Skin cancer can be fatal, but with early detection and treatment patients often can be cured. Dr. Nicole E. Rogers, a dermatologist at Old Metairie Dermatology (Old Metairie Village Shopping Center, 701 Metairie Road, Metairie, 836-2050), discusses skin cancer prevention, detection and treatment.
Q: What are the different types of skin cancer?
A: The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. They are usually a result of sun exposure and can appear on the top layer of the skin as a small bump or nonhealing sore.
The most deadly type of skin cancer is melanoma. Melanomas can occur on any part of the body. They are traditionally thought of as dark-brown moles, but they can appear without any pigment at all. Melanoma can run in families or, more commonly, can result from sun exposure. In the past, it has been a diagnosis of older people, but now we're finding it in young women in places like the legs, where they have had a lot of sun exposure. Melanomas can spread to other parts of the body. All it takes is a single melanoma cell to metastasize and spread to other places in the body. If melanomas are detected early and we're able to remove them quickly, patients do fine.
Q: What should people be on the lookout for?
A: This is where we talk about the A-B-C-D-Es of melanoma. "A" is for asymmetry, where one half is shaped differently from the other. "B" is for border, describing any irregular, scalloped or blurred border. "C" is for color. If there are more than two colors, we want to look at the mole carefully. "D" is diameter. We used to say that anything larger than the tip of a pencil eraser, about 6 milimeters, should be examined. Nowadays that is [not as good an] indicator because we are seeing even very tiny melanomas. "E" is for evolution, meaning that if your mole or lesion changes shape, gets bigger, itches or starts bleeding, definitely get it checked out.
Q: When should people start getting routine skin examinations?
A: Some people tend to have more atypical-appearing moles. Those people should follow up more routinely with their dermatologist. We recommend that as soon as you have had sun exposure, usually in the teenage years, you should see a dermatologist.
We strongly discourage the use of tanning booths because of the complete unfiltered exposure to UV (ultraviolet) light. The first time you come to see a dermatologist, he or she will let you know if you are at risk and how often you should have routine checkups.
Q: What treatments are available for skin cancer?>
A: Most skin cancers can be removed by simple excision. This involves surgically removing the cancer and a small margin of skin around the edge. Mohs (micrographic) surgery is a specialized technique that involves microscopic examination of the tumor edge to make sure it is completely gone, while sparing as much healthy tissue as possible. It can be valuable on the face, scalp, hands or feet, where appearance and function are important.
Q: With early detection, what is the prognosis for skin cancer patients?
A: Basal cell and squamous cell carcinomas have better than a 95 percent cure rate. If detected in the early stages, melanoma has a 99 percent survival rate in five years.
Q: Aside from limiting sun exposure and wearing sunscreen, what other precautions can people take?
A: Regular skin cancer screening is one. The main thing is to wear a good SPF of at least 15, preferably 30, on a daily basis. Try to reapply halfway through the day. There are many good sunscreens out there, but the best ones, such as Anthelios SX by LaRoche Posay, cover both UVA and UVB light. Broad-brimmed hats are helpful, as well as SPF-rated clothing such as Solumbra or Coolibar.