Skin cancer risks

You likely know that there are three major types of skin cancers: basal cell, squamous cell, and melanoma. There are a few others that occur infrequently, but these are the Big Three. Both basal and squamous cell cancers are almost always curable, but squamous cell can metastasize and basal cell will get bigger and more damaging until it is excised. Melanoma is the most dangerous type of skin cancer.

I have been thinking especially about this over the past weeks as I recently had a second basal cell removed from my nose. The first one was about fifteen years ago, and the good news is that I recognized this one (and got myself to a dermatologist) more quickly. Because it was smaller, the surgery was easier, but it is never fun. Mohs surgery is the treatment of choice for most skin cancers.

The American Cancer Society has a good overview on skin cancer and BIDMC has excellent skin cancer programs, both for melanoma and the less serious kinds of skin cancer.

We all know that skin cancers are caused by sun exposure. It is unfortunate that we didn't know that back when we were teenagers and spending time on the beach and even holding reflectors up to our faces. We thought tan was beautiful, and I still think, when not overdone, it looks healthy. But I have surely learned the lesson that using sunscreen and staying out of the midday direct sun is wise.

A recent study suggested that people who have an unusual number of basal cell carcinomas may be at an increased risk of other cancers, including blood, breast, colon, and prostate. This is especially distressing because we can't roll back the clock and undo our younger behaviors. The exposure has already happened. Of course, it is possible that a number of other factors are associated with these increased risks, and the study does not suggest that the skin cancers are causing other kinds of cancer.

In many ways, we are lucky that most of us get through our teens and young adulthood without more damage. All of us engaged in some behaviors that now make us cringe or would consider risky. We were generally not thinking carefully about some things that now seem quite serious, including drugs, alcohol, sex, fast driving, and sun exposure.

Since this is nothing that we can now change, why am I writing about it? The obvious answer is that being informed is always a good idea, and it can be a life-saving strategy in Cancer World. Finding something sooner rather than later probably will make treatment easier and may save your life. Just as you schedule annual mammograms and periodic colonoscopies, you should regularly see a dermatologist for a full skin check.