There are several types of skin cancer – melanoma is the deadliest of them. How do you differentiate between a benign mole and a melanoma? What is BCC? What is SCC? When to be tested? What are the chances of recovery?
What is skin cancer?
Skin cancer is cancer that develops on the surface of the skin. Skin cancer can be diagnosed relatively simply if you notice the appearance of a new lesion on the skin, a change in an existing lesion, or an examination by a dermatologist.
The most common skin tumors in USA and the world are melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC).
What is a skin mole? What is the difference between it and a sweet spot?
There is no difference between a skin mole and a mole! These are two words that describe the same phenomenon.
A mole or mole (in English: nevus or mole) is a proliferation of cells originating from the skin, i.e. a benign tumor. There are several types of cells in the skin, but most often, when we talk about a mole, we mean a melanocytic mole, that is, a mole composed of cells called melanocytes.
A melanocyte is a cell found in the upper layer of the skin (epidermis). This cell produces a pigment called melanin. This pigment is responsible for our skin color. The complete absence of pigment manifests itself in completely white skin – a condition called albinism.
How is a mole formed?
Most skin moles appear already in the first years of life and multiply in the second and third decades of life.
The reason for the appearance of moles is hereditary, but exposure to the sun significantly increases the number of moles that appear on the skin.
On average, a person has about 25 moles on the body, but about 7% of the light-skinned population has multiple moles. As mentioned, many moles are the most important risk factor for the development of melanoma skin cancer.
There are also birthmarks that appear in about 1% of children. Even these moles, especially the larger ones, are a risk factor for melanoma and require regular follow-up by a dermatologist.
What is a dysplastic mole?
Most moles are small, uniform in color, symmetrical, and with clear margins. A small mole is a mole with a diameter of fewer than 6 millimeters (about the diameter of the eraser at the end of the pencil). Moles whose characteristics are different, meaning they have the same characteristics as melanoma, are called “atypical moles” or “dysplastic moles”.
People with multiple dysplastic moles are at increased risk of melanoma.
What is melanoma skin cancer?
Melanoma (or in its full name: malignant melanoma of the skin – Malignant Melanoma of the Skin) is a deadly skin cancer. The cancer cells in melanoma are the melanocyte cells – the cells that create the pigment in the skin.
Melanoma is deadly cancer if not diagnosed at an early stage.
How do you differentiate between a benign mole and melanoma in the skin?
Moles appear in childhood and do not grow in adults, except during pregnancy. Usually, most of the moles that appear on a particular person look the same. On the other hand, if you notice a mole or a lesion that is different from the other lesions on the skin, you should suspect that it is melanoma.
There are five signs that raise the suspicion that a mole is actually melanoma in the skin:
- Geometry (Asymmetry): A mole that is not symmetrical.
- Border: jagged, irregular, or unclear borders.
- Colors: many shades (from 3 shades or more) or ruby around the mole.
- Size (Diameter): A mole that is more than 6 millimeters in diameter (about the diameter of an eraser at the end of a pencil). Today, the size criterion tends to be ignored since there are quite a few melanomas that are smaller than 5 millimeters.
- The most important warning sign is a change (Evolution): a change in an existing mole or the appearance of a new mole – especially in people over 40 – can indicate the appearance of melanoma. Spontaneous bleeding (without injury) from the mole or a strong feeling of itching requires an examination by a dermatologist.
What is the ugly duckling sign?
A mole on the surface of the skin that is different from the other moles in the same person is a mole that should be suspected of being melanoma. Such a mole is known as the “ugly duckling mark”, similar to the ugly duckling in the book by Hans Christian Andersen, who was different from his duckling brothers.
Can itchy skin be related to skin cancer?
In most cases, itching expresses a skin disease such as atopic dermatitis (atopic dermatitis) and is not related to cancer. However, in extremely rare cases, the appearance of itching in the skin may be a sign of cancer, so when an itch that did not appear before is felt, it is recommended to consult a dermatologist.
Is a red mole on the skin dangerous? Is mole skin cancer?
In most cases, a red dot on the surface of the skin is a lesion consisting of blood vessels and is called an angioma or hemangioma. However, in rare cases, melanoma may manifest as a red dot. A dermatologist – using a dermoscopy – can check if it is an angioma or a melanoma.
Can a skin rash be related to skin cancer?
A skin rash in most cases expresses a skin disease such as hives (urticaria). In extremely rare cases, a rash is a manifestation of cancer, so when a new rash appears, you should be examined by a dermatologist.
In which organs of the body can melanoma appear? Are there more common places than others?
Melanoma can appear in any area of the body. In the areas exposed to the sun – for example the face, neck or arms – there is an increased risk of skin cancer compared to areas not exposed to sunlight.
What are the chances of recovery from melanoma skin cancer?
It is very important to diagnose melanoma early! Early diagnosis of melanoma that is focused on the skin greatly increases the chances of a cure.
In recent years there has been an improvement in the chances of recovery from invasive melanoma. The most important index that predicts healing from melanoma is the depth of the tumor’s penetration into the skin. When it comes to melanoma that was removed when it was superficial, (melanoma in situ, in Hebrew: dormant melanoma) – the chances of cure are 100%.
The deeper the tumor, the smaller the chances of recovery from melanoma – up to only 10% in stage 4 melanoma. These data illustrate why the early detection of melanoma is so important.
What are the risk factors for getting melanoma skin cancer?
The most important risk factor for melanoma is multiple moles ( spots ). Studies show that there is a direct relationship between the number of moles (starting from 20 moles over the entire body) and the risk of melanoma. The risk in people with multiple moles is up to 10 times greater than the risk of the rest of the population.
And there are other risk factors for melanoma:
- The appearance of dysplastic moles (asymmetric, with irregular edges, with multiple shades, relatively large).
- Multiple freckles.
- Reddish (reddish) or light hair.
- Fair skin that tends to burn easily in the sun.
- Personal or family history of melanoma.
- Personal history of non-melanoma skin cancer (type BCC or SCC).
- Multiple exposures to the sun in the past (especially a history of multiple sunburns at a young age).
- Conditions of immunosuppression (eg cancer or taking drugs that suppress the immune system).
How is melanoma skin cancer treated?
The most important treatment for melanoma is the excision of the tumor. Despite many studies being done on this topic all over the world, effective treatment for metastatic melanoma has not yet been developed. That is why the early detection of melanoma is so important to the chances of recovery.
What is basal cell skin cancer? (Basal Cell Carcinoma – BCC)
BCC is the most common skin tumor in humans. The tumor is formed from the basal cells located in the upper layer of the skin (epidermis).
Is BCC skin cancer dangerous?
Although it is cancer, a BCC tumor is not life-threatening except in rare cases where the cancer is not treated appropriately. However, it can cause significant aesthetic damage, so it is advisable to take care of it when it is still small.
What does BCC skin cancer look like?
BCC is related to exposure to the sun, so the tumor appears mainly in areas exposed to the sun such as the face (including the forehead and nose), earlobes, cleavage, arms, and forearms. However, the tumor can be found anywhere on the body.
The tumor can manifest itself in different forms: a wound that does not heal (and sometimes bleeds spontaneously), a red or crimson surface, a pearl-gray or pink bump, or a white scar-like surface.
How is BCC skin cancer treated?
BCC treatment depends on the type of tumor (there are several types of BCC), its location, the number of lesions, and the patient’s priorities.
BCC can be removed with standard surgical excision. It is not customary to treat BCC by shaving, scratching, or burning due to the high risk of tumor recurrence, except in small lesions or in elderly or very sick people who cannot undergo surgical excision of the lesion.
BCC can be removed using the Mohs method, where the tumor is removed layer by layer. After each layer is removed, the remaining layers are checked – in real time, while the patient is in the operating room – until there are no more traces of cancer. The method is recommended mainly for the face area.
Imiquimod gel can also be used. It should be used 3 to 5 times a week for 6 to 16 weeks. The results of this treatment in BCC patients are usually excellent.
What is squamous cell carcinoma (SCC)?
Squamous cell carcinoma is a common skin tumor. It is formed from the squamous cells found in the upper layer of the skin (epidermis). These cells produce a scale consisting of keratin, which is a protein found in the skin, hair, and nails.
What does SCC look like?
Squamous cell cancer looks like a small bump or a red spot with a scab or a small bleeding ulcer that is difficult to heal. The tumor usually appears in the areas exposed to the sun: face, lips, earlobes, and upper and lower limbs. The tumor grows slowly, over months or even years, but if it is not treated, it may reach large dimensions, penetrate deep tissues of the skin and send metastases to distant organs.
Is SCC skin cancer dangerous?
SCC cancer can be dangerous in extremely rare cases.
How is SCC skin cancer treated?
The treatment of SCC is done through normal surgical excision. If the tumor appears in the face, the surgery can be done using the Moss method explained above.
What is the frequency of the recommended examination at the dermatologist and how is it done?
The recommendation is that every person, of any age (including children), should be examined by a dermatologist once a year.
Those who have found one or more of the risk factors mentioned above are recommended to be examined by a dermatologist twice a year.
The test includes a review of the entire body’s skin with the help of a dermoscopy – an optical aid that allows greater accuracy in diagnosis.
Should the entire skin area be checked?
The test must be done after the complete removal of the clothes – respecting the privacy and dignity of the subject.
When you come to check moles at a dermatologist, it is not enough to check the exposed areas, the entire skin area must be checked.
If a man or woman does not want to remove all their clothes, they can leave the underwear (bra, underwear), but this option is not recommended. The reason: it is especially important to check the buttock area, which the subject is not able to see by himself.
When it comes to children, it is recommended that the parents check them at home before going to the dermatologist and identify in advance where there are moles.
How can the chances of skin cancer detection be further increased?
In high-risk people, you should do a self-examination of the body’s skin once a month. To examine the back, you can use a mirror or have the help of your partner. It is very important to pay attention to any change in skin texture. At the appearance of a new skin lesion (of any color) or at any change in an existing lesion, it is recommended to consult a dermatologist.
How do we protect ourselves from uncontrolled exposure to the sun?
In order to protect ourselves from uncontrolled exposure to the sun and reduce the risk of developing skin cancer and other sun damage, the following rules of defense must be observed:
- Safe hours. The hours when the sun’s radiation is strongest are between 9 in the morning and 5 in the afternoon. Therefore, it is recommended to avoid staying in the sun as much as possible during these hours.
- Wide-brimmed hat. When outside the house, a wide-brimmed hat should be worn that casts a shadow on the face and back of the neck.
- Sunglasses. Sunglasses with dark lenses that filter the ultraviolet rays must be worn.
- Appropriate clothing. Be sure to wear a shirt with sleeves. Today there are special types of clothing in which there is a radiation filter inside the fabric itself that provides effective protection against the sun’s radiation. It is recommended to wear clothes made of this fabric.
- Shadow. It is recommended to stay in the shade as much as possible. But it is important to remember: shade does not provide complete protection from the sun’s radiation. You can stay under an umbrella at the beach and absorb plenty of radiation – for example, the one that comes back from the sand and the water.
- Sun protection product. Apply a protective product on the visible areas of the skin even before leaving the house. It is recommended to use sunscreen with a sun protection factor of 30 or more that protects against both UVA and UVB radiation. It is important to apply it every two hours and after staying in the water. The best protection is achieved if all these protection measures are used in combination.
Finally: some myths about skin cancer
- Myth: artificial tanning in tanning beds is safe and does not increase the risk of skin cancer.
Not true! Artificial tanning means exposure to ultraviolet radiation, similar to the sun’s radiation, so it too may increase the risk of skin cancer of all types.
On top of that, it causes all the other known damages of the sun: premature aging of the facial skin, spots, wrinkles, and cataracts. Remember: there is no safe tanning because the very act of tanning indicates that the body has been exposed to excessive radiation, and is trying to protect itself.
- Myth: staying in a shaded area gives full protection from the sun’s rays.
Not true! The protection is not complete because the sun’s rays are reflected from different surfaces such as sand, water, and walls and therefore can also penetrate under sheds. For this reason, additional protective measures must be used: a hat, sunglasses, suitable clothing, and protective products even when in a shady place.
- Myth: When the sky is cloudy, there is no need to take sun protection measures.
Not true! Ultraviolet radiation also penetrates through the clouds.
- Myth: When in water, the body is not exposed to ultraviolet radiation.
Not true! The rays are able to penetrate even through water up to a depth of half a meter. Furthermore, when in water, the radiation is reflected from the surrounding water surfaces, and its intensity is increased.