The ABCDEs of Skin Cancer from Sacramento Region Experts
02/23/2016 09:07AM ● Published by Kourtney Jason
Skin cancer is on the rise. “It’s estimated that one in every five Americans will develop skin cancer over his or her lifetime. And one in 50 Americans will develop melanoma in their lifetime,” explains Dr. Aieska De Souza, MD, a dermatologist with Mercy Medical Group, a service of Dignity Health Medical Foundation.
Dr. Scott Hearth, MD, a dermatologist at Granite Bay Dermatology and Laser Center, says melanoma is one of three types of skin cancer and typically the most aggressive, having the potential to spread at a much more rapid pace. “The rates of melanoma in the U.S. have doubled over the past 30 years,” he says.
Basal cell carcinoma is typically a slower growing type, “but if it’s not diagnosed in a timely manner, it can become locally destructive,” Hearth says. Squamous cell carcinoma has a similar behavior to basal cell carcinoma, but can progress at a quicker pace and has a higher rate of spread to lymph nodes and beyond.
To aid in early detection, Hearth recommends that the average person, with no history of skin cancer, should have a skin check at least once a year. “A person with more than 25 moles has an increased risk for developing melanoma, as do people with fair skin, and light hair and eye color,” he says.
Dr. David No, MD, Ph.D., a dermatologist at Dermatology Center of Northern California in Folsom, says concerning moles will exhibit one or more of these characteristics:
A = Asymmetry: One half is unlike the other half
B = Border: An irregular, scalloped or poorly defined border
C = Color: Is varied from one area to another; has shades of tan, brown or black, or is sometimes white, red or blue
D = Diameter: Melanomas are usually greater than 6 millimeters (the size of a pencil eraser) when diagnosed, but they can be smaller
E = Evolving: A mole or skin lesion that looks different from the rest, or one that has changed in size, shape or color
To detect skin cancer, providers will usually recommend a skin biopsy, which “is done by removing a small part of the skin so it can be examined. This takes about 10 minutes and is done in the office,” says Dr. David A. Berman, MD, medical director at Berman Skin Institute (offices in Roseville, Cameron Park and Placerville). Before the biopsy, the provider will numb the area of skin. There are different techniques to taking the sample based on the location, size and type of lesion. The tissue is examined under the microscope and results are often returned in a few days.
According to Berman, treating skin cancer varies depending on size, type, depth and location of the lesions; often, the lesion is surgically removed or destroyed with topical medications. Most treatments require local anesthesia and can be done in the office. “Mohs micrographic surgery has the highest cure rate, and is done in the dermatologist’s office without any sedation,” he says.
To aid in prevention, avoid going outside between 10 a.m. and 3 p.m. when most UV exposure is high. “Moving your daily walk, jog or tennis match to outside of these times will greatly reduce your sun exposure,” Dr. No says. “Sunscreen must be reapplied every one to two hours to ensure adequate protection. It’s better to use two applications of SPF 30 (spaced two hours apart) than it is to use SPF 100 once.”
If you see something unusual, especially if it’s a dark or changing mole, get it checked. “Most melanomas are found by the patient, not by a doctor,” he says. “Like most medical problems, early detection and treatment are the keys to preventing serious or life-threatening cases.”