Skin Cancer

Skin cancer is the most common form of cancer in the United States. In the United States in 2009, 61,646 people were diagnosed with melanomas of the skin, and 9,199 people died from it. The Centers for Disease Control and Prevention leads national efforts to reduce skin cancer through education. When in the sun:
  • Cover up
  • Get a hat
  • Seek shade
  • Use sunscreen
  • Wear sunglasses
A Common, Sometimes Deadly Form of Cancer
Several million individuals are diagnosed and treated for skin cancer each year, making it the most common form of cancer.Whereas the vast majority of these cases are curable basal or squamous cell carcinomas, more than 75,000 people will be diagnosed with melanomas of the skin, a dangerous form of skin cancer often caused by overexposure to ultraviolet (UV) rays, typically from the sun.Incidence of melanoma has grown markedly over the past several decades, having risen 3.8% a year since 1995 among those age 15 to 34, and 8.8% a year among those 65 and older since 2003. Skin cancers kill nearly 12,000 Americans each year, with more than 2/3 of these individuals dying from melanoma. Melanoma accounts for more deaths than any other form of cancer in women ages 25 to 30 and is second only to breast cancer in women ages 30 to 35.

In New Jersey
With good summer weather and many beaches, pools, and other outdoor venues, New Jersey has a higher incidence of skin cancer (including melanoma) and skin cancer deaths than most states.

Failure to Take Proper Precautions
Individuals who spend a lot of time in the sun often fail to take basic precautions to reduce the risk of melanoma and other forms of skin cancer, such as avoiding the sun at peak UV hours, wearing protective clothing in sunlight, and using sunscreen with a sun protective factor (SPF) of 15 or higher. In 2009, fewer than 10% of high school students reported using sunscreen routinely when out in the sun for prolonged periods of time. That same year, only about 1/3 of adults reported always or often using sunscreen or seeking shade when outside for an hour or more on a warm, sunny day, and only 13 percent reported wearing a hat. In addition, teenagers and adults often fail to take the steps needed to identify skin cancer as early as possible, such as conducting periodic self-skin examinations and getting screened regularly by a health professional. Late detection due to lack of screening is a particularly large problem among men (especially older Caucasian males), who are twice as likely as women to die from melanoma due to late detection. For their part, primary care physicians and other health professionals often fail to advise patients about the dangers of UV exposure and how to take appropriate precautions to reduce the risk of skin cancer.
Preventing Cancer
Protection from ultraviolet (UV) radiation is important all year round, not just during the summer or at the beach. UV rays from the sun can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand, and snow. Indoor tanning (using a tanning bed, booth, or sunlamp to get tan) exposes users to UV radiation. The hours between 10 a.m. and 4 p.m. daylight savings time (9 a.m. to 3 p.m. standard time) are the most hazardous for UV exposure outdoors in the continental United States. UV rays from sunlight are the greatest during the late spring and early summer in North America.

Additional Facts/Tips
  • Avoid tanning beds and tan accelerating agents.
  • Cutaneous melanoma prevention begins with avoidance of exposure to the sun, especially during midday.
  • During a skin cancer screening, your doctor will probably discuss your medical history and inspect your skin from head to toe — including areas not exposed to the sun. He or she will record the location, size, and color of any moles. If a mole looks unusual, he or she may arrange for a biopsy.
  • Gain knowledge about the UV Index. The UV Index is issued daily to advise you on the strength of the sun's UV rays in your region. The higher the UV Index level, the greater the strength of the sun's UV rays and the faster you may burn. The UV Index was designed to help you make informed decisions about the time you spend in the sun.
  • Schedule regular skin checkups.
  • Those who cannot avoid the sun should limit direct sun exposure using:
    • Broad-brimmed hats
    • Long-sleeved shirts
    • Pants
    • Sun-resistant fabrics
    • Sunscreen
How to Protect from UV Radiation
CDC recommends easy options for protection from UV radiation:

Seek shade
This is important, especially during midday hours. You can reduce your risk of skin damage and skin cancer by seeking shade under an umbrella, tree, or other shelter before you need relief from the sun. Your best bet to protect your skin is to use sunscreen or wear protective clothing when you're outside — even when you're in the shade.

Wear a Hat
  • If you wear a baseball cap, you should also protect your ears and the back of your neck by wearing clothing that covers those areas, using sunscreen with at least SPF 15, or by staying in the shade.
  • Wear a hat with a wide brim to shade the face, head, ears, and neck. For the most protection, wear a hat with a brim all the way around that shades your face, ears, and the back of your neck. A tightly woven fabric, such as canvas, works best to protect your skin from UV rays. Avoid straw hats with holes that let sunlight through. A darker hat may offer more UV protection.
Wear Clothing to Protect Exposed Skin
  • If wearing this type of clothing isn't practical, at least try to wear a T-shirt or a beach cover-up. Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well.
  • Loose-fitting, long-sleeved shirts and long pants made from tightly woven fabric offer the best protection from the sun's UV rays. A wet T-shirt offers much less UV protection than a dry one. Darker colors may offer more protection than lighter colors.
Wear Sunglasses That Wrap Around
  • Sunglasses protect your eyes from UV rays and reduce the risk of cataracts. They also protect the tender skin around your eyes from sun exposure.
  • Sunglasses that block both UVA and UVB rays offer the best protection. Most sunglasses sold in the United States, regardless of cost, meet this standard. Wrap-around sunglasses work best because they block UV rays from sneaking in from the side.
Use Sunscreen with Sun Protective Factor (SPF) 15 or Higher, UVA & UVB Protection
  • Check the sunscreen's expiration date. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been exposed to high temperatures.
  • Some make-up and lip balms contain some of the same chemicals used in sunscreens. If they do not have at least SPF 15, don't use them by themselves.
  • Sunscreen wears off. Put it on again if you stay out in the sun for more than two hours, and after you swim or do things that make you sweat.
  • Sunscreens are assigned a sun protection factor (SPF) number that rates their effectiveness in blocking UV rays. Higher numbers indicate more protection. You should use a sunscreen with at least SPF 15.
  • The sun's UV rays can damage your skin in as little as 15 minutes. Put on sunscreen before you go outside, even on slightly cloudy or cool days. Don't forget to put a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back.
  • The United States Food and Drug Administration has announced significant changes to sunscreen product labels that will help consumers decide how to buy and use sunscreen, and allow them to protect themselves and their families from sun-induced damage more effectively.
  • Understand how sunscreen works. Most sun protection products work by absorbing, reflecting, or scattering sunlight. They contain chemicals that interact with the skin to protect it from UV rays. All products do not have the same ingredients; if your skin reacts badly to one product, try another one or call a doctor.
Avoid Indoor Tanning
Using a tanning bed, booth, or sunlamp to get tan is called indoor tanning. Indoor tanning has been linked with skin cancers including:
  • Cancers of the eye (ocular melanoma)
  • Melanoma (the deadliest type of skin cancer)
  • Squamous cell carcinoma
Screening for Early Detection
People with fair complexions and freckles are at increased risk for basal and squamous cell carcinoma, as well as for melanoma. Those with moles are at increased risk for melanoma. Basal and squamous cell skin cancers often look like a pale, waxlike, pearly nodule, or a red, scaly, sharply outlined patch. Melanomas often start as small, mole-like growths that increase in size and change color, which usually starts as black or dark brown. Signs of melanoma are:
  • Asymmetrical spots
  • Borders that are uneven or irregular
  • Color that is uneven and unusual
  • Diameter larger than a 1/4-inch
These are often called the ABCDs of melanoma.

Regular examination of the skin by both you and your doctor increases the chance of finding melanoma early. Most melanomas that appear in the skin can be seen by the naked eye.

Usually, there is a long period of time when the tumor grows beneath the top layer of skin but does not grow into the deeper skin layers. This period of slow growth allows time for skin cancer to be found early. Skin cancer may be cured if the tumor is found before it spreads deeper. Monthly self-examination of the skin may help find changes that should be reported to a doctor. Regular skin checks by a doctor are important for people who have already had skin cancer.

For more information on screening, visit the National Cancer Institute.

Treatment Options
  • A team of specialists often treats people with melanoma. This team may include a:
    • Dermatologist
    • Medical oncologist
    • Plastic surgeon
    • Surgeon
  • After diagnosis and staging, the doctor develops a treatment plan to fit each patient's needs. Treatment for melanoma depends on the extent of the disease, the patient's age and general health, as well as other factors.
  • In some cases, doctors may also use chemotherapy, biological therapy, or radiation therapy.
  • The standard treatment for melanoma is surgery. Surgery to remove (excise) a melanoma is the standard treatment for this disease. It is necessary to remove not only the tumor but also some normal tissue around it in order to minimize the chance that any cancer will be left in the area.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. It is generally a systemic therapy, meaning that it can affect cancer cells throughout the body. In chemotherapy, one or more anticancer drugs are given by mouth or by injection into a blood vessel (intravenous). Either way, the drugs enter the bloodstream and travel through the body.

Biological Therapy
Biological therapy (also called immunotherapy) is a form of treatment that uses the body's immune system, either directly or indirectly, to fight cancer or to lessen side effects caused by some cancer treatments. Biological therapy is also a systemic therapy and involves the use of substances called biological response modifiers (BRMs). The body normally produces these substances in small amounts in response to infection and disease. Using modern laboratory techniques, scientists can produce BRMs in large amounts for use in cancer treatment. In some cases, biological therapy given after surgery can help prevent melanoma from recurring.

Radiation Therapy
Radiation therapy (also called radiotherapy) is used to relieve some of the symptoms caused by melanoma. Radiation therapy is the use of high-energy rays to kill cancer cells. Radiation therapy is a local therapy; it affects cells only in the treated area. Radiation therapy is most commonly used to help control melanoma that has spread to the brain, bones, and other parts of the body. The doctors may decide to use 1 treatment method or a combination of methods.

For more information on treatment options, visit the National Cancer Institute website.

View information on finding a doctor or treatment facility.

Children Coping with Parents with Melanoma
Visit Cancer Source Kids to:
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  • Learn more about all different types of cancers.
  • Read stories from other children.
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