Tips for Avoiding the Most Common Cancer in America

People around the nation are breaking out the grills, pool toys and swim trunks, so it’s a good time to take a quick look at the most common form of cancer in the U.S. and to find out what you can do to reduce your risk.

Skin Cancer Quick Facts:

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  • More people are diagnosed with skin cancer than all other cancers combined.

  • The annual cost of treating skin cancer in the U.S. alone is estimated to be 8.1 billion dollars. That’s Billion…with a B.

  • Light-skinned people are more likely to develop skin cancer than darker-skinned people.

  • However, people with darker skin are more likely to be diagnosed with later stages of the disease initially.

  • With early treatment skin cancer is highly treatable, but even non-melanoma skin cancers can grow to the point where their treatment is disfiguring.

Millions of cases of skin cancer are found annually in the United States alone.

While it’s true that the really ‘bad guy’ version of skin cancer, melanoma, accounts for relatively few cases of the entire skin cancer spectrum, (roughly 91,000 new cases estimated last year) the facts show that developing skin cancer over the course of our lifetime is a real possibility for any of us.

Fortunately, skin cancer is highly, we’re talking HIGHLY treatable when it’s caught early, but that means you have to be able to identify warning signs and see the correct specialists sooner than later.

The not-so-good news is that roughly 1 in 5 people develop skin cancer - and those rates are increasing.

With that in mind, let’s talk about skin cancer risks as well as what can be done to identify skin cancer early.

First, we’ll take a look at the type of skin cancer that is responsible for the most deaths per year: melanoma; then we’ll get into the much more common forms of skin cancer like Basal and Squamous Cell Carcinomas.

Melanoma

Melanoma (a specific form of skin cancer) is the 5th most diagnosed cancer in men and 6th most common in women (2).

In 2019 it’s estimated that there will be 96,480 cases of invasive melanoma.  Although it only accounts for 1% of all skin cancer diagnosis, melanoma accounts for the greatest mortality of all skin cancers (2).

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A lot of people mistakenly believe that skin cancer isn’t that bad.

Maybe that’s because we’re so used to our skin! We see it all the time, it gets injured, bruised, cut and calloused - and then we see it heal, repair, and get better.

We can take it for granted that most injuries and disorders of the skin are just that - skin deep - and therefore - less serious.

That just isn’t true when it comes to melanoma.

If not caught early, melanoma can easily metastasize through lymph nodes and be the cause of cancer that subsequently develops in the liver, lungs, bones or brain (just to name a few).

If melanoma is able to metastasize, the chance of survival decreases significantly (2).

The average age for diagnosis of melanoma is 63 years old; however, it is becoming increasingly common in younger individuals (1).

In the past decade, the rate of melanoma diagnosis has increased by 53% (3). The fact the number of these cancers has been increasing for many years can be attributed to a number of possible reasons. For example, better skin cancer detection routines and techniques, increased sun exposure, and people living longer (and therefore having more overall exposure to harmful UV rays) can all contribute to these increases.

One fact that’s remained consistent is that the greatest risk factor for developing melanoma is UV exposure.

It’s estimated that 86% of all melanomas can be attributed to UV exposure (3).

Regular use of SPF 15 or higher sunscreen has been found to decrease the incidence of melanoma by 50% (3).

Other risk factors for developing melanoma include:

  • Having more than 5 sunburns in your life

  • Having red or blonde hair, and light eye color

  • Having more than 50 moles

  • Tanning bed use

  • Immunosuppression

  • A family history of skin cancer (4).

What Can Help Me Identify Melanoma?

You’ve probably learned some kind of association between skin cancer and the ‘ABC’s’. If you haven’t heard of it before, the acronym to remember is: ABCDE

Look for the ABCDE’s

Look for the ABCDE’s

  • Asymmetrical - One half of the mole doesn’t match the other.

  • Borders - This one kind of goes with the asymmetry part, but a suspicious mole could have a border or edges that are irregular or poorly defined.

  • Color - Is the mole or lesion one color, or is it varied from one area to another? Varied color is a clue that something might be suspicious.

  • Diameter - Generally melanomas are 6 millimeters or greater when they’re diagnosed, but they can be smaller. If you notice a mole that seems to be growing or is about the size of the eraser on a pencil it might be good to have a dermatologist take a look at it.

  • Evolution - Is the mole that you’re suspicious of different in some way than the rest of your moles? And if you’ve been keeping an eye on it, is it changing in any of the A, B, C or D ways we just talked about? If so, it would be a good idea to have it examined by a professional.

If you find a lesion that you suspect has melanoma-like qualities, what should you do?

We recommend you see a board-certified dermatologist. The diagnosis of melanoma needs to be done in a clinical setting usually by means of a skin biopsy.

Are people with dark skin safer from melanoma than people with very fair skin?

The body’s ability to darken its skin provides some protection from UV damage that the sun can cause to our skin. But it turns out that dark skin can actually be a detriment when it comes to melanoma. How so?

People with fair skin tend to burn more easily and sustain the kind of damage that leads them to be more susceptible to developing melanoma; but when melanoma does develop it’s also easier to detect in its early stages.

“Late-stage melanoma diagnoses are more prevalent among Hispanic and black patients than non-Hispanic white patients; 52 percent of non-Hispanic black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced stage melanoma, versus 16 percent of non-Hispanic white patients.” - Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida (10).

When it comes to skin cancer, there is no one who is ‘safe’ as a rule. Contrary to popular belief, the color of your skin doesn’t prevent you from developing skin cancer. No matter who you are, it’s important to monitor suspicious skin patterns.

What About Other Types of Skin Cancer?

Skin cancer accounts for more cancer cases in the United States than all other types of cancer combined.

Non-Melanoma Skin Cancers:

According to the Skin Cancer Foundation, there was a 77% increase in nonmelanoma skin cancer between 1994 and 2014 (3).

This includes such types as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Together, BCC and SCC represent the two most common skin cancer diagnoses.

Basal Cell Carcinoma

BCC is the most commonly diagnosed skin cancer and results in about 3,000 deaths in the United States annually (3).

Basal Cell Carcinoma

Basal Cell Carcinoma

These carcinomas have low metastatic potential, however, they can become aggressive, invade, and cause destruction of surrounding tissue. Around 40% of individuals diagnosed with basal cell carcinoma will develop another lesion within 5 years (5).

Seventy percent of basal cell carcinomas develop on the face while fifteen percent develop on the trunk (5).

If a BCC is suspected your doctor will recommend a biopsy to confirm the diagnosis.

Risk factors for developing BCC carcinoma include:

  • UV exposure

  • Arsenic exposure

  • Radiation therapy

  • Immunosuppressive therapy and

  • Basal cell nevus syndrome (5)

Squamous Cell Carcinoma

Squamous Cell Carcinoma

Squamous Cell Carcinoma

SCC is the second most common skin cancer and is more aggressive than basal cell carcinoma.

Over 90% of SCC can be cured with local therapies, but that isn’t to say that it’s less important to seek treatment promptly. Delayed diagnosis and treatment can increase the risk of mortality (6).

Use of SPF 15 or higher sunscreens can reduce the incidence of SCC by 40% (6).

Squamous cell carcinoma can present as papules, plaques, nodules, ulcerations, smooth or hyperkeratotic skin. A biopsy should be performed to confirm the presence of an SCC lesion.

Squamous cell carcinoma can develop on any surface of your skin but are more common in sun-exposed areas. 

How to Minimize Your Skin Cancer Risks

We recommend you perform regular self-checks of your skin to see if you have any new or growing lesions on your skin. 

We also recommend that you see your dermatologist if you believe you have any changing or newly developed lesions on your skin. 

As we already discussed, the best way to prevent skin cancer from developing is by using sunscreen. However, all sunscreens are not created equally. Some may even be harmful to your health.

Additionally,

Sunscreens work by filtering incoming UV rays and preventing them from coming into our contact with our skin.

There are two common ingredients that are used; organic and inorganic filters of UV radiation. Organic filters absorb into our skin while inorganic filters coat our skin. 

Why care about the sunscreen you use?

Hawaii recently banned certain sunscreens because of the harm they were doing to coral reefs (7). Granted, no one wants to kill coral reefs…but beyond that, research has found that after administration organic UV filters can be found in the blood, urine, and breast milk samples. The true extent that sunscreens impact our bodies is currently unknown.

While that raises some concerns about what's in the sunscreens we use, the benefits currently outweigh the risks. 

The environmental working group (EWG) has compiled a guide of which sunscreens are protective to both our health and our environment. You can check out their sunscreen guide here.

It should be noted that sunscreen needs to be reapplied more than once if you’re out in the sun all day. Circumstances, like whether you’re in the water, playing sports, sweating profusely, or if it’s wiped off may require more applications than expected.

We recommend applying and then reapplying sunscreen multiple times per day if you are planning on being outside for an extended period.

There is some science behind dietary antioxidants helping to reduce or potentially avoiding sunburns in some situations. This could include increased intake of dietary antioxidants such as Vitamin C, Vitamin E and Omega-3’s (9). However, while there is some evidence that dietary antioxidants are helpful, they don’t protect your skin from sunburn.

It is recommended that appropriate steps are taken to protect the skin from damage in the first place.

 
 
If I could offer you only one tip for the future, sunscreen would be it.
— Mary Schmich
 

Common Sense Tips to Stay Sun Safe

  • Wear clothes that cover and protect your skin from exposure to UV rays

  • Stay in the shade

  • Avoid being exposed or take special precautions when the sun is most direct, usually between the late morning and mid-afternoo

  • Know how long you can be outside without burning; check your local UV index to see the recommendations for your area. If you plan on being exposed for longer than they recommend take special steps to protect yourself

  • Wear sunscreen. As discussed earlier, sunscreen helps to reduce damage from UV rays that can contribute to the development of various skin cancers.

  • Remember to protect your eyes. I can almost guarantee that you’re not putting sunscreen in your eyes. Believe it or not, you can develop melanoma at various locations INSIDE YOUR EYES. To help protect your eyes, get a pair of sunglasses that are rated to screen out UV rays. Many sources recommend getting sunglasses that are rated UV400 or higher.

  • For some extra tips including how to check yourself or your partner for skin cancer, sunscreen application recommendations and much more, check out the American Academy of Dermatology’s infographic/resource page.

Stay safe in the sun and make skin-safe choices this summer!


Written by Dr. Adam Kozin

Written by Dr. Adam Kozin

(Our blog isn't designed to provide specific medical advice or replace a medical professional.  If you have any specific questions about your health, how to make changes responsibly, or would like to set up an appointment with our clinic, head to our Contact Us page and let us know)!

References:

1.     Key Statistics for Melanoma Skin Cancer. (2018). Retrieved from https://www.cancer.org/cancer/melanoma-skin-cancer/about/key-statistics.html

2.     Melanoma: Statistics. (2018, April 03). Retrieved from https://www.cancer.net/cancer-types/melanoma/statistics

3.     Skin Cancer Foundation. (n.d.). Retrieved from https://www.skincancer.org/skin-cancer-information/skin-cancer-facts

4.     Swetter, S., Tsao H., Melanoma: Clinical features and diagnosis. 2018. In Corona, R., UpToDate. Retrieved May 17 2018 from https://www-uptodate-com.scnmlib.idm.oclc.org/contents/melanoma-clinical-features-and-diagnosis?search=melanoma&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2274199811

5.     Wu P., 2018. Epidemiology, pathogenesis, and clinical features of basal cell carcinoma. In Corona, R., UpToDate. Retrieved May 17 2018 from https://www-uptodate-com.scnmlib.idm.oclc.org/contents/epidemiology-pathogenesis-and-clinical-features-of-basal-cell-carcinoma?search=basal%20cell%20carcinoma&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H27

6.     Aasi, S., 2018., Treatment and prognosis of cutaneous squamous cell carcinoma. 2018. In Corona, R., UpToDate. Retrieved May 17 2018 from https://www-uptodate-com.scnmlib.idm.oclc.org/contents/treatment-and-prognosis-of-cutaneous-squamous-cell-carcinoma?search=squamous%20cell%20carcinoma%20skin&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

7.     Glusac, E. (2018, May 03). Hawaii Passes Bill Banning Sunscreen That Can Harm Coral Reefs. Retrieved from https://www.nytimes.com/2018/05/03/travel/hawaii-sunscreen-ban.html

8.     IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (1992) Solar and ultraviolet radiation. IARC monographs on carcinogenic risks to humans, vol 55

9.     Matsui, M. S., Hsia, A., Miller, J. D., Hanneman, K., Scull, H., Cooper, K. D., & Baron, E. (2009). Non-Sunscreen Photoprotection: Antioxidants Add Value to a Sunscreen. Journal of Investigative Dermatology Symposium Proceedings, 14(1), 56–59. https://doi.org/10.1038/JIDSYMP.2009.14

10. Hu S, Soza-Vento RM, Parker DF, et al. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida. Arch Dermatol 2006; 142(6):704-8.