Skin Cancer : Epidemic From The Sun
by David B. Schulman M.D., F.A.A.D.
There is a true epidemic of skin cancer in America. One million cases of skin cancer will occur this year in America. Lifelong sun exposure is increasing for Americans as we spend more time outdoors and the sun’s rays are becoming more intense with our loss of ozone. The use of tanning booths is a new way to further damage our skin and raise our risk for skin cancers. There are three common forms of skin cancer and we are seeing dramatic annual increases in the number of these skin cancers. Melanoma, which is the most aggressive form of skin cancer, is now the most common cause of cancer deaths in American women under forty years old.
Basal Cell Carcinoma The most common and least aggressive form of skin cancer is basal cell carcinoma. This is the most common cancer in America and happily it causes nearly no fatalities. This cancer is most common on light skinned people and thirty percent of Caucasian people in America are expected to have a basal cell in their lifetime. The great majority of basal cell carcinomas will occur on the head and neck. Though this form of cancer almost never enters the bloodstream or the lymph system, it may be locally invasive. Basal cells do grow by local extension and over time can erode and invade not just skin, but other important areas down to muscle or bone. There are more aggressive forms of basal cell carcinoma that will infiltrate and extend below the surface more than above the surface. These tumors are especially dangerous for the surrounding tissue. Basal cell tumors often appear as pale or translucent patches or raised bumps on the skin with fine blood vessels in them. They may grow for months or years without detection. The often ulcerate and bleed as they grow, but otherwise have no symptoms like itching or pain. The tendency towards growing basal cells is inherited and many patients report at least one family member with a history of basal cell. Patients will often have more than one basal cell in their lifetime and I have seen patients who have had dozens of them. Darker skin tends to get fewer basal cells but one of the first lesions I had in my new practice was an African-American women with a basal cell on the leg. She is fine and nearly everyone who has this is fine. With early detection and removal this should simply be a speed bump on the road of life.
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