL are very rare.
Cutaneous T-cell lymphoma is rare
The most common type of Cutaneous T-cell lymphoma often looks like a rash and develops on skin that gets little sunlight.
If you are diagnosed with CTCL, you may receive care from a team of doctors and other health care specialists. This team may include a dermatologist, hematologist , oncologist , and radiation oncologist .
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Basal Cell Skin Cancer
BCC is the most common type of skin cancer. About 75 out of every 100 non melanoma skin cancers are BCCs. They develop from basal cells and these are found in the deepest part of the outer layer of the skin .
They develop mostly in areas of skin exposed to the sun, including parts of the face such as the nose, forehead and cheeks. Also, on your back or lower legs.
They are most often diagnosed in people who are middle aged or older.
Doctors might also call a basal cell cancer a rodent ulcer.
There are a number of different types of BCC. Each type can look and behave differently. They include:
- nodular basal cell skin cancer
- superficial basal cell skin cancer
- morphoeic basal cell skin cancer – also known as sclerosing or infiltrating basal cell skin cancer
- pigmented basal cell skin cancer
Nodular basal cell cancer is the most common subtype.
It’s very rare for basal cell skin cancer to spread to another part of the body to form a secondary cancer. It’s possible to have more than one basal cell cancer at any one time and having had one does increase your risk of getting another.
Squamous Cell Carcinoma: Common In Sun
Squamous cell carcinoma, also called squamous cell cancer, is the second most common type of skin cancer. It accounts for about 20 percent of cases.
This type of cancer starts in flat cells in the outer part of the epidermis. It commonly crops up on sun-exposed areas, such as the face, ears, neck, lips, and hands. It can also develop on scars or chronic sores.
Squamous cell carcinomas may develop from precancerous skin spots, known as actinic keratosis .
These cancers might look like:
- A firm, red bump
- A flat lesion with a scaly, crusted surface
- A sore that heals and then reopens
People with lighter skin are more at risk for developing squamous cell carcinoma, but the skin cancer can also affect those with darker skin.
Other risk factors include:
- Having light eyes, blond or red hair, or freckles
- Being exposed to the sun or tanning beds
- Having a history of skin cancer
- Having a history of sunburns
- Having a weakened immune system
- Having the genetic disorder xeroderma pigmentosum
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What Is The Uv Index
In order to address the growing concern by Canadians regarding changes in UVR resulting from ozone depletion, Environment Canada rates the UV intensity as UV Index on a scale of 0 to 11+ . It can go to the mid-teens at midday in the tropics. In Canada the UV Index is categorized into low , moderate , high , very high and extreme .
The human health effects and precautions relating to the UV Index are summarized in the following table.
Sun Protection Messages, Environment and Climate Change Canada
Global Solar UV Index: A Practical Guide. A joint recommendation of the World Health Organization, World Meteorological Organization, United Nations Environment Programme, and the International Commission on Non-Ionizing Radiation Protection.
What Are The Survival Rates For Scc
The vast majority of SCC is cured. Only about 2 percent to 5 percent of SCC cases grow back or spread. Unfortunately, because cases of SCC are not reported to the U.S. cancer registry it is hard to estimate survival rates. It is clear that metastatic SCC is very difficult to treat. . In large groups of people studied who have distant metastatic SCC, about 70 percent died from their disease.14,15
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How Are Skin Cancer Survival Rates Measured
Cancer survival is measured in many different ways, including:1
- Five-year overall survival rate is the percentage of people who are still alive 5 years after diagnosis or treatment. If the 5-year overall survival rate after diagnosis is 85 percent, that means that 5 years after being diagnosed with melanoma, 85 of 100 people are still alive. Some of those people may still have cancer, others do not.
- Disease-free survival is how long a person survives after treatment without any sign of that cancer.
- Median overall survival is the average length of time from treatment that half the study population is still alive. For example, consider 100 people who are treated with a medication and 3.1 years later, 50 have died and 50 are alive. The median overall survival is 3.1 years.
When looking at a skin cancer survival rate, it is important to know what group was studied. Survival rates can differ greatly by cancer stage, age at diagnosis, gender, and race/ethnicity. The most accurate numbers about skin cancer survival are about melanoma because cases of melanoma are tracked in national cancer registries.
Keeping Cancer In Check
Chronic exposure to the sun or intermittent sunburns can lead to skin cancer. Skin cancer risk doubles with five or more sunburns in a lifetime, but just one bad sunburn can double the risk of melanoma. While skin cancer is uncommon in African Americans, Latinos and Asians, it can also be more deadly because they are often diagnosed later in the course of the disease.
Its important to examine your skin regularly. You should report any changes in an existing mole or any new moles to your physician. People with fair complexions have the highest risk of developing skin cancer, but everyone should avoid the sun and practice safety measures to protect their skin.
The American Cancer Society recommends the Slip, Slop, Slap and Wrap policy. When you go out in the sun, slip on a shirt, slop on sunscreen, slap on a hat and wrap on sunglasses to protect your eyes and the sensitive skin around them.
Exposure to the UV rays of tanning lamps is not safe. Tanning lamps give out UV rays, which can cause long-term skin damage and can contribute to skin cancer. Tanning bed use has been linked with an increased risk of melanoma, especially for people under 30. Most doctors and health organizations recommend not using tanning beds and sun lamps.
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Can Bcc Be Cured
Most BCCs can be treated and removed with minor surgery or other local treatment. The goals of treatment are to completely remove all cancer cells while preserving the function and appearance of the affected body part. Less than 5 percent of BCCs come back after Mohs surgery and wide excision compared to 15 percent or higher for some other treatment options.8
Your doctor will recommend a treatment approach based on how likely the cancer is to grow back and its location. Even when one BCC is removed, your risk of another separate BCC is higher. Ask your doctor how oftenand for how many yearsyou should have follow-up exams.
What Are The Survival Rates For Bcc
Cancer registries do not collect information about basal cell carcinoma because the majority of BCCs are diagnosed and treated easily in a doctors office.
Advanced BCC is so rare that there is very little information about survival rates. One study of 100 cases of metastatic BCC between 1981 and 2011 showed that median overall survival is 4.5 years. How far the cancer spread made a big difference in survival. For regional metastasis, survival was 7.2 years. For distant metastasis, it was 2 years. These estimates are based on a time when chemotherapy or radiation therapy were the only treatment options.9
Survival time with advanced BCC might be improving with newer treatments. In trials for a targeted therapy called Erivedge® , median overall survival was 2.8 years. The 1-year survival rate was 84.4 percent and the 2-year survival rate was 68 percent. Odomzo® , another targeted therapy, has similar survival outcomes. Trials of sonidegib show that 2-year survival is 93 percent for people with locally advanced BCC and 69 percent for people with metastatic BCC.10,11
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Signs Of Merkel Cell Cancer
Merkel cell cancer growths usually appear as firm, painless bumps or sores. They are found on sun-exposed areas of the body, especially the head, neck, and eyelids. The growths look like pearly pimple-like lumps and may be difficult to recognize. They can be pink, red, or purplish-blue. They usually grow quickly, which is why they are three to five times deadlier than melanoma.
A helpful way to spot Merkel cell cancer is by using the AEIOU tool:
- Asymptomatic: Most lesions are not painful or tender to the touch
- Expanding: Merkel cell cancer growths expand and grow quickly
- Immunocompromised: A compromised immune system puts someone at higher risk
- Older: More common in individuals over age 50
- UV-exposed skin: Lesions are more likely to present on sun-exposed skin
Three Most Common Skin Cancers
It is estimated that one in seven people in the United States will develop some form of skin cancer during their lifetime. Although anyone can get skin cancer, people who burn easily and are fair-skinned are at higher risk. Researchers believe that one serious sunburn can increase the risk of skin cancer by as much as 50%. A yearly skin exam by a doctor is the best way to detect skin cancer early, when it is most treatable. If you have a new growth or any change in your skin, be sure to see your doctor to have it examined. Remember, protecting yourself from the sun is the best way to prevent all forms of skin cancer.
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Types Of Melanoma Skin Cancer
Melanoma skin cancer can grow into and destroy nearby tissue. It can also spread to other parts of the body. Melanoma skin cancer is also called cutaneous melanoma and malignant melanoma of the skin.
There are 4 main types of melanoma skin cancer superficial spreading, nodular, lentigo maligna and acral lentiginous.
Know The Flow: Melanoma
Know the Flow is an educational game for you to test your knowledge. To play:
- Drag the appropriate choices from the column on the right and place them in order in the boxes on the left. Note that you will only use five of the six choices to complete the game.
- When done, click on ‘Check’ to see how many you got correct.
- For incorrect answers, click on ‘Description’ to review information about the processes.
- To try again, choose ‘Reset’ and start over.
Signs Of Squamous Cell Carcinoma
Like BCC, SCC is most commonly found in areas with frequent sun exposure like the face, ears, neck, scalp, and hands. The growths can also occur in scars or sores and look like open sores, red patches, warts or thickened skin. They can also appear in areas not affected by the sun, such as the genitals.
The skin around an SCC growth may show signs of sun damage like wrinkling and darker pigment. They can bleed or itch as well.
Risk Factors For Melanoma
Risk factors specific to melanoma:
- Sun Burn
Watch the video below to learn about some great skin cancer prevention tips. Watch the full interview with Dr. Suephy Chen.
Sun exposure:Sun exposure increases one’s risk of skin cancer. Individuals are inevitably exposed to sunlight, or ultraviolet radiation, during their daily activities. However, certain outdoor behaviors elevate an individual’s likelihood of developing cancer. Infrequent, but intense exposure to sunlight during childhood increases one’s risk of developing melanoma. 1 Melanoma is often observed on areas of the body that receive infrequent, but intense sun exposure such as the neck and the back of the legs. 19
Also, it is important to note that cutaneous melanoma may occur in regions of the body typically shielded from sunlight such as the groin and bottom of the feet.
Family HistoryIndividuals who have first degree relatives, including parents, siblings or children, diagnosed with melanoma have an 8 to 12 fold increased chance of developing melanoma. 10 This increased risk is likely due to a biological predisposition to cancer development.
Melanocytic NeviThe medical term for a marking on the skin, such as a mole or birthmark, is “nevus” . Most melanocytic nevi develop during childhood and adolescence as a result of sun burn and sun exposure. The presence of melanocytic nevi is associated with an increased risk of developing melanoma.10
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