By RICK COUSINS Correspondent

Although everyone fears cancer in general, one type of this dreaded disease is the most likely to affect the largest number of Americans at some point in their lives: Skin cancer. And, importantly, it is among the most curable cancers as long as it is detected and treated early. Ignored, it can, at times, prove deadly.

Our guide to this topic is Dr. Sharon Raimer, who chairs the Department of Dermatology at the University of Texas Medical Branch. She noted that your skin is your largest bodily organ, a fact that offers cancer a large area to aim for.

Most people know that skin cancer comes in two common types: basal cell carcinoma and melanoma. Although the latter is more feared with good reason, the first can be disfiguring if ignored.

“By far the most common is basal cell,” Raimer said. “These destroy tissue as they grow, but almost never metastasize (spread). When found and removed early, treatment usually results in minimal scarring. If not noted or allowed to grow, they can destroy large areas of skin including ears, noses, and occasionally even eyes, in which case more aggressive treatments may be required.”

What should you look for when checking your skin for possible cancer?

“Some of the ways that basal cell carcinoma can present is as a new clear bump that looks like a mole, a red bump that is persistent or as an ulcerated or crusted area which will not heal,” she said. “Any lesion on the skin which bleeds should be examined by a physician.”

But, in addition to the skin’s large area, the wonderful Gulf Coast sun is more than a suspect when it comes to creating incipient skin cancers.

“Most skin cancers appear to be initiated by exposure of the skin to ultraviolet light, most commonly by long-term exposure to sunlight,” Raimer said.

But since it is the young who tend to worship the sun, they suffer from a disproportionate share of the most serious kind of skin cancer, melanoma.

“Melanoma is, however, the most common form of cancer for young adults 25 to 29 years of age,” Raimer said. “It is the leading cause of cancer death in women 25 to 30 years old and the second leading cause of cancer death in women 30 to 35 years old.

“The incidence of melanoma has increased in young women in the last few years and appears to be associated with an increased use of tanning beds. Using tanning beds before age 30 increases your risk of developing melanoma by 75 percent. Occasional use of tanning beds triples your chances.”

So, old or young, skip the tanning salon. But does having skin cancer put one at risk for other forms of cancer?
“Although there has been some controversy about this in the past, the answer to this question appears to be no,” Raimer said. “There is a higher incidence of skin and possibly other cancers in individuals who have been immune-suppressed for a long period of time. It is very important for these individuals to be extra cautious in protecting their skin from the sun.

“Adequate levels of vitamin D in the body can be maintained through vitamin D supplementation.”

Common causes of immunosuppression include the extended use of cortisone-like drugs, such as Prednisone, to manage arthritis, Crohn’s and other inflammatory conditions. Vitamin D3 is available over the counter at any supermarket or drugstore and is the most effective form of this nutrient.

The next most common type of skin cancer is called squamous cell carcinoma which favors those who are immuno-suppressed, older or fair-skinned.

“They can have different appearances but often started as a red bump, a red warty lesion or an ulceration,” Raimer said. “Their removal generally results in a cure.

“Large squamous cell carcinomas on the skin or lips can spread to lymph nodes and occasionally to other organs.”
The least common, but most deadly, form of this disease is melanoma. It has a strong tendency to migrate from the skin throughout the body making it the most fatal version of skin cancer. Early removal is the only sure treatment since once it has set up shop in other organs, it may be all but incurable.

What should one look for when checking for melanoma?

“Nodular melanomas, which develop rapidly, tend to be black or blue-black and regular in shape and color,” Raimer said. “Most other melanomas have irregularities in either shape or color.

“The pneumonic ‘ABCDEs’ has been developed to help recognize suspicious lesions. A is for asymmetry, that is, one half of the lesion is different from the other half. B is for irregular borders to the lesion. C is for color; it has an irregular or very black color. D is for diameter which is generally greater than 5 mm (or greater in size than a pencil eraser). E stands for evolving-growing or changing.”

Melanomas tend to be rare in children, but do show up in every other age group.

Next week: Advice on self-screening and lowering your risk for skin cancer.

Rick Cousins can be reached at rick.cousins@galvnews.com.