KNOW YOUR ABCDE's of Skin Cancer by, Traci McCormick, MD
Almost every adult has at least a few moles. Moles that appear in childhood grow along with your body. They can get darker over time. Or lighter. That’s normal. But other changes can be signs of melanoma, the most serious type of skin cancer. Because melanomas can develop quickly, Traci Cole McCormick, MD, a radiation oncologist with Alliance Cancer Care in Decatur, recommends self-examining your moles at home every month following the ABCDE rule:
Asymmetrical: does one half match the other?
Border: is it irregular, with ragged or notched edges? Color: is it the same all over?
Diameter: is it larger than about ¼ inch?
Evolution: is it growing, itching or bleeding?
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If you answered “yes” to one or more of those questions, or have a sore on your skin that does not seem to be healing, Dr. McCormick says you should go see a physician right away for a more thorough evaluation. Skin cancers that are found early and removed are almost always curable, but they can be deadly if allowed to grow and spread to other parts of the body. It is estimated that one in five Americans will develop some form of skin cancer by age 70, making it the most frequently diagnosed type of cancer. Basal cell carcinoma is the most common form of skin cancer, which more than four million cases diagnosed every year, followed by squamous cell carcinoma and melanoma. Many cases of skin cancer can be linked to ultraviolet radiation – either from sunlight or commercial tanning beds. Other skin cancer risk factors include fair skin, abnormal moles, family history of skin cancer, and living in a sunny or high-altitude climate. “In hot, sunny climates like Alabama, you really need to take precautions if you’re going to be outside for any length of time,” Dr. McCormick said. “Always apply a broad spectrum sunscreen with an SPF (sun protection factor) of 30 or higher. Protective clothing, wide-brimmed hats and UV-blocking sunglasses are also smart ideas.” Let’s take a closer look at the three most common types of skin cancer. Basal cell carcinoma begins in the basal cells – a type of cell that produces new skin cells as old ones die. It often first appears as a Inside Medicine | Spring Issue 2019
bump on the skin in a part of the body that is regularly exposed to the sun, such as the head or neck. Basal cell carcinomas are easily treated if caught early and rarely spread, or metastasize, beyond the tumor site. Squamous cell carcinoma develops in the squamous cells that make up the middle and outer layers of skin. While it can occur anywhere on the body, it is most often found in areas that get frequent sun exposure such as the face, ears, scalp, lower lip, neck, hands, arms and legs. Squamous cell carcinomas are more common in men, but women under 40 are increasingly affected. Many experts attribute this to use of commercial tanning beds. Melanoma, the most serious type of skin cancer, develops in the cells (melanocytes) that produce melanin, the pigment that gives your skin its color. Melanomas often resemble moles and sometimes develop from existing moles. Like basal and squamous cell carcinomas, early detection is the key to successful treatment. Melanomas are much harder to treat, and often fatal, if the disease reaches the lymph nodes or metastasizes to distant organs. Physicians consider a number of factors when deciding how to treat skin cancer, including the location, type and stage of the disease, the patient’s age and overall health, and potential side effects. “Some cancers are better treated with radiation therapy and others with surgical removal of the tumor,” Dr. McCormick said. “Each case is individual and requires a conversation with your doctor.”
Alliance Cancer Care uses external beam radiation therapy (EBRT) to safely and painlessly deliver high-energy X-rays to skin cancer cells while preserving the surrounding, healthy tissue. The X-rays damage the cancer cells so they cannot multiply. The treatments take only about 15 minutes and are offered at all six Alliance locations across Alabama.
