1. FOH Presents… Skin Cancer
Many cancers in our bodies give us little warning since they grow inside. It isn’t until we feel a lump, experience rectal bleeding, or feel very sick or fatigued that we know something is wrong and we go to the doctor. Skin cancer is one type of cancer that often times give us a warning. But, we need to know what to look for so we can get to our physicians early so it can be treated before it causes more harm.

2. Overview: What is skin cancer What causes skin cancer
Types of skin cancer
How is skin cancer treated
Here is what we will be discussing today.

3. Your Skin…
Skin is the largest organ in the body. It helps to protect us; helps with temperature regulation; and allows us a sense of touch. Understanding the various layers of the human skin can help visualize the development of skin cancer. The skin has 3 main layers: epidermis, dermis and subcutaneous.
The EPIDERMIS is the top layer of the skin. It is thin and protects the deeper layers of the skin and the organs of the body from the environment. At the very top of the epidermis, dead cells form a soft but protective sheet. The dead cells come from younger, living cells in the lower part of the epidermis, where they are constantly produced. Young cells rise to the surface as they age. From new creation of cells to sloughing off takes approximately days. (
If the top layer of skin is totally replaced every month, why does skin age so much and have the problems it does? The Dermis, the next layer down, is much thicker than the epidermis. It contains hair follicles, sweat glands, blood vessels, and nerves that are held in place by a protein called collagen, and once the collagen weakens, it is difficult to replace. (
The last layer is the subcutaneous tissue. It consists of connective and fatty tissue. The fatty tissue, or adipose, not only cushions and insulates the internal tissues, but also helps store nutrients. (

4. What is Skin Cancer?
Skin cancer is a disease in which cancer (malignant) cells are found in your skin.
UV light stimulates the production of melanin (pigment). These surround the cells move up to the surface of the skin. The result is a tan. Even though this “tan” is acting to protect our body, tanning has occurred because of damage. Exposure to UV light stimulates melanin because the UV rays “break” parts of your DNA, and one of the pieces that breaks off triggers the production of melanin, otherwise known as tanning. Unfortunately, it’s the initial “breaking” of the DNA to stimulate melanin production that can damage your skin permanently and lead to skin cancer. (

5. Occurrence Most common cancer in the U.S
1 in 5 Americans will develop skin cancer in
their lifetime
Largely preventable
There are many reasons we are seeing a rise in skin cancer. For one, people are living longer. To stay healthier, we are encouraged to stay active. Much of that activity is done outside: walking, jogging, cycling, swimming, etc. The fashion industry is still telling us that a beautiful tan makes a beautiful person…and our society is believing this with either hours in the sun, not using adequate sunscreen or using tanning beds. All of this is starting at a much younger age as well. (

6. Who is at Risk Light skin color, hair color, eye color, freckles
Genetics
Certain types of moles
Long-term sun exposure
History of childhood sunburns
Melanin offers protection against UV rays for African Americans and other dark-skinned people. Conversely, fair-skinned people are much less protected and more susceptible to skin cancer. Furthermore, albinos’ skin offers no protection.
Although dark-skinned people produce more melanin than lighter-skinned, all skin has the same number of cells that manufacture the melanin.
The same individuals who are most likely to burn are also most vulnerable to skin cancer. Studies have shown that individuals with large numbers of freckles and moles also have a higher risk of developing skin cancer. Although individuals with darker skin are less likely to develop skin cancer, they should still take action to protect their skin and eyes from overexposure to the sun.
People who have had a least one severe, blistering sunburn as a child or teenager are at increased risk of melanoma. Because of this, doctors advise that parents protect children’s skin from the sun. Such protection may reduce the risk of melanoma later in life. Sunburns in adulthood are still a risk factor for melanoma. (

7. What Causes Skin Cancer
Ultraviolet (UV) radiation is the main cause
Artificially-produced UV radiation
Chemicals
Overexposure to UV-radiation can cause skin cancer. UVA & UVB have both been implicated in causing DNA damage resulting in cancer. Sun exposure between 10AM and 4PM is most intense and therefore most harmful.
Natural (sun) & artificial UV exposure (tanning salons) are associated with skin cancer. Since sun beds cause mostly indirect DNA damage (free radicals) their use is associated with the deadliest form of skin cancer, malignant melanoma.
Skin cancers caused by chemical exposure (e.g., arsenic, etc) are rare when compared to cancers caused by UV exposure. Certain chemical exposures can directly cause skin cancer, or the exposure can increase the risk of skin cancers from UV exposure. If in doubt, read warning labels on both household products and industrial chemical labels. (

8. Types of Skin Cancer Pre-Cancerous Cancerous Actinic keratosis
Squamous cell carcinoma
Basal cell carcinoma
Melanoma
Others
Here are the types of skin cancer we will discuss. (

9. Actinic Keratosis
A pre-cancerous condition of thick, scaly patches of sun-damaged skin.
The 2 words ACTINIC KERATOSIS are Greek and describe precisely what is happening to the skin. Actinic means “rays” or radiant energy. Keratosis stands for hard and callous. Actinic keratosis are areas of calloused (thick and scaly) skin caused by chemical changes brought about by exposure to the radiant energy (sunlight, tanning beds, etc).
So we see these lesions on body areas exposed to the sun. The face, ears, lips, scalp, hands, neck, forearms and the “V” of the neck are especially susceptible. They are generally small in size (less than ¼ in across), slow growing, rough, and appear pink-red or flesh-colored.
Early on, it may disappear only to reappear later. It is not uncommon to see several of these lesions at a time; and people with one actinic keratosis usually develop many more. Those having this condition need to be seen by their physician and managed by a dermatologist since it can develop into squamous cell carcinoma. Actinic Keratosis is a warning that your skin has suffered significant sun damage.
The most common treatment used for AKs is cryosurgery. This is using liquid nitrogen to freeze them. They subsequently shrink or become crusted and fall off. (

10. Squamous Cell Carcinoma
Begins in squamous cells which are found in the surface of the skin
They are thin, flat cells that look like fish scales
Approximately 20% of all skin cancers
This slow-growing disease affects individuals who have regular exposure to sunlight. Until recently, this cancer was most common in older people, particularly men who worked outdoors. Now, however, more women and younger individuals are being diagnosed with squamous cell carcinoma, especially those who spend leisure time in the sun. We need to avoid long exposure to the sun, especially at midday, to prevent this type of cancer.
This form of skin cancer occurs most frequently on areas of the body exposed to the sun—the face, ears, neck, scalp, shoulders, and back. The rim of the ear and lower lip are especially vulnerable. Squamous cell carcinoma also can develop on areas of the skin that have been injured or damaged: not just sun damage but also burns, scars, sores, or sites exposed to x-rays or chemicals.
Depending on your risk factors, your physician may recommend that your skin be examined regularly to detect skin cancer Watch for changes in size, color, texture and appearance, as well as skin pain, bleeding, itching, crusting, or inflammation. Diagnosis is always a biopsy of the area with a clear and concise pathology report.
Treatment for this kind of cancer depends upon the size, depth and location. The usual treatments is to remove the tumor by cutting it out (surgical), cryosurgery (freezing), topical medication (kills the rapidly dividing cells) or radiation. (

11. Squamous Cell Cancer Warning Signs
Scaly Red Patch
Elevated with Central Depression
Sore that Persists
In squamous cell skin cancer can look like:
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.
An open sore that bleeds and crusts and persists for weeks.

12. Basal Cell Carcinoma
Skin cancer that arises from basal cells, small round cells found in the lower part of the skin (epidermis).
Over 75% of all skin cancers
Slow-growing
Generally treatable
“Each year about 750,000 people in the U.S. learn that a small growth in their body is basal cell carcinoma—the most common skin cancer. Repeated long-term exposure to sunlight is the primary cause. Light-skinned and middle-aged people who spent a lot of time in the sun as children are especially susceptible. X-ray treatments for acne and exposure to arsenic and hydrocarbons (industrial pollutants) also increase their chances of basal cell cancer.” (Harvard Medical School Family Health Guide / Copyright 1999)
According to the Skin Cancer Foundation, from their 2007 Skin Cancer Facts, the percentage of women under age 40 with basal cell carcinoma has tripled in the last thirty years….
ASK THE QUESTION: Why do you think this is?

13. Basal Cell Cancer Warning Signs
Some of the warning signs for basal cell cancer are the same for squamous cell. Here are five signs you need to watch for:
OPEN SORE-it bleeds, oozes, or just won’t heal.
REDDISH PATCH- crusty, can itch, and sometimes, but not always hurts.
SHINY BUMP- can be waxy looking or sometimes resemble a blemish or pimple.
PINK GROWTH- pink lesion with sometimes an indentation in the center.
SCAR-LIKE AREA – shiny, flat, skin may be taut. Sometimes skin cancer can just appear as if there is a texture change in the skin.
When in doubt, ask your physician. Treatment for this kind of cancer as stated before is surgery. Some may have freezing done, but the only accurate way to determine if it is skin cancer and the type is by biopsy. Always ask that your skin lesions are sent to a pathologist. (
Small, smooth, pale, or waxy shiny lump
A lump that bleeds or develops a crust
Firm, red lump

14. Check In Quiz Thick, scaly patches of sun-damaged skin#1
Thick, scaly patches of sun-damaged skin
Persistent, scaly red patch sometimes crusts or bleeds #2 #3
Red growth with indentation in center
Let’s do a quick review..
#1 This is a thick, scaly patches of sun-damaged skin. Any guesses? Actinic Keratosis. Precancerous or Cancer?
#2. A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds. Squamous cell Cancer
#3. Red or pink growth with sometimes an indentation in the center. Basal cancer but could also squamous cell.
So we have talked about precancerous lesions like actinic keratosis and two types of cancers (squamous cell and basal cell cancers). Now I would like to talk with your about the deadliest form of skin cancer – Melanoma. This cancer accounts for
more than 75% of the deaths from skin cancer
melanoma is the most common form of cancer for young adults years old
It is the second most common form of cancer for adolescents and young adults years old.
It is increasing faster in females years old than males in the same age group. In young females years old, the torso is the most common location for developing melanoma which may be due to high-risk tanning behaviors. Melanoma in the average person can occur anywhere, but is more likely to start in certain locations. The trunk is the most common site in men. The legs are the most commonly affected site in women. The neck and face are other common sites.
Having darkly pigmented skin lowers your risk, but it is not a guarantee that you will not get melanoma. Anyone can develop this cancer on the palms of the hands, soles of the feet, and under the nails. Melanomas in these areas represent about half of all melanomas in African Americans but fewer than 10% of melanomas in whites.
1 in 58 men and women will be diagnosed with melanoma during their lifetime. Caucasians and men over 50 years of age are at higher risk of developing melanoma than the general population.
In 2008, it is estimated that there will be about 116,500 new cases. One American dies of melanoma almost every hour (62 min). (

15. Melanoma A skin cancer that arises in a pigment producing cell
Usually begins in a mole
Deadliest form of skin cancer
5% of all skin cancers
Can be found anywhere on the body
We have talked about precaneruous lesions like actinic kerotisis and two types of cancers (squamous cell and basal cell cancers) Melanoma is the deadliest form of skin cancer, accounting for more than 75% of the deaths.
It is the most common form of cancer for young adults years old and the second most common form of cancer for adolescents and young adults years old. Melanoma is now increasing faster in females years old than males in the same age group. In females years old, the torso is the most common location for developing melanoma which may be due to high-risk tanning behaviors.
Melanoma in the average person can occur anywhere, but is more likely to start in certain locations. The trunk is the most common site in men. The legs are the most commonly affected site in women. The neck and face are other common sites.
Having darkly pigmented skin lowers your risk, but it is not a guarantee that you will not get melanoma. Anyone can develop this cancer on the palms of the hands, soles of the feet, and under the nails. Melanomas in these areas represent about half of all melanomas in African Americans but fewer than 10% of melanomas in whites.
1 in 58 men and women will be diagnosed with melanoma during their lifetime. Caucasians and men over 50 years of age are at higher risk of developing melanoma than the general population.
In 2008, it is estimated that there will be about 116,500 new cases. One American dies of melanoma almost every hour (62 min). (

16. Benign Mole or Melenoma
How Do I Tell The Difference?
ABNORMAL
NORMAL
NORMAL: Here is the a picture of a mole (Nevus). This is a benign growth on the skin. While very few moles become cancer, abnormal or atypical moles can develop into melanoma over time. "Normal" moles can appear flat or raised or may begin flat and become raised over time. The surface is typically smooth. Normal moles are round or oval and no larger than a pencil eraser. Most moles develop in youth or young adulthood. It's unusual to acquire a mole in the adult years.
ABNORMAL: Here is picture of an abnormal skin growth. This is an early type of squamous cell carcinoma "in situ “(Boman’s disease). This type of skin cancer spreads outward on the surface of the skin. By contrast, "invasive" squamous cell carcinomas can grow inward and spread to the interior of the body. Bowen disease looks like scaly, reddish patches that may be crusted; it may be mistaken for rashes, eczema, fungus, or psoriasis. So for most of us it may not always be easy to tell the difference between a normal or abnormal skin lesion. In the next few slides I want to give you some general rules to help you determine when a “funny looking” skin lesion should be evaluated by a professional.

17. ABCDEs of Melanoma Screening
“A” = ASYMMETRY
NORMAL
ABNORMAL
ABCDE’s of Skin Cancer.
“A” stands for asymmetry. Asymmetry means one half of a mole does not match the other half. Normal moles are symmetrical. When checking your moles or freckles, draw an imaginary line through the middle and compare the two halves. If they do not look the same on both sides, have it checked by a dermatologist.
In this example, you can easily see that one half of the NORMAL lesion, on the left, is almost a duplicate of the other half. In the ABNORMAL example, you can see that one side of the lesion is raised and round and the other side is flat and irregular.
If you have a lesion like this --- it does not mean you have cancer -- but does suggest the lesion is growing more asymmetrical or haphazard. Lesions that grow fast or appear non-uniform (out of control) are suspicious and should be watched more careful. Let’s finish your ABCDE screening criteria using these examples.

18. ABCDEs of Melanoma Screening
“B” = BORDERS
NORMAL
ABNORMAL
ABCDE’s of Skin Cancer.
“B” stands for Borders. If the border or edges of the mole are ragged, blurred, or irregular, have it checked by a dermatologist. Melanoma lesions often have uneven borders.

19. ABCDEs of Melanoma Screening
“C” = COLORS
NORMAL
ABNORMAL
Multiple Colors
Uniform Color
ABCDE’s of Skin Cancer.
“C” stands for Color. A mole that does not have the same color throughout or that has shades of tan, brown, black, blue, white, or red is suspicious. Normal moles are usually a single shade of color. A mole of many shades or that has lightened or darkened should be checked by a doctor.
Variation of color (e.g., more than one color or shade) within a mole is a suspicious finding. Different shades of browns, blues, reds, whites, and blacks are all concerning.

20. ABCDEs of Melanoma Screening
“D” = DIAMETER
NORMAL
ABNORMAL
<6mm
>6mm
ABCDE’s of Skin Cancer.
“D” stands for Diameter A mole is suspicious if the diameter is larger than the eraser of a pencil. Benign moles are usually less than 6 millimeters in diameter. This is the size of a pencil eraser. Small lesions on the left that are smaller then a pencil eraser are usually not something to be concerned about. Larger lesion on the right that are larger then a pencil eraser can be something you should be more concerned about.
If a portion of the mole appears elevated, or raised from the skin, have it looked at by a doctor. Melanoma lesions often grow in size or change in height rapidly. A mole that is evolving – shrinking, growing larger, changing color, begins to itch or bleed – should also be checked.
Examine your skin after a shower while skin is wet. A common location for melanoma in men is on the back, and in women, the lower leg. But check your entire body for moles or suspicious spots once a month. Start at your head and work your way down. Check the "hidden" areas: between fingers and toes, the groin, soles of the feet, the backs of the knees. Check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you look at these areas. Be especially suspicious of a new mole. Take a photo of moles and date it to help you monitor them for change. Pay special attention to moles if you're a teen, pregnant, or going through menopause, times when your hormones may be surging.
If you find a mole or spot that has any ABCDE's of melanoma -- or one that's tender, itching, oozing, scaly, doesn't heal or has redness or swelling beyond the mole -- see a doctor. Your doctor may want to remove a tissue sample from the mole and biopsy it. If found to be cancerous, the entire mole and a rim of normal skin around it will be removed and the wound stitched closed. Additional treatment may be needed.
Malignant melanoma, especially in the later stages, is serious and treatment is difficult. Early diagnosis and treatment can increase the survival rate. Nonmelanoma skin cancers include basal cell carcinoma and squamous cell carcinoma. Both are common and are almost always cured when found early and treated. People who've had skin cancer once are at risk for getting it again; they should get a checkup at least once a year.
Melanoma is not as common as other types of skin cancer, but it's the most serious and potentially deadly. Possible signs of melanoma include a change in the appearance of a mole or pigmented area. Consult a doctor if a mole changes in size, shape, or color, has irregular edges, is more than one color, is asymmetrical, or itches, oozes, or bleeds.
This nonmelanoma skin cancer may appear as a firm red nodule, a scaly growth that bleeds or develops a crust, or a sore that doesn't heal. It most often occurs on the nose, forehead, ears, lower lip, hands, and other sun-exposed areas of the body. Squamous cell carcinoma is curable if caught and treated early. If the skin cancer becomes more advanced, treatment will depend on the stage of cancer.
Bowen disease is also called squamous cell carcinoma "in situ." It is a type of skin cancer that spreads outward on the surface of the skin. By contrast, "invasive" squamous cell carcinomas can grow inward and spread to the interior of the body. Bowen disease looks like scaly, reddish patches that may be crusted; it may be mistaken for rashes, eczema, fungus, or psoriasis.
Basal cell carcinoma is the most common and easiest-to-treat skin cancer. Because basal cell carcinoma spreads slowly, it occurs mostly in adults. Basal cell tumors can take on many forms, including a pearly white or waxy bump, often with visible blood vessels, on the ears, neck, or face. Tumors can also appear as a flat, scaly, flesh-colored or brown patch on the back or chest, or more rarely, a white, waxy scar.
Uncommon types of skin cancer include Kaposi's sarcoma, mainly seen in people with weakened immune systems; Merkel cell carcinoma, which is usually found on sun-exposed areas on the head, neck, arms and legs but often spreads to other parts of the body; and sebaceous gland carcinoma, an aggressive cancer originating in the oil glands in the skin.
Sun exposure is the biggest cause of skin cancer. But it doesn't explain skin cancers that develop on skin not ordinarily exposed to sunlight. Exposure to environmental hazards, radiation treatment, and even heredity may play a role. Although anyone can get skin cancer, the risk is greatest for people who have:
Fair skin or light-colored eyes
An abundance of large and irregularly-shaped moles
A family history of skin cancer
A history of excessive sun exposure or blistering sunburns
Lived at high altitudes or with year-round sunshine
Received radiation treatments
 Limit your exposure to the sun's ultraviolet rays, especially between 10 a.m. and 4 p.m., when the sun's rays are strongest. While outdoors, apply sunscreen liberally (don't forget the lips and ears!), wear a hat and sunglasses, and cover up with clothing. And remember, if you notice changes to your skin such as a new growth, a mole changing appearance, or a sore that won't heal, see a doctor right way.
Skin Cancer 101
What You Need to Know About Melanoma
Does Skin Cancer Lead to Other Cancers?
Treatment Options for Skin Cancer
Preventing Sun Exposure in Children
Treating Skin Cancer? Share Your Experience
Video: Surgery-Free Skin Cancer Treatment
Free Skin & Beauty Newsletter
Previous
13/23

21. ABCDEs of Melanoma Screening
“E” = Elevation
ABNORMAL
Raised
Area
Flat
ABCDE’s of Skin Cancer.
“E” stands for Elevation. If a portion of the mole appears elevated, or raised from the skin, have it looked at by a doctor.
When part of the lesion is elevated but other parts are not then that can be an important danger sign. Melanoma lesions often grow in size or change in height rapidly. A mole that is evolving – shrinking, growing larger, changing color, begins to itch or bleed – should also be checked.
Examine your skin after a shower while skin is wet . A common location for melanoma in men is on the back, and in women, the lower leg.
Check your entire body for moles or suspicious spots once a month. Start at your head and work your way down. Check the "hidden" areas: between fingers and toes, the groin, soles of the feet, the backs of the knees. Check your scalp and neck for moles. Use a handheld mirror or ask a family member to help you look at these areas. Be especially suspicious of a new mole. Take a photo of moles and date it to help you monitor them for change. Pay special attention to moles if you're a teen, pregnant, or going through menopause, times when your hormones may be surging.
If you find a mole or spot that has any ABCDE's of melanoma -- or one that's tender, itching, oozing, scaly, doesn't heal or has redness or swelling beyond the mole -- see a doctor. Your doctor may want to remove a tissue sample from the mole and biopsy it. If found to be cancerous, the entire mole and a rim of normal skin around it will be removed and the wound stitched closed. Additional treatment may be needed.
Although anyone can get skin cancer, the risk is greatest for people who have:
Fair skin or light-colored eyes
An abundance of large and irregularly-shaped moles
A family history of skin cancer
A history of excessive sun exposure or blistering sunburns
Lived at high altitudes or with year-round sunshine
Received radiation treatments
NORMAL

22. How is Skin Cancer Found?
Self-examination
Exams and Doctors visits
Early detection is KEY
The main point is that you need to check your skin regularly.
Then you will become familiar with what is normal for you. Also, DO NOT try to self-diagnose. Only a physician can diagnose a skin cancer. A skilled or knowledgeable eye is needed. Some skin cancers can look harmless.
There are a variety of doctors that can detect skin cancers, especially melanoma: family, OB-Gyn., opthamologist; ENT, GI, and even your dentist)
If you have any personal history of precancerous or cancerous lesion, you should have a yearly skin exam by a dermatologist or knowledgeable physician.

23. Treatment The Physician will:
Review medical history and perform a physical
Determine what type of cancer
Then treat the cancer with:
topical medication
laser, freezing, and various surgeries
radiation and/or chemotherapy
Your physician will examine the questionable lesion and in most cases BIOPSY it. This is the only definitive way of knowing if it is benign or cancerous.
He or she will also take a history and physical. Ask questions about how long you have noticed the skin growth and any changes lately; if you work or play a lot outside; chemical exposure; and of course family history. Melanomas sometimes run in families. Having 2 or more close relatives who have had this disease is a risk factor. About 10 percent of all patients with melanoma have a family member with this disease. When melanoma runs in a family, all family members should be checked regularly by a doctor.
People who have been treated for melanoma have a high risk of a second melanoma. Some people develop more than two melanoma. People who had one or more of the common skin cancers (basal or squamous cell) are at increased risk for melanoma.
As to treatment, doctors generally divide skin cancer into 2 stages: local (affecting only the skin) or metastatic (spreading beyond the skin, sometimes through the blood and lymph to other organs). Skin cancer usually involves some type of surgery and pathology testing. Sometimes the cancer is completely removed at the time of the biopsy and no further treatment is needed. Other times, a wider margin of skin and tissue is needed to remove all the cancer cells. In cases where the growth is large or has been present for a long time, the doctor will check local lymph nodes. In addition, patients may need further x-rays or tests to find out whether the cancer has spread to other parts of the body.
Cryosurgery is where extreme cold is used to treat precancerous skin conditions, such as actinic keratosis, as well as certain small skin cancers. Here liquid nitrogen is applied to the growth to freeze and kill the abnormal cells. Sometimes more than one freezing application is needed.
Laser therapy uses a narrow beam of light to remove and destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin.
Topical chemotherapy is the use of anticancer drugs in a cream or lotion applied to the skin. This is used in some cases of actinic keratosis and other skin cancers limited to the top layers of the skin. The medication is applied daily for up to several weeks. Intense inflammation is common during treatment, but scars usually do not occur.
Radiation therapy uses high-energy rays to damage cancer cells and stop them from growing. Doctors use this often with places that are hard to do surgery on such as cancers on the eyelids, tip of the nose, or the ear. Again, several treatments may be required. Previous CHPS Skin Cancer Briefing). Internal radiation therapy uses a radioactive substances sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer to destroy it.
Chemotherapy is used to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When taken by mouth or injected in a vein or muscle, the drugs enter the bloodstream and can reach the cancer cells throughout the body. When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, the drugs mainly affect cancer cells in those areas. The way chemotherapy is given depends on the type of skin cancer and on the location. (

24. Prevention Avoid Artificial Sun Limit Sun Exposure Tanning/sun lamps
Avoid midday sun
Apply sunscreens often (at least 30 SPF)
Use UVA/UVB blocking SUNGLASSES
We all know that we need to avoid the direct sunlight , but we need to know about avoiding the “artificial sun”
Did you know that Ultraviolet Radiation is a proven human carcinogen, and is now listed as one according to the U.S. Dept. of Health and Human Services. Nearly 30 million people tan indoors in the US annually. 2.3 million of them are teens.
On an average day in the US, more than 1 million people tan in tanning salons; 70% are caucasian women aged years. Exposure to tanning beds before the age of 35 increases melanoma risk by 75%. People who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times likely to develop basal cell. Even occasional use of tanning beds almost triples the chances of developing melanoma.
(2007 Skin Cancer Facts / Skin Cancer Foundation / Internet article viewed 6/12/07)
The sun’s UV rays are strongest and do the most damage during midday, so it’s best to avoid direct exposure between 10:00am and 4:00pm.
They are also more intense in summer months, at higher altitudes, and in areas closer to the equator. UVA rays are more constant year-round, and penetrate deeper into the skin’s layers. We need year round protection which we will discuss later.
Make sure Sunscreen is at least SPF 30.
Also remember to protect one’s eyes with UV-blocking sunglasses (99-100% UVA and UVB protection). This is important since ultraviolet light may damage the eyes, leading to cancer of the eyelids and conjunctiva (the membrane covering the eyeball and the lining of the lids), as well as to the development of cataracts. (Sun Safety Alliance /Internet article/ Glossary page/posted 05/02/2006) (

25. Remember Clouds DON’T protect you!
Sand, water, snow, and ice magnify exposure
Increased altitude = increased exposure
Since about 80% of harmful UV rays can penetrate clouds, you can get a nasty dose of UV radiation on a hazy or cloudy day, the kind of day that can lead you to think the sun is not intense. Remember sunburn is caused by UV rays that cannot be felt. The heating effect is caused by the sun’s infrared radiation and not by UV. They are also more intense in summer months, at higher altitudes, and in areas closer to the equator. UVA rays are more constant year-round, and penetrate deeper into the skin’s layers. We need year round protection. (

26. What else can you do? Ask for complete skin exam with physical
Do not self-diagnose, see your doctor right away if you find:
A new mole in an adult
A sore that doesn’t heal
A suspicious change in the appearance of any skin feature
A mole fails the ABCDE screening

27. ABCDEs of Melanoma Screening?
Final Quiz
Do You Remember Your
ABCDEs of Melanoma Screening?
Let’s do a quick review..
#1 This is a thick, scaly patches of sun-damaged skin. Any guesses? Actinic Keratosis. Precancerous or Cancer?
#2. A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds. Squamous cell Cancer
#3. Red or pink growth with sometimes an indentation in the center. Basal cancer but could also squamous cell.
So we have talked about precancerous lesions like actinic keratosis and two types of cancers (squamous cell and basal cell cancers). Now I would like to talk with your about the deadliest form of skin cancer – Melanoma. This cancer accounts for
more than 75% of the deaths from skin cancer
melanoma is the most common form of cancer for young adults years old
It is the second most common form of cancer for adolescents and young adults years old.
It is increasing faster in females years old than males in the same age group. In young females years old, the torso is the most common location for developing melanoma which may be due to high-risk tanning behaviors. Melanoma in the average person can occur anywhere, but is more likely to start in certain locations. The trunk is the most common site in men. The legs are the most commonly affected site in women. The neck and face are other common sites.
Having darkly pigmented skin lowers your risk, but it is not a guarantee that you will not get melanoma. Anyone can develop this cancer on the palms of the hands, soles of the feet, and under the nails. Melanomas in these areas represent about half of all melanomas in African Americans but fewer than 10% of melanomas in whites.
1 in 58 men and women will be diagnosed with melanoma during their lifetime. Caucasians and men over 50 years of age are at higher risk of developing melanoma than the general population.
In 2008, it is estimated that there will be about 116,500 new cases. One American dies of melanoma almost every hour (62 min). (

28. Thanks for Attending
For further information please contact: