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WHAT IS SKIN CANCER?


Skin cancer is the most common type of cancer worldwide. South Africa has one of the highest monitored ultra violet levels in the world. Therefore we have one of the highest skin cancer rates.

The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. These can lead to disfigurement and the loss of an eye, nose or ear if left untreated.

Melanoma, the most dangerous form, is on the increase. This life threatening disease is curable if detected and effectively treated in the earliest stages.

Solar keratosis, an abnormal skin growth, is a pre-cancer that can develop into skin cancer.

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WHAT CAUSES SKIN CANCER?

The main cause is chronic exposure to sunlight.

The non-melanoma types of skin cancer are linked to long-term exposure to the sun. Malignant melanoma is linked more with more short, sharp bursts of exposure. Even one incident of bad sunburn, especiall in childhood, may be enough to trigger off damage that I’ater develops into melanoma.

Ultra violet (UV) rays are part of the light spectrum reaching the earth. There are two kinds of UV rays that damage our skins. The broader UVB rays cause the browning reaction and are responsible for the painful burning, redness and ultimately skin cancer. UVA rays penetrate deeper into the skin and can cause damage to the structure of cells, causing ageing and increasing the risk of cancer.

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WHO IS AT RISK?

  • if you are exposed to the sun on a regular basis for a long period of time

  • if your skin burns easily

  • if you have fair skin with red or blond hair

  • if you have light-coloured eyes

  • if you freckle easily when exposed to the sun

  • if there is a history of melanoma in your family

  • if you have a large number of moles
The darker your natural skin colour, the lower your probable risk of developing skin cancer. However, this does not exclude individuals with darker skins from getting skin cancer. No one is immune to.the sun’s harmful rays.

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WHAT ARE THE WARNING SIGNS?

  • A Skin growth that increases in size and looks pearly, translucent, tan, brown, red, pink or multicoloured.

  • A mole that changes in colour or texture, becomes irregular in shape, gets larger or is bigger than the end of a pencil (6mm) in diameter

  • A spot or growth that continues to itch, burn, hurt, crust, scab, erode or bleed.

  • An open sore that doesn’t not heal, or heals and then opens

  • A scaly or crusty bump that is horny, dry, and rough and may produce a prickling or tender sensation.
If you see any of these signs if skin pre-cancer or cancer, consult your doctor immediately.

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TYPES OF SKIN CANCER

BASAL CELL CARCINOMA


Basal cell carcinomas are raised, translucent, pearly nodules, which may crust, ulcerate and sometimes bleed. They occur most often on the face and other exposed areas of the body, but can appear on other areas.

AN OPEN SORE that bleeds, oozes or crusts and remains open for 3 weeks or more. A persistent, non-healing sore is very common sign of an early basal cell carcinoma.

A REDDISH PATCH or irritated area frequently occurring on the chest, shoulders, arms or legs. Sometimes the patch crusts. It may also hurt or itch. At times, it persists with no noticeable discomfort.

A PINK GROWTH with a slightly elevated rolled boarder and crusted indentation in the centre. As the growth enlarges, tiny blood vessels may develop on the surface.

A SHINY BUMP or nodule that is pearly or translucent and is often, pink, red or black or white. The bump can also be tan, black or brown, especially in dark haired people and can be confused with a mole.

A SCAR LIKE AREA, which is white yellow or waxy and often has poorly defined borders. The skin itself appears shiny. It can indicate the presence of an aggressive tumor.






SQUAMOUS CELL CARCINOMA


Squamous cell carcinoma can take on the form of a persistent scaly red patch that sometimes crusts or bleeds; an open sore that does not heal; or a raised or wart like growth that may bleed.

A PERSISTENT SCALY RED PATCH with irregular borders that sometimes crusts or bleeds.

AN ELEVATED GROWTH with a central depression that occasionally bleeds. A growth of this type may rapidly increase in size.

A WART-LIKE GROWTH that crusts and occasionally bleeds.

AN OPEN SORE that bleeds and crusts and persists for weeks.











MALIGNANT MELANOMA


Malignant melanoma is a deadly form of skin cancer that usually arises in or around moles. In its early stages, when it can easily be treated, the disease is not life threatening. But in later stages, it spreads to other parts of the body. At this point, treatment is not always successful.

Malignant melanoma occurs in varying shades of browns or black or in multicoloured patches of red, white and blue. It may have an asymmetrical outline or scalloped edges and is usually larger than 6mm. Many melanomas may arise in pre-existing moles.

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ABCD of MELANOMA

The ABCD of melanomas must be kept in mind when doing skin self-examination.

  • Asymmetry - a mole or mark with one half unlike the other. Common moles are round and symmetrical

  • Border irregularities – scalloped or poorly defined edges. Common moles have smooth, even borders

  • Color Variations – inconsistency: tan, brown, black, red, white and even blue. Common moles usually have a single hade of brown or black.


     
  • Diameter – larger tan 6 mm

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DO A REGULAR SELF-EXAMINATION

Every-month, check your skin carefully and ask a family member or a friend to examine your back and to of your head, If you note any changes, don’t delay, go see your doctor.
The best defense against skin cancer – apart from prevention – is early detection, If detected at an early stage, the most skin cancers a re curable
 

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GUIDELINES FOR SUN SAFETY

  • Take note of the daily UV radiation warnings in weather forecasts and plan your activities accordingly

  • Limit your total time in the sun, especially between the hours of 10 am and 3 pm, when as much as 60% of the days harmful rays occur.

  • Cover up. It is possible to get badly burnt through thin fabrics. Wear thick hat with a wide brim. Look out for approved UV resistant clothing.

  • Use a broad-spectrum (UVA & UVB) sun protection factor (SPF)

  • Take note of the principle:
    The higher, the better. Nothing less that factor SP30

  • Choose a water-resistant product if you perspire a great deal or participate in water sports

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WHAT DOES SPF MEAN? Skin self-examination.

SPF is a time factor and area dependent. It revolves around the safe sun time:
The safe sun time is area specific and depends on the U concentration! In South Africa this is 10 mm! If you use SPF of say 15 you can prolong the SST to 10 x 15 = 150 mm = 2 1/2 hrs. So if you are spending most of the day outdoors you need,~ to use a Factor 30 - 60.

  • Apply sunscreen on all exposed areas of skin, especially on the back of the neck, tips of the ears, the
    lips, arms and hands. Re-apply frequently, especially after being in the water.

  • UV rays are reflected off sand, light coloured concrete, walls and grass increasing your chances of getting burnt, even in the shade.

  • UV rays are not the same as heat. You can be overexposed even when it is cool, so be careful on windy or overcast days.

  • Infants under 6 months should never be exposed to the sun.

  • Encourage children to wear sunscreen and hats when playing outside in the sun.

  • Use a self-tanning cream rather than spending hours in the sun getting a tan.

  • Keep away from sun beds and sun lamps.

  • Hats, umbrellas and sunglasses all help to protect us from the sun.

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For more information contact the Schering-Plough Oncology Division
Tel: (011) 922 3320

SAMAB
South Afncan Melanoma Advisory Board


Schering Plough (Pty) Ltd. Co. Reg. No. 1934/005207/07 (Applicant). 54 Electron Avenue, Isando 1600. Tel +27 (0) 11 922-3320.