Skin is the largest organ of the body and is made of several cell types, each of which can give rise to a different form of cancer. There are a variety of effective treatments for skin cancer, especially if discovered early, when still localized. Early detection depends on knowing your risk for skin cancer, doing regular self-exams and protecting yourself against the sun's harmful ultraviolet radiation.
Skin cancers are divided into two main groups: non-melanoma skin cancer and melanoma
Non-melanoma skin cancer (NMSC)
The two major forms of NMSC are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). NMSCs are common compared to malignant melanoma. They arise from skin cells near the surface of the skin.
BCC rarely metastasizes. When it does, the cancer cells do not grow effectively. However, if untreated, the primary BCC tumor can become locally aggressive and destructive. SCC usually develops on the face or other sun-exposed regions as a precancerous lesion. Both BCC and SCC are slow-growing cancers. SCC, if untreated, has a much greater tendency to metastasize than BCC.
Melanoma
The most dangerous form of skin cancer is malignant melanoma, which arises from pigment-producing cells (melanocytes) just below the epidermis. There will be an estimated 7,700 deaths from melanoma in 2005.
Exposure to the sun's ultraviolet (UV) rays appears to be the most important factor in the development of skin cancer.
The overall level of UV light reaching the Earth's surface is increasing because our planet's atmospheric ozone layer, which filters out much of the UV radiation, is thinning over certain parts of the globe. "The greatest hazard humans face from the effects of ozone depletion is skin cancer," according to the Skin Cancer Foundation, a nonprofit group that raises research funds and educates the public and medical community about skin cancer.
The beach, pool-side and golf course are not the only places where you need sun protection. UV radiation can pierce your car window and damage your skin as you drive. Sun exposure also can damage facial skin in winter when you go skiing or sledding, and accelerate the skin's aging process with premature dryness and wrinkles. Development of sun-induced skin cancer is a very slow process. Research suggests that long-term exposure to UV radiation raises your skin cancer risk visibly through sunburn and invisibly by damaging the DNA in skin cells.
While nearly 90 percent of all skin cancers are thought to stem from the sun's UV radiation, other factors also can cause skin cancer, according to the American Cancer Society. They include:
Chemical exposure: Exposure to arsenic, a heavy metal used in making some insecticides, and found in some water supply, increases the risk of developing non-melanoma skin cancer. Occupational exposure to industrial tar, coal, paraffin and certain types of oil also may increase the non-melanoma skin cancer risk.
Radiation exposure: Radiation therapy may increase the risk of a non-melanoma skin cancer.
Long-term or severe skin inflammation or injury: In rare cases, non-melanoma skin cancers grow in scars from severe burns, on areas of skin over severe bone infections, and on skin damaged by certain severe inflammatory skin diseases.
Psoriasis treatment: Patients treated with the drug psoralen and ultraviolet light (PUVA) may have an elevated risk of squamous cell carcinoma.
Xeroderma pigmentosum: This very rare hereditary disease makes it difficult for the skin to repair DNA damage from UV light. Xeroderma pigmentosum patients typically suffer many skin cancers, which may begin in childhood.
Basal cell nevus syndrome: People born with this rare condition develop multiple basal cell carcinomas and other health problems.
Reduced immunity: People whose immune system is diminished because of HIV infection, drugs that prevent rejection of donor organs or chemotherapy are at increased risk for non-melanoma skin cancer. New immune drugs used to treat skin disease may affect the body's immune system and increase the risk of cancer, especially lymphomas
Although anyone with skin is susceptible to skin cancer, there are certain genetic and lifestyle factors that increase your risk. According to the American Cancer Society (ACS), the Centers for Disease Control (CDC), the American Academy of Dermatology (AAD), and the Skin Cancer Foundation, the major risk factors are:
Fair skin. Light-skinned individuals are more than 20 times more likely than dark-skinned African-Americans to develop skin cancer. The reason is that dark-skinned people have more melanin (skin pigment), which filters out the sun's harmful ultraviolet (UV) radiation. People born with no skin pigment (albinos) are at a particularly high risk unless they take proper precautions to protect their skin.
Male gender. Men are twice as likely as women to have basal cell carcinomas and three times as likely to have squamous cell carcinomas, according to the ACS. The disparity, says skin cancer specialist and AAD spokesman Brett Coldiron, M.D., is believed to stem entirely from lifestyle factors. That hypothesis is supported by the fact that women, who wear skirts and dresses, are more likely than men to get skin cancers on their legs, he says. Overall, though, men are at increased risk because they tend to have more outdoor occupations, "or at least they used to," says Coldiron, a clinical assistant professor of dermatology at the University of Cincinnati. "Until recently, there haven't been too many telephone lineswomen, and fewer women served in the military." Another probable reason, Coldiron says, is that women wear makeup, which usually contains a sunscreen or acts as one.
Family history of skin cancer. If a blood relative has had skin cancer, you should consider your risk higher than average, do a skin self-exam monthly, stay out of direct sunlight, and avoid tanning parlors.
Personal history of skin cancer. According to the ACS, 35 percent to 50 percent of patients diagnosed with one basal cell cancer will develop a new skin cancer within five years of the initial diagnosis.
Chronic exposure to the sun. If you work outdoors, play outdoor sports, or otherwise spend lots of time outdoors, your skin cancer risk is increased.
History of sunburns early in life. Instead of sunscreens, most baby boomers slathered on the baby oil and baked in the sun when they were young. If you sustained multiple blistering sunburns in your youth, consider yourself at high risk for skin cancer and show any suspicious skin changes to a dermatologist.
Unusual moles. According to Coldiron, 99 percent of moles remain benign. But there's a certain subset of moles, called dysplastic nevi, that are not typical, often run in families, and occasionally become cancerous. Another cause of concern is congenital nevi, or moles that you are born with. "If they're bigger than a quarter, you should have them checked out because sometimes those can turn malignant," Coldiron says. "If they're bigger than your hand, then they're a real problem."
A large number of moles.
Freckles. Freckles form when pigment-producing cells clump together. While the freckles themselves rarely become cancerous, they are an indicator of sun sensitivity, sun damage and after over-exposure to the sun.
Living in a sunny climate.
Outdoor enthusiasts. Skiers, hikers, and others who enjoy high-altitude outdoor activities are exposed to far more UV radiation than they would be exposed to at sea level, according to a study reported in the Journal of the American Academy of Dermatology. Darrell S. Rigel, M.D., and colleagues from the New York University School of Medicine measured UV light energy in Vail, CO, Orlando, FL, and New York City at solar noon in direct sunlight on cloudless days. Direct UV-B levels at 8500 feet in Vail were approximately 60 percent higher than at sea level in New York, researchers found. "In addition, the direct UV-B levels in Vail were the same as those in Orlando, a site nearly 775 miles closer to the equator," Rigel said in an AAD press release. The intensity of the UV-B exposure suggests that a person having an average complexion, with unprotected skin, would burn after only six minutes of sun exposure on a clear day at noon in Vail at 11,000 feet above sea level. The same person would develop sunburn after 25 minutes of noontime exposure in New York or 14 minutes of unprotected noontime exposure in Orlando, the release said.
Know your skin type
If you are unsure about your skin type, and thus your relative risk for skin cancer, the following list of classifications provided by the Skin Cancer Foundation should help. Type I has the highest risk; Type VI the lowest.
Type I is someone who always burns, never tans and is very fair, with red or blond hair and freckles.
Type II is someone who burns easily and tans minimally. This person is usually fair-skinned.
Type III is someone who sometimes burns and gradually tans.
Type IV is someone who has minimal burning and who always tans.
Type V is someone who very seldom burns, always tans and has medium-to-heavy pigmentation.
2006-06-26 13:16:36
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answer #9
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answered by purple 6
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