otherOctober 2, 2017

When a change in the skin is discovered, it's time for a trip to the doctor. It might be nothing, but there's always the chance that it could be skin cancer, and it's better to rule that out in a hurry. Skin cancer is the most common type of cancer. According to information released by the American Cancer Society (ACS), more than 3 million people are diagnosed with skin cancer each year...

Cutline-File Credit:Stock image
Cutline-File Credit:Stock image

When a change in the skin is discovered, it's time for a trip to the doctor. It might be nothing, but there's always the chance that it could be skin cancer, and it's better to rule that out in a hurry.

Skin cancer is the most common type of cancer. According to information released by the American Cancer Society (ACS), more than 3 million people are diagnosed with skin cancer each year.

"Skin melanoma is usually suspected when a patient, a partner or a physician notice a dark lesion on the skin," says Dr. Joseph Sokhn, a dermatologist with Saint Francis Medical Center. "The lesion is diagnosed by a skin biopsy, usually performed by a dermatologist."

Melanomas are the most common of skin cancers, and rates of occurrence have been on the rise in the last 30 years, according to information from the ACS.

A melanoma starts in the melanocytes, the cells that makes the skin pigment melanin. The cancerous cells can still make melanin, which is why these cancers can have varying shades of tan, brown, black and blue.

"Any patient who notices a skin spot that is asymmetric, with irregular borders, changing in colors or size, greater than 6 millimeters and/or growing in size should seek medical attention as soon as possible," Sokhn says. "Patients with significant sun exposure, personal or family history of skin cancers, should be seen by a dermatologist to look for suspicious spots at least once a year."

ACS guidelines recommend regular self-examinations, because individuals are more familiar with the mole, blemish or freckle patterns on their skin, so they are able to determine changes. Self-examinations should be done in a brightly lit area, using a hand mirror to inspect places like the back that are not easily visible.

People with fair skin are at a much higher risk to develop melanoma. It is more than 20 times more common in Caucasian than in African-American people, according to ACS.

"Melanoma is more common in people with fair skin and with a history of sunburns. Sun is one risk factor that can be limited through prevention," Sokhn says.

Ultraviolet (UV) rays make up a small portion of the sun's rays, but they are the main cause of damaging effects on the skin.

Sometimes melanomas occur later in life.

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"Melanoma is a skin cancer that becomes more prevalent with aging but it can affect any age," Sokhn says. "Melanoma can also affect the eyes, the nail beds and mucosal organs."

Melanoma can start without warning and can spread to other parts of the body. Once it has spread to internal organs, it is much more difficult to treat and cure.

Dermatologists typically refer to specialists for treatment.

Sokhn says patients with invasive melanoma are always referred to an oncologist for assessment, but another specialist is often involved in the patient's care.

"Every patient diagnosed with invasive melanoma should be evaluated by a multidisciplinary team that includes a plastic surgeon, specialized in treating skin cancers, and by an oncologist," he says. "The plastic surgeon performs a wide excision, and may perform an excisional of a regional lymph node, to assess if the melanoma has spread, in a process called Sentinel lymph node biopsy.

"Sometimes, if the cancer has spread to distant organs at the time of diagnosis, then surgery will be omitted and the oncologist will assume the care."

Treatment varies depending on the progression of the disease.

"For early-stage disease, the treatment usually consists of surgery," Sokhn says. "For advanced disease, immunotherapy is given. The response rate to therapy is about 50 percent overall.

"The oncologist will decide whether we need to treat to prevent recurrence or we can watch closely. If the lymph nodes are involved by cancer, the oncologist may prescribe a form of immunotherapy that help prevent the cancer from coming back."

When caught early, treatment is very successful, but as the old adage says, "An ounce of prevention is worth a pound of cure."

Reducing the risk of developing melanoma is simple.

"Avoid excessive sun exposure and sunburns, and diligently use sunscreens," Sokhn advises.

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