Skin Cancer
When I was young, having a tan was a must have in order to look healthy. We never used sun screen. In fact, I don’t think it was invented yet. Those long days at the beach were spent collecting vitamin D, a tan, and a good feeling from being in the warm sun all day. It was either enjoy life or stay hidden in our fallout shelters afraid of nuclear annihilation. No wonder we lived in such bliss then.
As they grew older my dad, mom and sis developed skin cancer. It recently happened to me. As I write this, the stitches on my forehead from the removed squamous skin cancer are beginning to throb. The boil on my head that never wanted to go away tested positive for cancer and was removed.
If you’ve never had skin cancer it begins like this. When you’re young, you enjoy your time in the sun. As you get old, your skin starts looking downright motley. Like different colors of white, tan, and dark brown. Then you may get a sore or something like a boil that just doesn’t go away. In my case there was skin around the boil that felt numb. That was my clue that something was wrong.
The most common kinds of skin cancer is basal cell cancer. It affects 800,000 Americans each year. Basal cell cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer). Until recently, those most often affected were older people, particularly men who had worked outdoors. Although the number of new cases has increased sharply each year in the last few decades, the average age of onset of the disease has steadily decreased. More women are getting basal cell cancer than in the past; however, so far this has been a mostly man’s cancer. Basal cell cancer may look like a sore that just doesn’t want to go away.
Squamous cell carcinoma is the second most common skin cancer after basal cell carcinoma. It affects more than 200,000 Americans each year. It arises from the epidermis. Although squamous cell carcinomas usually remain confined to the epidermis layer of your skin, if untreated they can penetrate the underlying tissues and spread to distant tissues and organs. When this happens, they can be fatal. Squamous cell carcinomas that metastasize most often arise on sites of chronic inflammatory skin conditions or on the mucous membranes or lips.
Melanoma is the most serious form of skin cancer. But, if diagnosed and removed while it is still thin and limited to the outermost skin layer, it is almost 100% curable. However, if the cancer advances and spreads to other parts of the body, it is hard to treat and can be deadly.
During the past 10 years the number of cases of melanoma has increased more rapidly than that of any other cancer. Over 51,000 new cases are reported to the American Cancer Society each year, and it is probable that a great many more occur and are not reported. If you have a strange-looking, irregular shaped mole, don’t mess around. Have it looked at by your doctor.
Melanoma comes in four flavors:
Superficial spreading melanoma is by far the most common type, accounting for about 70 percent of all cases. This melanoma travels along the top layer of the skin for a fairly long time before penetrating more deeply. You can identify it by the appearance of a flat or slightly raised discolored patch that has irregular borders and is somewhat geometrical in form. The color may vary, and you may see areas of tan, brown, black, red, blue, or white. Sometimes an older mole will change in these ways. Or a new mole may arise with these attributes. Melanoma can be seen almost anywhere on your body, but is most likely to occur on the areas of your back or stomach if you are a man. In women it usually appears on the legs or upper back.
Lentigo maligna is similar to the superficial spreading type, as it also remains close to the skin surface for quite a while, and usually appears as a flat or mildly elevated mottled tan, brown, or dark brown discoloration. This type of melanoma is found most often in the elderly, arising on chronically sun-exposed, damaged skin on the face, ears, arms, and upper trunk. Lentigo maligna is the most common form of melanoma in Hawaii. Lentigo maligna melanoma is the insidous form.
The third type of melanoma, acral lentiginous melanoma, also spreads superficially before penetrating more deeply into your skin. It is quite different from the others, though, as it usually appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands. This type of melanoma is sometimes found in dark-skinned people. It is the most common melanoma in African-Americans and Asians, and the least common among Caucasians.
Unlike the other three types, nodular melanoma has usually spread by the time it is diagnosed. The malignancy is recognized when it becomes a bump. The color is most often black, but occasionally is blue, gray, white, brown, tan, red, or skin tone. The most frequent locations are the trunk, legs, and arms, mainly of elderly people, as well as the scalp in men. This is the most aggressive of the melanomas, and is found in 10 to 15 percent of cases.
If you know of anyone who has a strange-looking mole—talk them into having it looked at by a doctor. Better to have a slight scar from early removal than to be taking chemotherapy because you put it off.. Here are some websites for learning more about skin cancer.
http://www.skincancer.org/self_exam/spot_skin_cancer.php
http://www.nlm.nih.gov/medlineplus/skincancer.html
September 2nd, 2005 at 3:52 am
No kidding about your last statement—get a yearly checkup. It only takes a few minutes and—(trust me from personal experience)—ALL you’re gonna be thinking about from the time you are diagnosed with something suspect until they cut it out is—Did they find it in time??? Better sooner than later, and better safe than sorry. After yearly checks for the past decade they found and successfully removed a lentigo melanoma from my chest a couple of months ago. Don’t put it off, and don’t underestimate how good it feels to know that you checked out OK, either. By the way—my dermatologist says he has seen more fatalities from squamous cell carcinomas than from any other kind.
September 3rd, 2005 at 11:01 pm
Amen Brother Jess!
I got my stiches removed, and found out that the doc hadn’t remove all the cancer cells. Apparently, doctors send the skin they cut out to a lab, to make certain all the skin cancer was all cut out. Otherwise, you’d go blissfully on your way while the squamous skin cell cancer keeps spreading—hidden from view. This is why it is so insidious. What appears to be a small sore or (in my case a small boil) can have hidden tendons of growth spreading under your skin, (like an alien parasite) and you’d never know it.
So now I’m on my way to a plastic surgeon. From what I’ve heard, I’ll be staying in the surgeon’s office while they cut some more skin out, examine it under a microscope, and keep a-cuttin’ until they remove it all. Sounds like a day of fun. Enough fun to make me keep my face slathered in sun block for the rest of my life.
By the way, thanks for sharing that part about the fatalities from squamous cell skin cancer. I’ve been worried these swollen glands in my neck. Now I think my toes are aching. It’s amazing how the word “cancer” can heighten your paranoia—especially when you discover how quietly it spreads.
September 8th, 2005 at 2:05 am
Bill, sounds like you are having the Mohs procedure.
I work for a group of skin cancer surgeons who perform the Mohs micrographic procedure. With the Mohs procedure, the tissue is processed in a lab in our office immediately following an “pancake layer” (flat, thin) type of excision. While the patient remains in our waiting room, our physicians, who are also certified dermatopathologists, examine the tissue under the microscope. If cancer cells remain, you are brought back for another excision immediately. The process goes on until no cancer cells remain. Mohs micrographic surgery has the higest cure rate when it comes to skin cancer removal. You also achieve the best cosmetic result because the surgeons are only removing the affected tissue and not guessing at where the cancer cells are located. I recommend this method of removal for anyone diagnosed with a squamous cell carcinoma or basal cell carcinoma (Mohs is not appropriate for treatment of melanoma). If you are looking for a Mohs surgeon, be sure to find one who is a fellow of the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO). These surgeons have received extensive, 1-2 year training in nothing but Mohs surgery and reconstruction of the area. Be weary of surgeons who are trained by the American Society for Mohs Surgery (ASMS) as many of these physicians have received nothing more than a weekend course with no training in reconstruction. You can search for a Mohs College trained physician at http://www.mohs.net/surgeon_finder.html.
Best wishes to you !
September 8th, 2005 at 7:55 am
Thank you Laura!
For explaining the mohs procedure and contributing the information above. You are exactly right!
I just went to the dermotologist today. After looking at what was left of my squamous cell skin cancer the doc advised instead of the Mohs procedure that I might want to try applying Efudex to the area for two weeks and then return for an evaluation and another biopsy.
According to the doc, Efudex is like chemotherapy in a tube. You apply it twice a day until you start to look really ugly as it peels off the keratoses on your skin. After two weeks your skin is (according to the doc) “as smooth as a baby’s butt.” But according the the pictures on the promotional literature I’ll be looking about 20 years older in a few days. I guess you could call it “ugliness in a tube”. But I guess it beats slowly cutting a quarter-sized hole out of my forehead.
I don’t look good enough for anyone to be able to tell the difference anyway. A little bit uglier no one would notice.
September 11th, 2005 at 8:05 pm
Bill, what a detailed informative post.
I think I will reference this post on my blog about senior safety and health issues.
Your advice is sage; however, do you think the younger folk are getting the message?
Do you think George Bush’s administration will ever get what global warming is doing to these alarming increases in skin cancer?
I too remember the days of deep tanning…of baby oil and iodine to get the darkest tan. How fun it was to cut high school in the early days of spring in Philadelphia…to head with the crowd down to the Jersey shore to play football on the sand. We would arrive the next day in school wearing our great early tan…and of course, we always wore white that next day to show off our tans better.
Oh my, what we didn’t know then.
September 11th, 2005 at 10:04 pm
Hi Jeff,
Thanks for posting! I’ll post a link to your blog also, as I feel it could be of interest to the folks that read this one.
I don’t think that we can expect the Bush administration to act on the number of Americans developing skin cancer until perhaps the oil industry starts to produce sunblock products.
Then the new (oil product) sun blocker may be promoted as the cure. New scientists may be drawn in to debunk the theory of ozone depletion, or weather changes due to warming of the atmosphere from burning oil-related products. Oil will be our friend—again. And we’ll be protected, provided that we slather our bodies with SPF 86 suntan cream from Mobil/Exxon on everytime we venture outdoors.
Of course, we’ll have to blame the Chinese for global warming and the climate changes, and the ozone depletion.
—See what you started?
September 14th, 2005 at 2:50 am
Hi Bill,
LOL…
“I don’t think that we can expect the Bush administration to act…(period). At least not in our best interests. Kinda like the dark ages to me.
Do you think it will be cool to be seen wearing “SPF 86 suntan cream fromMobil/Exxon”, or will be have to wear designer brands?
Thanks for the positive thoughts on my blog…this is a new world to me.
“See what you started?”
I have been called a gadfly (had to look it up).
I’ll be popping off from time to time.
March 24th, 2006 at 11:06 pm
I am a 36 yrs. old white female. I was told by 3 different doctors for 7 years that a spot on the shin of my leg was eczema. It felt like it itched down to the bone. Last fall, at my request, I had a biopsy. It came back as squamous cell. I also had a biopsy done of a bicycle scar that I had on my knee. It was less than a year old and never was exposed to the sun. It came back as squamous cell. The bicycle scar never healed correctly and always itched. I had both removed. Now, the spot on my shin is looking “bumpy” and itching. The lab report said they got clear margins. But, now I am wondering if I need to get the stitched spot biopsied??? And I am wondering how do they know if it has gone pass the skin layer and invading the bone, etc.
May 13th, 2006 at 4:19 am
I wanted to thank you for the information that you have provided here about skin cancer. I’m a 43 year old white female that has had 3 basal cell carcinomas removed in the last 3 years. I don’t know if Tommie will check back to see this, but I definitely recommend that she get the stitched area that she is concerned about biopsied, since that is how my 2nd BCC was discovered (it was along the scar line of my first Mohs procedure and looked like it was part of the scar). I wouldn’t be overly concerned about it invading the bone unless it had spread deeply enough to be in contact with the bone. If there’s normal tissue between the tumor and the bone, it’s a pretty sure bet they got it all.
You’re performing a valuable service by talking about your skin cancer experiences. Keep up the good work!
August 11th, 2007 at 7:06 am
I’ve put up my site dealing with skin cancer and my personal treatment with Aldara. I hope this can help others.
http://www.skincancersolution.com
September 2nd, 2007 at 12:39 am
Hi Mark,
Good luck with your site at http://www.skincancersolution.com.
I see you use a cream called Aldara. How does it work compared to Effudex 40?
Your site is very informative. So many people may have skin cancer and never realize it. I hope that they’ll find their way to your site.
—Bill
July 1st, 2008 at 10:45 am
Can you say, “basal cell carcinoma”? I’ve had a number of them; I have red hair, green eyes, light complexion… and one of my cars has a sunroof and the other is a convertible. Do I remember my sunscreen? Not always.
I must! Resolution: keep SPF 45 t the 113th power—nearby—and use it!
Once a year—find a great dermatologist and see her or him.
Meantime, if you see something that looks odd, see the doc asap.
Use sunscreen. And, as Auntie Vida said in Too Wong Foo (movie)...
“believe in yourself, think good thoughts, and MOISTURIZE!”
Yeah, I know… I need to get some moisturizer… even if it is a lot
of trouble to use!
I will start using the high spf sunscreen, though!
—30—
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