According to the American Cancer Society, cancer of the skin is by far the most common of all cancers. Melanoma accounts for less than 2% of those cases but causes the most skin cancer deaths. The other two forms of skin cancer, basal cell carcinoma and squamous cell carcinoma can typically be treated or removed and are not usually deadly. Premier Surgical Associates Surgical Oncologist Paul S. Dudrick, MD, FACS, describes why melanoma can be so deadly, and why early detection is crucial for survival.
“Basal cell and squamous cell carcinomas are from actual skin cells that make cancer. If you take those skin cells out, the cancer is normally gone,” Dr. Dudrick says. “Those procedures can be done in-office, and a narrow excision is normally enough to simply get the tumor out.
“Melanoma, on the other hand, is a pigment producing cell but not a skin cell. Melanoma can “leave the neighborhood” so to speak, spreading beyond what is visible. Removal needs to include a wide margin of normal skin—for example, removal of a small mole may result in an eight-inch large scar much wider and deeper than the mole appears to be. If you do not remove enough, the melanoma is likely to come back. And when it comes back, it’s usually much worse.”
According to Dr. Dudrick, melanoma can fragment and more readily spread in other places. If the melanoma is thicker than one millimeter the likelihood of it spreading to the lymph nodes increases. If the nodes contain melanoma, the cancer is considered stage 3.
Dr. Dudrick says, “Do frequent self exams, including using a handheld mirror to see your back. Melanoma can develop anywhere on the body—scalp, between toes, even the soles of your feet—not just areas that get the most sun. Any dark moles should be checked, and any moles that are changing. Skin lesions that itch or bleed should also be checked.
“The most important thing to look for is change in a mole’s shape, size, or color,” says Dr. Dudrick. “Get it checked immediately—don’t wait until a yearly exam. In dermatology, melanoma is the biggest emergency.”
Dr. Dudrick also advocates watching for brown moles that get bigger and then all of the sudden go away. “Melanoma on the skin can actually regress, but it can metastasize before it goes away,” he says.
Practicing sun protection needs to start early, he adds. “Ninety-percent of sun exposure damage is for an average person’s lifetime is done during the teen years,” says Dr. Dudrick. He recommends keeping kids out of the sun or at the very least using sunscreen when they are outdoors.
Dr. Dudrick recommends that anyone who wants to minimize their risk of melanoma should wear sunscreen, avoid direct light, wear long sleeve shirts and pants, and wear a wide-brimmed hat, or even use an umbrella. Such preventative practices will help with basal and squamous cell cancers as well.
The surgical oncologists of Premier Surgical Associates in Knoxville are certified by the American Board of Surgery and have specialized knowledge and skill relating to the diagnosis, pre-operative, operative, and post-operative management of surgical oncology issues, including skin cancer. To learn more about surgical oncology at Premier Surgical Associates visit our surgical oncology page at www.premiersurgical.com.