Posts for tag: actinic keratosis

            Each year in the U.S. over 5.4 million cases of nonmelanoma skin cancer(NMSC) are treated in more than

3.3 million people.

           Each year there are more cases of skin cancer than the combined incidence of cancers of the breast,prostate,                                             

lung and colon and that over the past  3 decades more people have had skin cancer than all other cancers combined.

           According to the statistics basal cell carcinoma (BCC) is the most common form, of skin cance ( with more

than 4 million cases diagnosed in the U.S. annually,while squamous cell carcinoma( SCC) is the second most common

form-with more than 1 million cases diagnosed every year.

          However, I should like to point out that in my many years of practice,SCC has been far and away the most

common type of skin cancer diagnosed. And,in my opinion, SCC is harder to diagnose than BCC since it often

appears simply like dry skin areas and is easy to miss-unlike BCC which,in spite of the fact that there are several

different types,is easier to diagnose in my opinion.

         While actinic keratosis is the most common pre-cancerous skin lesion,about 90 % of NMSC are associated

with UV radiation from the sun. Other causes of skin cancer include  medical radiation ,chemotherapy (especially in already

immunosuppressed individuals suffering from internal cancer),non-healing ulcers,sores,vaccination marks and tatoos.

In addition,people drinking well water contaminated with arsenic from fertilizers used in sod farms,etc. are prone to

squamous cell carcinomas and if present in non-sun exposed areas of the skin can be more likely to spread

internally.

          Also, people who have had organ transplants have an incidence of squamous cell carcinoma about

100 X more than the general public-possibly due to the anti-rejection drugs (which depress the immune system)

they must take to prevent their body from attacking the  the organ transplant.

            One person dies of melanoma skin cancer every 54 minutes and that an estimated 87,000 + new cases of melanoma

will be diagnosed in the U.S.in 2017.And, that an estimated  9700 + will die of melanoma in 2017-the vast majority of which

are caused by the sun and that the risk of melanoma doubles if he or she has had more than 5 sunburns.

            And if you want to hear something really scarey,listen up: people who first use a tanning bed before age 35

increase their risk for melanoma by 75 %.

           In 2016 I diagnosed several people with malignant melanoma  over a six month period. My experience in

both internal medicine and dermatology over many years has been how certain diagnoses occur in clusters.

I could never figure out how as a young doctor working many a night in emergency rooms that one evening

everyone seemed to have chest pain,the next night breathing difficulty due to pulmonary problems,the next

night everyone needed sutures,the next night was pediatric night and on and on-almost as if there was a sign over the

emergency room entrance. 

           Even though I may not see a patient with malignant melanoma in many months,I know that if one

comes in,there will be at least 2 more in the near future since from my personal experience things seem to

always occur at least in 3's.

           It is also interesting to note that women aged 49 and under have a higher probability of developing

melanoma tha any other cancer except breast and thyroid cancer.

          And,it is very important to note that in darker skinned people such as blacks,Asians,Filipinos,Indonesians

and native Hawaiians ,melanomas are more likely to occur on non-sun exposed areas such as the ano-genital

area,palms of the hands,soles of the feet,mucous membranes and fingernail and toenail areas. Therefore,it is

encumbent on the clinician to examine these areas.

          And,SCC,the most common skin cancer in black and Asian peoples,tends to be more aggressive

(perhaps,because of delayed diagnosis in non-sun exposed areas) in black people with a 20 to 40 % chance

of metastasis(spreading internally).

         And,although malignant melanoma accounts for only up to 3 percent of all pediatric cancers,its treatment

is often delayed due to misdiagnosis of pigmented lesions,which occurs up to 40 percent of the time.Parents

should ask their child's pediatrician for a sunscreen SPF recommendation.

         In conclusion, regular use of a sunscreen with an SPF of at least 30 applied at least 30 minutes before

exposure and reapplied after bathing and at least every 2 hours while avoiding excessive sun exposure

during the heat of the day 10 AM-4 PM can markedly cut the risk of skin cancer and show 24 percent less

skin aging than those who do not use sunscreens daily.

        Also,one should get regular skin exams and check their own skin on a regular basis and report any 

changes to their clinician.

         

 



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