Skin cancer is currently the most commonly diagnosed cancer in Canada. It can be divided into two forms:
- Non-melanoma, (includes basal and squamous cell carcinomas)
- Malignant melanoma
Basal Cell Carcinoma - most common form of skin cancer, the least likely to spread, and can be very destructive locally if not diagnosed and treated early.
Risk factors: Directly related to sun exposure, but also to genetics, fair skin, and chronic dermatitis.
Location and appearance: A nodule with broken blood vessels; sometimes a central ulceration or scab surrounded by a raised, pearly border, most commonly found on the face, ears and arms.
Squamous Cell Carcinoma - most often seen in the elderly, commonly on the lower lip. It is less common than basal cell cancer, the most easily treated, but more likely to spread.
Risk factors: Sun-damaged skin (actinic keratosis), immunocompromised patients, old scars, burns, and frostbite.
Location and appearance: Flesh-colored to pink, scaly, rough warty surface on sun-exposed areas, especially shins in women.
Malignant melanoma - least common skin cancer, most lethal, and spreads to other parts of the body. Early detection and treatment is imperative. BC has the highest rate in Canada.
Risk factors: Intermittent, rather than chronic sun exposure, genetics, high-fat diet, caffeine, tobacco, Vitamin D deficiency, exposure to coal tars, cutting oils, arsenic or polycyclic aromatic hydrocarbons.
Location and appearance: Upper back in men, and back and legs in women. Changes in shape and color of pigmented lesions are important early signs. Ulceration and bleeding are late signs. Obvious warning signs include lesions with asymmetry, irregular borders, color variegation, hair growth, diameter greater than a pencil eraser, elevation, itchiness, and bleeding. Pigmented lesions on the soles and palms and under nails should always be checked.
All patients with significant risk factors should undergo periodic skin exams. Ulcers that don’t heal must be biopsied to rule out malignancy.
Dr. Setterfield’s topic in the next issue of The Cordovan will be “SUNSCREEN FOR DUMMIES”.