Common Skin Cancer Can Signal Increased Risk Of Other Cancers
Frequent skin cancers due to mutations in genes responsible for repairing DNA are linked to a threefold risk of unrelated cancers, according to a Stanford study. The finding could help identify people for more vigilant screening.
Basal cell carcinomas are common. More than 3 million cases a year are diagnosed nationwide.jax10289/Shutterstock.com
People who develop abnormally frequent cases of a skin cancer known as basal cell carcinoma appear to be at significantly increased risk for developing of other cancers, including blood, breast, colon and prostate cancers, according to a preliminary study by researchers at the Stanford University School of Medicine.
The increased susceptibility is likely caused by mutations in a panel of proteins responsible for repairing DNA damage, the researchers found.
We discovered that people who develop six or more basal cell carcinomas during a 10-year period are about three times more likely than the general population to develop other, unrelated cancers, said Kavita Sarin, MD, PhD, assistant professor of dermatology. Were hopeful that this finding could be a way to identify people at an increased risk for a life-threatening malignancy before those cancers develop.
Sarin is the senior author of the study, which was published online Aug. 9 in JCI Insight. Medical student Hyunje Cho is the lead author.
Treatment And Clinical Trials:
- The 5-year relative survival rate from diagnosis for localized, early melanoma is over 98%, but only about 25% for melanoma that has spread to distant sites.
- Since 2007, 12 new FDA-approved melanoma therapies have been developed for treatment of the disease.
- 100% of treatments and medications currently available for melanoma were first rigorously tested in clinical trials.
- 1 in 4 clinical trials fail because they dont enroll enough patients lack of enrollment in clinical trials is one of the biggest obstacles to bringing new, potentially life-saving therapies to market.
- Of all clinical trial participants in the U.S., 80-90% are white.
- Almost half of all people who participate in a clinical trial do so to help advance science and the treatment of their condition.
- Today there are more than 400 melanoma-focused clinical trials currently recruiting patients.
- Only 15% of patients in North America have been asked to participate in a clinical research study.
- Over half of clinical trial participants would recommend participation to family and friends.
- Today, only 1 out of 20 cancer patients enroll in a clinical trial.
- About Melanoma
Q: What Other Skin Cancer Precautions Do You Recommend To Patients Of Color
I constantly stress the importance of monthly self-examinations of the skin that include not just sun-exposed areas but also the soles of the feet, the palms, the toenail and fingernail beds and also the genital areas places that one might not even think to look. Thats really where the biggest learning gap is. And everyone should get a full-body examination from a dermatologist once a year or any time they see something unusual, such as a new or changing growth or mole or, particularly in skin of color, a sore that doesnt heal. Unfortunately, most people of color are not doing this.
However, Ive observed growing awareness of the dangers of skin cancer among populations of color. We have a long way to go, but the interest is there. I think in the next phase were going to see larger-scale change that results in actual reduction of some of the disparities. Im very optimistic about the future. Interview by Lorraine Glennon
About the Expert:
Andrew Alexis, MD, MPH, is chair of the Department of Dermatology at Mount Sinai St. Lukes and Mount Sinai West in New York City. He is also professor of dermatology at the Icahn School of Medicine at Mount Sinai. As director of the Skin of Color Center in New York City, he is actively involved in advancing patient care, research and education pertaining to dermatologic disorders prevalent in ethnic skin.
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Varying Attitudes Regarding Skin Cancer
Different understandings of skin cancer and risk in minority groups may contribute to the later, more aggressive, diagnoses. For example, in one Florida-based study, researchers found that:
- Only a quarter of minorities at a health clinic had heard of skin cancer.
- About 20 percent thought their darker skin meant they could not get skin cancer.
- Just under half thought it was unlikely or very unlikely to get skin cancer.
- Around 60 percent had never done a self-skin check and only about 20 percent had ever seen a dermatologist.4
Although minorities are at a lower risk of skin cancer, it is still possible. Results like these show the importance of monitoring for signs of skin cancer to prevent delays in diagnosis. Education and awareness of skin cancer across all skin types may be key to reducing disparities.
Myth : Skin Cancer Is Not That Big Of A Deal
It is true that the most common types of skin cancers are not as deadly as many other malignancies. According to the American Cancer Society, 8.7 million people are diagnosed with the two most common types of skin cancer each year â basal cell carcinoma and squamous cell carcinoma â and very few will die from these cancers. The U.S. records about 2,000 deaths from these two cancer types every year, according to the society. In comparison, the biggest cancer killer in the U.S. â lung cancer â takes the lives of more than 150,000 Americans a year.
However, Cranmer pointed out, while the most common skin cancers aren’t as deadly as other malignancies, they can affect quality of life. Skin cancers âcan have significant impact even if they donât kill someone in terms of the destruction they cause,â he said. The costs are also significant.
And some types of skin cancers are more lethal, including melanoma, which more than one out of every 50 Americans will develop at some point in their lifetime, according to the National Cancer Institute.
In short, Cranmer emphasized, the best practice is just to take steps to prevent skin cancers and not run the risk.
Early detection and treatment also save lives from skin cancer, he added. Watch out for hallmark warning signs, including changes in a moleâs size or color, bleeding or itching.
âWhen someone around you tells you, âYou should have that checked out,â theyâre probably right,â Cranmer said.
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Myth : Its Ok As Long As Im Not A Frequent User Of A Tanning Salon
So you want to go to a tanning salon “just this one time” to get that sun-kissed look for a special event? Skip it, researchers say.
According to a systematic review of research by the International Agency for Research on Cancer, any use of a tanning bed before age 35 is associated with a 75 percent increase in risk for melanoma. The reviewers also identified an increased risk of squamous cell carcinoma, one of the most common types of skin cancer, from tanning bed use before one’s mid-30s.
The increase in risk from even limited use of tanning beds is âso impressive and disturbing,â Lee said. âEach time is hugely damaging.â
Also, a growing body of evidence supports the idea that tanning has an addictive quality. Exposure to UV releases endorphins, the âpleasure chemicalâ of the human body that stimulates the brainâs reward center. But that rush can be dangerous.
âThere are some people who are prone to addictive behavior who are prone to suntanning for the same reasons,â Cranmer said.
Racial Differences In Skin Cancer
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Cancer development, treatment, and outcomes are tricky topics to understand. The underlying reasons why a person gets cancer or how they might respond to treatment are often unknown and depend on a variety of factors. Just as we can study different risk factors and treatments, we can study different characteristics of people with cancer. Learning more about the individuals getting cancer and their overall outcomes can help us develop new treatments and better identify those at risk.
Many different cancer characteristics have been studied in recent years. However, there has been a growing interest in learning more about race and ethnicity in relation to skin cancer. In honor of Minority Cancer Awareness Month, interesting findings from a few studies on the topic are below.
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What Are The Most Common Forms Of Skin Cancer
Three types of skin cancer are the most common:
Basal cell carcinoma is a slow-growing cancer that seldom spreads to other parts of the body. Basal cells, which are round, form the layer just underneath the epidermis, or outer layer of the skin.
Squamous cell carcinoma spreads more often than basal cell carcinoma, but still is considered rare. Squamous cells, which are flat, make up most of the epidermis.
Melanoma is the most serious type of skin cancer. It occurs when melanocytes, the pigment cells in the lower part of the epidermis, become malignant, meaning that they start dividing uncontrollably. If melanoma spreads to the lymph nodes it may also reach other parts of the body, such as the liver, lungs or brain. In such cases, the disease is called metastatic melanoma.
Skin Cancer: Quick Facts From The Surgeon General
Skin cancer is a serious public health concern.
Every year, there are more than 63,000 new cases of melanoma, the deadliest form of skin cancer, resulting in nearly 9,000 deaths.
Skin cancer is the most commonly diagnosed cancer in the United States, with 5 MILLION PEOPLE treated each year.
Treatment for skin cancer costs $8.1 BILLION each year in the United States.
Anyone can get skin cancer. Although those with lighter skin are at higher risk of getting skin cancer, people with darker skin may often be diagnosed with skin cancer at a later stage, making it difficult to treat.
Most skin cancers can be preventedbut we arent doing enough.
More than 1 out of every 3 Americans reports getting sunburned each year. Sunburn is a clear sign of overexposure to UV rays, a major cause of skin cancer.
More than 400,000 cases of skin cancer, about 6,000 of which are melanomas, are estimated to be related to indoor tanning in the U.S. each year.
Tanned skin is damaged skin, yet nearly 1 out of every 3 young white women engages in indoor tanning each year.
Choose sun protection strategies that work:
- Wear a hat, sunglasses, and other protective clothing, seek shade, especially during midday hours.
- Use broad spectrum sunscreen with SPF 15+ to protect any exposed skin. Remember that sunscreen is most effective when used in combination with other methods, and when reapplied as directed.
For more information, visit: www.cdc.gov/cancer/skin
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Should You Be Screened For Skin Cancer
May 20, 2019
Skin cancer is the most common form of cancer in the United States, and some people are more prone to it than others. You should see a dermatologist if a change in your skin concerns you, but how do you know whether you require regular skin cancer screening?
We talked to UNC Medical Center dermatologist Puneet Singh Jolly, MD, PhD, to learn more.
Five Things People Of Color Should Know About Skin Cancer
This post is available in: Spanish
A common misconception about skin cancer is that, because their skin contains a higher amount of melanin, African-Americans and people with darker skin dont have to worry about exposure to the suns radiation. While it is true that skin cancer is far less prevalent in dark-skinned populations, experts say anybody can be at risk for the disease.
Skin cancer among black people makes up only one to two percent of all cases of cancer in the U.S. according to the Skin Cancer Foundation, while Hispanic and other darker-skinned populations represent four to five percent of all cases of cancer.
Everybody is at risk for developing skin cancer, says Naiara Abreu Fraga Braghiroli, M.D., Ph.D., a dermatologist at Miami Cancer Institute who specializes in skin cancer treatment that uses the latest technology to monitor and diagnose high-risk patients. Yes, darker skin has more natural protection from higher amounts of melanin equivalent to an SPF13 sunscreen, essentially but they are still at risk of developing skin cancers.
Dr. Braghiroli says there are five things people of color should know about skin cancer:
Early detection is key in curing melanoma, Dr. Braghiroli says, so if you do find an unusual spot, changing mole or a wound that doesnt heal, you want to see your dermatologist right away.
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What You Need To Know
Skin cancer is the most common cancer in the United States and worldwide.
- 1 in 5 Americans will develop skin cancer by the age of 70.
- More than 2 people die of skin cancer in the U.S. every hour.
- Having 5 or more sunburns doubles your risk for melanoma.
- When detected early, the 5-year survival rate for melanoma is 99 percent.
Theres more than meets the eye when it comes to skin cancer, so make sure you know all the facts. You can #SharetheFacts on social media by downloading images from our Skin Cancer Awareness Toolkit. For the latest news, visit our Press Room.
What Are The Survival Rates For Melanoma
The 5-year overall survival rate for melanoma is 92.7 percent, based on the most recent data from the National Cancer Institute from 2010-2016. That means that 5 years after being diagnosed with melanoma of any type, about 92 out of 100 people are still alive. This estimate includes people of both genders, all races, and all stages at diagnosis.4
Cancer stage. One important factor in estimating survival is how far the cancer has spread by the time it is diagnosed. Local melanoma is melanoma that has not spread beyond the original tumor. About 83 percent of melanomas are caught at this early stage. The 5-year survival rate for local melanoma is 99 percent.5
If cancer cells have spread to a nearby lymph node, it is called regional metastasis. In 9 percent of cases, the melanoma has spread to regional lymph nodes at diagnosis. The 5-year survival for regional melanoma is 66.2 percent.5
Distant spread is when cancer cells have traveled to distant parts of the body. About 4 percent of melanoma cases have metastasized to distant locations at the time of diagnosis. The 5-year survival for distant metastatic melanoma is 27.3 percent.5
Gender. Skin cancer survival rates in women are higher than survival rates in men at all ages and stages of cancer. Five years after diagnosis, 92.5 percent of women were alive compared to 87.3 percent of men.4,6
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Skin Cancer: Facts Statistics And You
Skin cancer refers to any cancer that begins in your skin. It may develop on any part of your skin and can spread to nearby tissues and organs if the disease advances.
There are two main types of skin cancer:
- Keratinocyte cancer develops in skin cells called keratinocytes. It has two main subtypes, basal cell carcinoma and squamous cell carcinoma .
- Melanoma develops in skin melanocyte cells. Melanocytes are skin cells that generate skins brown pigment.
Other types of skin cancer include:
- Merkel cell carcinoma
most common form of cancer in the United States. More people receive skin cancer diagnoses each year in the United States than all other cancers combined, including breast, prostate, lung, and colon cancer.
Each case of skin cancer is considered unique if a doctor believes its a separate cancer. A person may have multiple different types and cases of skin cancer.
Each year, more than 3 million Americans are affected by BCC or SCC, estimates the American Academy of Dermatology. Having one skin cancer diagnosis puts you at a for having another, too, but there are preventive measures you can take.
Here are the main types of skin cancer:
Treatment Options For Skin Cancer
The goal of any skin cancer treatment is to remove the cancer before it has a chance to spread. If the skin cancer has spread to nearby tissues or organs, treating the cancer becomes more difficult. If it hasnt spread, though, treating skin cancer is often very successful.
Treatment options include:
- Surgery. Surgically removing the cancerous spot is a common option. In some cases, the spot can be removed easily in a doctors office. More advanced cases may require in-depth surgery.
- Cryosurgery. This type of surgery freezes the affected skin, killing the cancerous cells. Over time, the dead skin cells fall off.
- Immunotherapy. Immunotherapy uses a persons immune system to target and destroy cancer. In the case of skin cancer, a medicated cream is applied to the cancerous area. The immune system then works to destroy the cancer.
- Chemotherapy. If skin cancer has progressed beyond the skin, chemotherapy can help target and kill any cancer cells surgery cant remove. Chemotherapy comes in several forms, including oral medication, injected shots, and IV infusions. It can even be applied to the skin.
- Radiation therapy. Radiation seeks out and destroys cancer cells. Radiation is used to treat a larger area, or an area thats too difficult to treat with surgery.
- In this type of therapy, a chemical is applied to the skin cancer. After staying on the skin for many hours, the skin is exposed to a special light, destroying the cancer cells.
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Myth : Im Definitely Applying My Sunscreen Correctly
Are you sure?
âItâs pretty common that people donât apply it frequently enough,â Lee said. âI think itâs common that people just apply it early in the day, but it really should be applied every two hours if youâre out in the sun.â
The Centers for Disease Control and Prevention recommends applying a thick layer of a broad spectrum sunscreen of at least SPF 15 before going outside, even on cloudy or cool days. Sunscreen should be reapplied after two hours in the sun or after swimming, sweating or using a towel.