Skin Cancer

Gone are the days when people sent children outside to play to get a little
color in their cheeks. They know too much about the dangers of unprotected sun
exposure and the threat of skin cancer. Or do they? Despite the fact that 58%
of parents remembered hearing about the importance of protecting their children
from the sun, children are still playing in the sun without sunscreen or
protective clothing (3., p 1). Sunburn is the most preventable risk factor of
skin cancer. Skin type and family history cannot be changed. Protection from
the sun and education of the potential hazards of the sun need serious attention.
The American Cancer Society estimates that over 850,000 cases of skin cancer
will occur in the United States during 1996. Of those cases, they predict that
9,430 will end in death (4., p 1). Apparently, Americans still do not have an
adequate amount of prevention information to help reduce the disfigurement and
mortality from this cancer.

Exposure to the ultraviolet radiation from the sun is the most frequently blamed
source of skin cancer. Due to the reduction of ozone in the earth\'s atmosphere,
UV radiation is higher today than it was several years ago. Ozone serves as a
filter to screen out and reduce the UV light that reaches the earth\'s surface
and its people. Very simply, sunburn and UV light can damage the skin and lead
to skin cancer (1., p 1). The American Cancer Society also faulted repeated
exposure to x-rays, artificial forms of UV radiation like tanning beds, and
contact with chemicals like coal tar and arsenic as other causes of skin cancer
(4., p 1). Additionally, if there is a history of skin cancer in the family, an
individual may be at a higher risk (1., p 1). Individuals who have experienced
only one serious sunburn have increased their risk of skin cancer by as much as
50% (1., p 4).

There are three main types of skin cancer: basal cell carcinoma, squamous cell
carcinoma, and malignant melanoma. Basal cell carcinoma usually imposes itself
on areas of the skin that have been exposed to the sun. It usually appears as a
small raised bump with a smooth shiny surface. Another type resembles a scar
that is firm to the touch. Although this specific type of skin cancer may
spread to tissue directly surrounding the cancer area, it usually does not
spread to other areas of the body (9., pp 2-3).

Squamous cell carcinoma growths also appear most frequently on areas of the
body that have been exposed to the sun. These areas can include the hands,
lower lip, forehead, and the top of the nose. Additionally, skin that has been
exposed to x-rays, chemicals, or has been sunburned can host these tumors. The
squamous tumors may feel scaly or develop a crusty appearance. Some growths may
bleed. These particular tumors may spread to lymph nodes in the surrounding
area (9., pp 2 -3).

Malignant melanoma is a far more serious type of skin cancer. It can spread
quickly to other parts of the body through the lymph system or blood. This type
of skin cancer is more common among adults. Findings have indicated that men
most often develop melanoma on the trunk of the body. Whereas, women most often
develop it on the arms and legs (6., pp 2-3). The warning signs of melanoma
are: changes in the color, size, or shape of a mole, bleeding or oozing from a
mole, or a mole that is hard, lumpy, swollen, and is tender to the touch, or
feels itchy. A new mole can also be an indicator of melanoma. A simple "ABCD"
rule outlines the warning signs of melanoma. "A" is for asymmetry. One half of
the mole does not match the other. "B" is for border irregularity. The edges
are ragged, notched, or blurred. "C" is for color. The pigmentation is not
uniform. "D" is for a diameter of greater than 6mm. Any progressive increase
in size should be of particular concern (8., p 1).

For both basal and squamous cell carcinomas, surgery is the most common
treatment. Electrosurgery is the process in which the cancer is scooped out
with a sharp instrument and then an electric current is used to burn the edges
around the site to kill any remaining cancer cells. Cryosurgery freezes the
tumor to kill the diseased tissue with liquid nitrogen. Simple excision cuts
the cancer from the skin along with some of the healthy tissue around it.
Micrographic surgery removes the cancer and as little normal tissue as possible.
During this surgery, the doctor