Skin Cancer
Below is an overview about melanoma and non-melanoma skin cancers, your risk of getting the disease, and how you can prevent it. Also see our Quick Facts page.
| Information | |
| Your Skin The Sun and Your Skin Types of Skin Cancer Types of Melanoma |
Detection Skin Cancer Self Exam Follow-Up and Monitoring UV Index |
Sources: Health Canada - Canadian Cancer Society - Shade Foundation - BC Cancer Foundation - AIM at Melanoma
Your Skin
Our skin is the largest organ of our body and it’s health is the easiest to monitor. We can feel our skin and we can see it, so we tend to be more familiar with the health of our skin than we are our other organs. That is likely why cosmetics companies have a much easier time selling us products for our skin thandoctors and naturopaths do making recommendations to help our liver, kidneys, or intestines. We know when our skin is dry and when it starts to show signs of aging. The downside with our familiarity with our skin is that we tend to take it for granted and when it is under duress, we do not get particularly concerned. Our bodies are an amazing integrated system though and our skin plays an important role. Our tendency to under-estimate the importance of healthy skin can be detrimental to our health. « Back to top
The Sun and Your Skin
What Are the Risk Factors for Skin Cancer? Our goal is to help increase awareness of skin cancer and to help you find more information. There are some hot debates going on these days about the sun and our skin and the health benefits of Vitamin D from the sun and the potentially damaging consequences of sunscreens. All of this debate is important and will ultimately lead to a better understanding of how we can best protect our skin and our lives. Risk factors for non-melanoma and melanoma skin cancers include:
- unprotected and/or excessive exposure to ultraviolet (UV) radiation
- fair complexion
- tendency to freckle
- occupational exposures to coal tar, pitch, creosote, arsenic compounds, or radium
- medications such as immune suppressants
- family history
- multiple or atypical moles
- severe sunburns as a child
Skin cancer is the most commonly diagnosed cancer in Canada and we are not even a nation known for our “Sun”. As you can imagine, the rates of skin cancer are highest in countries like Australia and southern places in the U.S., like California. Despite that, skin cancer is still one of the fastest growing diagnoses for cancer in Canada and it has become imperative that we all learn as much as possible so that we can be aware of the potential dangers and take precautions that can save our lives and preserve a part of our body that we all value so much. If you have any concerns about your skin and possible skin cancer, contact your physician immediately. « Back to top
Types of Skin Cancer
Cancer is a disease of the cells and skin cancer is a disease of our skin cells. There are 3 types :
- Basal Cell – This is a cancer of the epidermis – the outermost level of the skin – it is the protective coating to our inner organs and is the toughest in texture. Basal cell cancer grows very slowly and usually appears as a small bump on an exposed area of our skin, such as our face, hands, arms, neck, etc.
- Squamous Cell – This cancer may also appear as a bump or nodule, but also often presents as a persistent scaly patch of skin. It is most often found on the ears, face, lips and mouth areas.
- Melanoma – Melanoma is a cancer that begins in the melanocytes – the cells that produce the skin coloring or pigment known as melanin. Melanin helps protect the deeper layers of the skin from the harmful effects of the sun. While all of the skin cancers can be dangerous if left untreated, Melanoma is the most serious of the skin cancers.
Types of Melanoma
There are five different types of melanoma. The melanoma type is determined by microscopic examination of the biopsy sample.
Superficial spreading melanoma
Superficial spreading melanoma makes up about 70% of melanomas of the skin. This type usually develops from an atypical mole and can be found anywhere on the body.
Nodular melanoma
Nodular melanoma makes up about 10-15% of melanomas. This type starts growing down into the skin and spreading quickly.
Lentigo maligna melanoma
Lentigo maligna melanoma makes up about 10-15% of melanomas. This type of melanoma is most often seen on sun-exposed skin, and it is often large.
Acral lentiginous melanoma
Acral lentiginous melanoma occurs as often in black people as in whites. This type quickly grows down into the skin and begins to spread.
Mucosal lentiginous melanoma
Mucosal lentiginous melanoma develops in the lining of the respiratory, gastrointestinal, and genitourinary tracts. It is often seen in the elderly. It is often diagnosed at an advanced stage.
« Back to top
Detection
Moles, spots and certain growths on the skin are usually harmless – but not always. That is why it is so important to examine the skin all over your body once a month and have a physician check you over once a year. Early detection of skin cancer can ensure effective treatment. Using a bright light and mirrors, and working from top to bottom, examine:
- head and face (use a blow-dryer to inspect your scalp)
- elbows, arms, and underarms
- neck, chest, and torso
- genitals and breasts
- back of neck, shoulders, upper arms, back, buttocks, and legs
- feet (including soles, heels, and nails)
Look for the following “ABCDE” warning signs:
- Asymmetry. Do the two halves not match if you imagine drawing a line through the mole?
- hands and nails
- Borders. Are the edges uneven, scalloped or notched?
- Colors. Is there a variety of shades (brown, red, white, blue or black)?
- Diameter greater than 6mm. Is the mole the size of a pencil eraser or larger?
- Evolution. Has there been a change in size, shape, color, or height? Has a new symptom developed (such as bleeding, itching or crusting)?
If you detect any of these warning signs, see a physician promptly. It is particularly important for you to select a physician who specializes in skin cancer and is trained to recognize a melanoma at its earliest stage.
Canadian Dermatology Association, patient handout “Melanoma Skin Cancer: Know the signs, Save a life” 2009.
« Back to top
5 Steps to Skin Cancer Self-Exam
1. Using a mirror in a well lit room, check the front of your body -face, neck, shoulders, arms, chest, abdomen, thighs and lower legs.
2. Turn sideways, raise your arms and look carefully at the right and left sides of your body, including the underarm area.
3. With a hand-held mirror, check your upper back, neck and scalp. Next, examine your lower back, buttocks, backs of thighs and calves.
4. Examine your forearms, palms, back of the hands, fingernails and in between each finger.
5. Finally, check your feet – the tops, soles, toenails, toes and spaces in between.
Source:Canadian Dermatology Association, patient handout “Melanoma Skin Cancer: Know the signs, Save a life” 2009.
« Back to top
Follow-Up and Monitoring
Follow-up after melanoma treatment depends on the stage of the melanoma. A melanoma diagnosis increases the risk of another melanoma. Therefore, your doctor will perform a full-body skin examination, at least every year, for the rest of your life.
Self-monitoring
Your doctor will also teach you how to examine your skin and lymph nodes. You should examine your skin at least monthly. Make sure you check the back of your body. Use a mirror or have someone check for you. Look for changes in moles, any new growths, sores that do not heal, and abnormal areas of skin.
Contact your doctor right away if you notice any abnormalities. Your doctor may also recommend that you examine your lymph nodes every month. A schedule like the following one is followed if you have no signs or symptoms of melanoma.
If you do develop new signs or symptoms, your doctor will investigate them and determine appropriate treatment and follow-up based on your test results.
Stage 0 (in situ)
Your doctor will perform a full-body skin examination at least every year. You should examine your skin every month.
Stage IA
Your doctor will see you on the following schedule to take a history and perform a physical examination:
- Every 3 to 12 months for 5 years
- Once a year after that
Also, at least every year, your doctor will perform a full-body skin examination. You should examine your skin and lymph nodes every month.
Stage IB, IIA, IIB, IIC
Your doctor will see you on the following schedule to take a history and perform a physical examination:
- Every 3 to 6 months for 2 years
- Every 3 to 12 months for 2 years
- Once a year after that
Your doctor may decide to perform selected investigations, such as blood tests or imaging studies, every 6 to 12 months, to screen for tumour recurrence or spread.
Also, at least every year, your doctor will perform a full-body skin examination. You should examine your skin and lymph nodes every month.
Stage IIIA, IIIB, IIIC
Physical Examination (skin examination, chest x-rays, CT scans of trunk, pelvis, and head)
- Year 1: every 3 months
- Year 2 : every 4 months
- Years 3-5: at least every 6 months
- Annually after 5 years
What is the UV Index
The UV index is a simplified measurement system for the sun’s damaging rays and a guideline to protection. UV Index
- 0-2 – Low Risk – minimal sun protection required (unless near water or snow). Wear sunglasses if bright.
- 3-5 – Moderate Risk – take precautions – wear sunscreen, sunhat, sunglasses, seek shade during peak hours of 11 am to 4 pm.
- 6-7 – High Risk – wear sun protective clothing, sunscreen, and seek shade.
- 8-10 – Avoid the sun – seek shade – wear sun protective clothing, sun screen & sunglasses. White sand increases UV radiation exposure.
- 11 + – Take full precautions. Unprotected skin can burn in minutes. Avoid the sun between 11 am and 4 pm, wear sunscreens & sun protective clothing.