On a warm May afternoon in 1996, I sat on the phone, speaking to my grandpa for the last time. I will never forget the sadness I felt or the words he spoke to me in those final moments from his hospital bed.
Take care of your skin,” he whispered. “Don’t let this happen to you.”
My grandfather died a couple of days later from his long-fought battle with lymphoma, which was brought on and precipitated by melanoma, the deadliest form of skin cancer.
Thirteen years later, driving home from an annual routine check-up at the dermatologist’s office, his words came back to haunt me. What I assumed was just a patch of itchy skin surrounding a small pink mole on my collarbone turned out to be skin cancer. Basal Cell Carcinoma, to be specific. I was told the cancer would have to be cut out, and there would be a scar. Because my wedding was only six months away, and I refused to have an ugly scar exposed (I was wearing a strapless gown), my doctor allowed me to wait until I returned from my honeymoon. However, he was adamant that I come in for the MOHS surgical procedure the week we returned, and I was also to have monthly visits throughout the six months to make sure the mole didn’t get larger. If it did, then negotiations were over, and the mole would have to be removed pre-wedding.
Exactly four days after returning from my honeymoon, I arrived for my surgery, and the mole had in fact grown, which required more tissue removal. It amazed me that something so small could actually be very dangerous.
So what types of skin cancer are there, and how can you tell the difference?
Actinic Keratosis
There are three different types of skin cancer, and there is a pre-cancerous condition called Actinic Keratosis, which is generally found in sun-exposed areas of skin, such as the face, hands, forearms, and neck. It is more common in fair-skinned, light-eyed, fair-haired people, and usually starts making appearances between the ages of 30 and 40. Actinic Keratosis is diagnosed through a skin examination and shows up as small, noticeable, red, brown, or flesh-colored patches that may itch, burn, or sting. They may also be surrounded by red, irritated flesh. Actinic Keratosis spots, moles, or patches may require biopsy to rule out the progression to squamous or basal carcinoma, and there are several treatment options (most in-office or at-home) that can be done to get rid of the Actinic Keratosis. (Click here for more information on Actinic Keratosis.) While many occurrences of Actinic Keratosis have been found on me, they were easily treatable and the least of my skin concerns.
Basal Cell Carcinoma
My experience with skin cancer is largely based on the lesion of Basal Cell Carcinoma that was found on my collarbone six months before my wedding. To be perfectly honest, I really didn’t think anything of the scaly, red patch of skin that had been itching me for months. I assumed it was a case of eczema or seborrheic dermatitis and that the doctor would tell me to buy a cream which would erase or at least calm the problem within a couple of months. I drove home in shock after he told me it was skin cancer and, though the most common form, was something that absolutely had to be removed and watched closely. Basal Cell Carcinoma accounts for more than 90% of all skin cancer cases across the country. Most of the time, it does not spread to other body parts, but can invade surrounding tissue, causing damage. While light-colored skin and sun exposure are factors in contracting this form of skin cancer, Basal Cell lesions usually show up on unexposed skin, such as: chest, back, arms, neck, legs, and scalp. The face, though, is the most common canvas for basal cell lesions.
But what does it look like? “[It] usually begins as a small dome-shaped bump and is often covered by small, superficial blood vessels called telangectasias. The texture of such a spot is often shiny and translucent, sometimes referred to as ‘pearly.'”Sometimes basal cell carcinoma cannot be easily distinguished from a benign growth like a flesh-colored mole without performing a biopsy. Basal cell carcinomas can take months or even years to grow or change shape and become noticeable. There are several options for removing these carcinomas, which include radiation therapy and surgical removal.
Squamous cell skin cancer is the second most common type of skin cancer in fair-skinned people and is rare in darker skin complexions. In addition to the basal cell carcinoma found on my collarbone before my wedding, that same appointment revealed pre-cancerous cells of the squamous variety on the right side of my face from my forehead to my cheek. Luckily, these cells had not fully developed, and a chemotherapy cream was prescribed for several months to kill the cells. Squamous cell carcinoma most often occurs on sun-exposed areas, like the ears, nose, forehead, hands, and lower lip. However, this form of skin cancer can also develop in skin that has been burned or been exposed to radiation or chemicals. Squamous cell carcinoma is dangerous because it can develop rapidly into large masses and invade nearby lymph nodes. Squamous cell carcinoma may look like a firm red bump, a patch of skin that feels scaly, bleeds, or develops a crust, or may resemble a sore that doesn’t heal.
Melanoma
The least common form of skin cancer is also the most serious and dangerous. Melanoma is unique from the other types of skin cancer since can affect your skin only or, and most scary, may affect your organs and bones as well. Too much time spent in the sun is the biggest culprit behind melanoma. The sun causes normal skin cells to become abnormal, and those abnormal cells quickly spread to attack any surrounding tissue. Melanoma tends to be hereditary, and the presence of atypical (or abnormal) moles can be an indicator that melanoma runs in the family. The main symptoms to watch out for with melanoma are change in size, shape, or color of a mole or birthmark. Melanoma can show up in pre-existing moles or birthmarks, and it can also show up in previously unmarked skin. Melanoma is not limited to any specific part of the body and can grow anywhere. Most of the time, melanoma shows up on the upper back of men and on the legs and upper back of women. What do melanomas look like? They are usually flat, brown or black moles with uneven edges. Unlike a normal mole, melanoma can be lumpy or rounded, is usually asymmetrical (both sides are not evenly shaped or sized), changes size, shape, or color, and can sometimes bleed, ooze, or become crusty.
I know all too well the dangers of melanoma, because it is what began my grandpa’s long battle with cancer. His melanoma spread to his lymph nodes and developed into lymphoma. He underwent chemotherapy and surgeries. He even enjoyed many years with the cancer in remission. In 1996, however, it reared its ugly head with a vengeance and ultimately ended his life. Now, whenever I notice a new mole or a new “skin tag,” I hear his words and worry, wondering if the next mole will reveal melanoma. I’ve been diagnosed and treated for A.K., Basal Cell Carcinoma, and pre-Squamous cell skin cancers, and I know that awareness and sun protection are the best preventions and fight against the most common of cancers…skin cancer.
Sources:
Author’s personal experience
“Melanoma Skin Cancer Health Center.” webmd.com. 06 June 2012. Web.
