MONDAY, May 26, 2003 (HealthDayNews) -- More than 1 million Americans will learn this year they have skin cancer.
That's more than twice the number who will hear they have prostate or breast cancer, making skin cancer the most common cancer in the United States.
While prostate and breast cancers kill far more people, skin cancer -- usually caused by excess sun exposure -- can be deadly, too. The American Cancer Society expects about 7,600 deaths this year from melanoma, the most virulent of skin cancers.
Dermatologists like Dr. David J. Goldberg, who practices at the Mt. Sinai School of Medicine in New York City, are worried because their skin cancer patients are younger and younger when first diagnosed.
"I've been in practice 17 years," he says. "Seventeen years ago, I saw people in their 50s. Now, I see fair-complected women in their 30s."
As discouraging as the news may sound, there are encouraging developments to note as Americans kick off the unofficial start of summer with Memorial Day.
Blocking out the sun's harmful rays has never been easier, thanks to new forms of sunblock as well as sun-protective clothing such as hats specially treated to filter the sun.
And, if caught early, skin cancers are highly curable.
Also, new treatments for skin cancer promise to be less disfiguring than surgery but just as effective, cancer experts say.
Fair-skinned, freckled, light-eyed persons who burn easily are most at risk for skin cancer, although others can get it as well. Changes on the skin are the most common warning sign of skin cancer, according to the National Cancer Institute. Not surprisingly, the most common skin cancers -- called basal and squamous cell -- are found mainly on areas often exposed to the sun, such as the face, neck, hands, arms and head.
Melanomas, so named because they develop in the pigment-producing skin cells called melanocytes, are most often found on the trunk of men and the lower legs of women, although they can appear on other sites as well.
Any change on the skin, especially in the color or size of a mole, should be checked by a dermatologist, experts say. The dermatologist may then decide to biopsy the area, taking a small sample of skin to examine it under a microscope for cancerous or pre-cancerous cells.
Standard treatments include removing the cancer with surgery, laser therapy, radiation or chemotherapy drugs in lotion or cream form applied to the skin, experts say.
A newer approach, says Goldberg, is photodynamic therapy. First, a light-activated drug that targets cancer cells is applied or injected. A day or so later, a laser light is aimed at the cancerous tissue and "switches on" the drug, which destroys the cancer cells but does not affect healthy cells, he says.
So far, the approach is only approved by the U.S. Food and Drug Administration for treating other forms of cancer -- such as esophageal cancer -- and for pre-cancerous skin lesions. But some doctors are now trying it for skin cancers.
Another new approach being tested for some skin cancers is a so-called immune modifier, says Dr. Martin A. Weinstock, a professor of dermatology at Brown University and chairman of the American Cancer Society's skin cancer advisory group. A drug called imiquimod (Aldara) is applied topically; it works by triggering an immune response, causing the body to attack the malignant cells, he says.
Increasingly, doctors are also using digital photography to monitor people with suspected melanomas, to track and quantify how much the growth changes from visit to visit.
Even with these advances, Weinstock says, "the most important thing people can do is look carefully at their skin once a month."
An annual skin exam by your physician or dermatologist is also wise, says Dr. Diane Berson, an assistant professor of dermatology at the Weill Medical College of Cornell University in New York City and a spokeswoman for the American Academy of Dermatology. It's crucial, she says, if you have a family history of skin cancer or are at high risk.
Sunblocks are also vital, and an array of new products is making it easier to follow that recommendation, says Goldberg. Sunblocks and screens now come not only in cream form but gels and sprays, minimizing the "ick" factor of greasy creams. Clothing specially treated with sunblocking agents can help, too.
Despite all that has been said about skin cancer and the need for sunscreens, some people still don't bother to read the directions or know how to use the products properly, Goldberg says. Among the most common mistakes: People wait to apply a sunscreen after they've gone outdoors.
"Put it on a half hour before you go out," he says. And use a product with a sun protective factor (SPF) of at least 15. "And reapply SPF 15 every two hours," Goldberg adds.
More information
For information on basal and squamous cell cancers, see the American Cancer Society. For information on melanoma, click here.
