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How to Prevent and Detect the Most Common Cancer

How to Prevent and Detect the Most Common Cancer



Dr. Dendy Engelman, MD, FACMS, FAAD

Skin cancer is the most common cancer in the United States. One in five people will be diagnosed with skin cancer by 70 years old.

Although skin cancer is common and treatment for most types can be successful, early detection is key. Thankfully, nearly all skin cancer is visible to the human eye which makes it easier to be diligent about skin health. Stay educated on how to do regular self-checks. Additionally, visiting a dermatologist for an annual check is always recommended - and could save your life!

For Skin Cancer Awareness Month, we interviewed skin expert Dr. Dendy Engelman for the latest on skin cancer prevention and early detection.

Dr. Engelman is a board certified dermatologic surgeon the Director of Dermatologic Surgery at New York Medical College where she oversees the training of future Mohs surgeons and dermatologists. She is a fellow of the American Academy of Dermatology, American Society of Dermatologic Surgery and American College of Mohs Surgery. She is the Directory of Dermatology at the Shafer Clinic Fifth Avenue in New York.

What are some of the key things we need to know about skin cancer?

Skin cancer is most common on the face, scalp, chest and neck as these areas are typically the most sensitive and receive the most sun exposure. Check these areas regularly for any unusual spots or bumps that persist for an extended period of time. Excessive scaliness and itchiness are also warning signs that should be checked by a medical professional.

What are the most common types of skin cancer and what are the causes?

Basal and squamous cell carcinoma, merkel cell cancer, and melanoma are the four types of skin cancer. Basal cell carcinoma is attributed to about 80% of skin cancer diagnoses. While it can be found anywhere on the skin, the head and neck are the most common developing areas. About 20% of skin cancers develop from the cells of squamous cell carcinoma. It is mainly caused by sun damage. Basal and squamous cell carcinoma typically appears as a pinkish, round growth. Merkel cell cancer is an aggressive, fast-growing cancer and rare type that stems from hormone-producing cells. Melanoma is the most aggressive type but uncommon, accounting for only 1% of skin cancers. It is often pigmented. This year, an estimated 100,000 cases of invasive melanoma will be diagnosed.

Are there any new tips on spotting skin cancer?

Irregularly-shaped marks and spots that change in size and color over time are strong indicators of skin cancer. Besides the standard ABCDE monitoring (Asymmetry, Borders, Color, Darkness, Evolving) studies show that patients with skin cancer may experience itching skin. If sudden flare-ups cause itchiness, I recommend consulting with a doctor to determine if this could be a sign of skin cancer.

Some cancers can develop as red, crusty, pimple-like sores. If a sore is bleeding, growing and not healing, it could be a sign of skin cancer. These can often be confused with pimples. Once again, consult a doctor if the growth persists.

Are there any new ways to prevent or treat skin cancer?

Mohs surgery is not new, but it is the most effective method of treating the most common types of skin cancer, basal cell carcinomas and squamous cell carcinomas. Mohs surgery involves surgically removing thin layers of cancerous tissue until all cancer cells are gone.

Laser ablation treatments, like Fraxel, can effectively eliminate pre-cancerous cells (actinic keratosis). When possible, this treatment method is preferred because it is non-invasive and recovery is quicker. However, more developed skin cancer may require surgical (Mohs) treatment.

Aggressive and advanced skin cancers can be harder to treat. For example, advanced melanoma cannot be treated with chemotherapy - but if caught early, the 5-year survival rate is 99% survivable. The survival rate drops to 68% if the disease reaches the lymph nodes, and 30% if it spreads to distant organs. Early detection is key!

What are some skin cancer myths you’d like to debunk?

Even if you wear SPF daily, I recommend getting an annual skin cancer screening. If you are at a high risk, have a family history of skin cancer or spend long periods of time in the sun regularly, I suggest getting checked bi-annually.

Another myth is that self-examinations are enough. While it’s important to monitor your skin, as this can help catch skin cancer early in the event that it does arise, it’s impossible to thoroughly examine every part of your body yourself. Even those who are proactive about their own skin health, it’s still important to schedule an annual skin cancer screening.

What are the steps to take to always stay ahead of skin cancer?

Getting an annual full-body skin cancer screening from your dermatologist is a must! If you have a family history of skin cancer or are at a higher risk of developing it, I recommend getting checked bi-annually, or as often as recommended by your doctor.

You should also perform your own skin cancer checks regularly - examine yourself in the mirror before you get dressed, and pay attention to any new or abnormal-looking marks on your skin.

Educate yourself on the basics of skin cancer: the different types of skin cancer, how to identify potentially cancerous spots, etc. Even when armed with the right information, it can be difficult to accurately identify skin cancer, so be sure to visit your dermatologist regularly, especially if you find a suspicious spot on your body. Self-checks should not replace a professional examination from your dermatologist, but they can help you detect skin cancer early on, which makes a world of difference when it comes to treatment and recovery.

It’s always better to prevent a problem than to treat it down the line. Wearing sunscreen daily year-round is an important step for preventing skin cancer. I recommend an SPF of at least 30 for daily wear, and an SPF of at least 50 if you plan to spend time outdoors. Protective UPF clothing is another way to protect yourself, especially if you are photosensitive or spending a lot of time exposed to UV rays (for example, when you’re at the beach).

How do you protect your own skin?

I wear sunscreen daily - it’s always the final step in my skincare routine. Elizabeth Arden’s PREVAGE City Smart Broad Spectrum SPF 50 Hydrating Shield, Glo Skin Beauty’s C-Shield Anti-Pollution Moisture Tint SPF 30, and ISDIN Mineral Brush SPF 50 are some of my favorites.

I also wear UPF protective clothing whenever I’m spending a significant amount of time outdoors. I like Coolibar, Mott50 and Lilly Pulitzer. I perform self-examinations regularly, and at least once a year I will have another dermatologist do a full skin cancer screening.

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