LVHN dermatologist talks about skin cancer
Skin cancer is the most common form of cancer in the United States. Nearly 20 people die every day from the disease, according to the American Academy of Dermatology Association.
Dr. Stephen Schleicher, a dermatologist with Lehigh Valley Health Network with offices in Sugarloaf, Gilbert and Bethlehem, said about 2 million people are diagnosed with skin cancer every year in this country.
“We’re talking about an epidemic of skin cancers,” he said. “Fortunately, the vast majority of them are readily cured. The key thing with skin cancer is the earlier it is caught, the easier it is to treat, and certainly the easier it is to cure.”
Schleicher said most skin cancers are not deadly, but they can get bigger and cause cosmetic disfigurement. These cancers are called basal cell carcinomas and squamous cell carcinomas.
”They really don’t spread internally, but they will eat away at your face or your nose or wherever if you let them grow and grow,” he said. “So of course, you want to get them treated as well.”
Schleicher said melanoma is the form of skin cancer the skin cancer that concerns dermatologists the most. It kills thousands of Americans every year, because it can spread rapidly. For that reason, it can be deadly even when it is caught in its early stages.
Schleicher explained that if the melanoma metastasizes, the cancer cells go into the lymph glands and into the blood. If it goes into the lymph nodes, the cancer can spread throughout the body.
According to the American Academy of Dermatology Association, the five-year survival rate is 99% for people whose melanoma is detected and treated before it spreads to the lymph nodes.
People who have a melanoma that has spread to nearby lymph nodes have a five-year survival rate of 66%. The survival rate drops to 27% for melanoma that has spread to distant lymph nodes and other organs.
“It’s not hopeless,” Schleicher said.
New immune therapies have saved many people’s lives.
Detecting melanoma early is a person’s best defense.
Melanoma can arise from a pre-existing mole or can develop on its own, Schleicher said. Sometimes people think they have a pimple, but they are not of an age that readily gets pimples or it’s in an area that generally doesn’t have pimples.
“It’s not a pimple, especially in someone who is elderly. Most elderly people don’t break out in pimples,” Schleicher said.
“A lot of people are in denial. They just say, ‘Well, it can’t be anything bad.’ Well skin cancers can look very, very harmless, and just over time, they grow. The longer you have them, the more difficult it’s going to be to get rid of them.”
Know the signs
Some warning signs of skin cancer in moles include:
• Changes in the size: It gets larger than a quarter inch.
• Changes to the shape: The outer edges become uneven or changes shape entirely.
• Changes to the color: Dark black spots or multiple colors develop in the mole.
• Itchiness can also be a very early sign that a mole is changing.
Schleicher said it is easy for a dermatologist to check moles to see if they are potentially harmful. They have a special instrument that can magnify the moles.
“Many times, we can see changes that are not visible to the naked eye,” he said.
If a mole is suspicious, a dermatologist can take a biopsy of it, which is a simple procedure that takes just a few seconds.
As for treatment, most skin cancers are treated surgically and are cut out, Schleicher said, sometimes accompanied by radiation therapy.
Skin cancers that are not melanoma and are found early can be treated with a cream approved by the federal Food and Drug Administration, he said.
“The majority of those cancers will be cured,” he said.
People of all colors of skin are at risk for skin cancer, Schleicher said.
“Skin cancers can appear anywhere,” he said.
People who are fair skinned with natural blond or red hair are at the highest risk, while people with darker skin have more protection for damaging solar radiation.
Schleicher recommends that all people get checked for skin cancer through a dermatologist. People at the highest risk of skin cancer should be checked at minimum once a year.
Schleicher also recommend doing self mole checks, and asking a family member, beautician or barber to check the scalp.
“We see so many skin cancers develop on the scalp and many of them are advanced skin cancers, because people don’t know that they have them,” he said. “It may be that your hairdresser or barber is saving your life by recognizing early skin cancer.”
Ways to prevent skin cancer
As Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”
Here are some tips for preventing skin cancer from Dr. Schleicher:
• Don’t let children get sunburned. A person’s risk of melanoma increases with every sunburn received as a child.
• Wear sun lotion with an SPF of at least 30. People who are fair skinned should wear the highest number possible or at least 50.
• Even if it is a cloudy day, wear SPF. The sun’s rays can pass through the clouds. Likewise, wear SPF in the winter when doing outside activities like skiing. The sun reflects off the snow.
• Use enough sunscreen. A full shot glass of sunscreen is usually enough to cover the body of the average adult person.
• Clothing can protect the skin from solar radiation, and some clothes are made especially for sun protection.
In addition to things people should do to protect their skin, there are some things they shouldn’t do, too. These include:
• People with an immunologic condition such as lupus should avoid being in the sunlight. The sunlight can trigger the lupus and make it worse. They should also make sure to wear the highest sunscreen available. Likewise, people with rosacea should avoid sunlight.
• Don’t go to indoor tanning salons. It is a concentrated solar radiation that can increase the risk of getting skin cancer. Use a self-tanner instead.
• And stop smoking. Cigarette smoking can cause lip cancer, which is a skin cancer. Chewing tobacco can cause skin cancer inside the mouth. And the smoke can cause skin cancers on the face, as well as promotes wrinkles.