by Nancy L Synderman, M.D.
The irony does not escape me that as I sit down to write this article on skin cancer, I have just had my own skin cancer scare.
As is so common, I had my share of childhood sunburns. So when my dermatologist examined the small lesion on my chest, we both thought it was cancerous. Luckily, we were both wrong.
Skin cancer statistics are stunning. Every year, 3.5 million skin cancers are diagnosed in the U.S., more than the tally for all other cancers combined. The deadliest form, malignant melanoma, will kill 9,700 people this year; the next deadliest, squamous cell, has increased 200 percent in the past 30 years. Fortunately, we’ve made tremendous strides in diagnosis and treatment.
Warning Signs of Skin Cancer
Asymmetry: Half of a mole doesn’t match the other.
Border irregularity: The border is blurred or ragged.
Color: The mole has a variety of colors, often shades of brown, tan or black, with patches of pink, red, white or blue.
Diameter: Lesion is new or at least 1/4 inch in diameter.
Evolving: Mole is changing in size, shape or color.
Two technologies — MelaFind and dermatoscopy — use light waves and sophisticated data analysis to diagnose suspicious lesions. In a 2011 study, MelaFind was able to detect 98 percent of melanomas, compared with 78 percent by a dermatologist’s examination alone. Because melanoma can be difficult to diagnose in its earliest stages, when it’s most treatable, this is good news indeed.
On the treatment front, doctors are increasingly aggressive in attacking precancerous lesions with cryotherapy, phototherapy and topical chemotherapies such as trichloroacetic acid, 5-fluorouracil and ingenol mebutate.
Once a skin cancer is diagnosed, the first step is usually to surgically remove it. If that’s not possible, the Food and Drug Administration has approved, in addition to topical chemotherapies, several medications — among them, imiquimod and ipilimumab — that treat skin cancers by activating the body’s immune system.
The best treatment, of course, is to prevent skin damage in the first place. Be sure to wear sunscreen with an SPF of at least 15 daily. And if you notice any of the American Cancer Society’s warning signs, at right, see your doctor right away.
Nancy L. Snyderman, M.D., is the chief medical editor for NBC News