This lecture provides an overview of skin cancer including risks, early detection, and treatment. Learn to identify the early signs of skin cancer. Melanoma and non-melanoma skin tumors will be discussed and prevention of skin cancer will be emphasized.

1. An Overview of Skin Cancer:
Diagnosis, Treatment &
Prevention
Naheed R. Abbasi, MD, MPH
Summit Medical Group
July 11, 2012

2. Skin Cancer: An Epidemic
 2012 SEER data reveal that the most prevalent type of cancer
in men are prostate (43%), colorectal (9%) and melanoma
(7%) ; in women the top three are breast (41%), uterine (8%)
and colorectal (8%.) (Siegel R, Desantis C, Virgo K et al. CA Cancer J Clin 2012 June 14)
 Incidence of skin cancer is rising in both women and men and
lifetime risk of invasive melanoma has increased from 1/100
in 1993 to 1/52 in 2012. (Rigel et al., NYU Melanoma Cooperative Group, 2012.)
 Among Caucasians in 2012, lifetime risk of melanoma is 1/55
in women and 1/36 in men.

3. Why Such An Epidemic?
 Ultraviolet light is still the greatest risk factor
 Tanning beds are a major culprit
 Baby boomers are living longer
 Sun protection has not always been practiced
widely by Americans, and childhood sun
exposures play a major role in skin cancer risk.

4. Key Skin Cancer Risk Factors
 Ultraviolet light, natural and artificial, cummulative
 Radiation
 Multiple nevi, especially dysplastic
 Family history
 Light skin, light eyes
 Skin that burns easily
 History of blistering sunburns, including childhood
 Chronic sores or inflammation

5. The Skin
webmd.com

6. Basal Cell Carcinoma
 Most common type of skin cancer with 80% of lesions
presenting on the head and neck
 Three main types: superficial, nodular and infiltrative
 Local invasion is the key risk in untreated cases or delayed
diagnoses
 Presents with waxy, pearly, skin-colored, pink or red patches
or plaques.
 Look out for red or scaly patches; red, flesh-colored or pink
bumps or growths

7. Basal Cell Carcinoma: Images
webmd.com

8. Squamous Cell Carcinoma
 Presents most commonly in heavily sun-exposed
areas
 Associated with chronic inflammation or ulceration
 Can present in a precancerous stage (actinic
keratosis); a non-invasive stage (in-situ or Bowen’s
disease) or invasive SCC.
 Main symptom is a red, dry scaly patch or a growing
bump that is red, pink or flesh-colored.

9. Squamous Cell Carcinoma: Images
medicinenet.com ; dermatology.ucsf.edu; dermis.net

10. Melanoma
 Melanoma is the leading cause of death from skin
disease
 A disorder of melanocytes, melanoma can begin in
normal skin, within a mole, or within a freckle
 Four commonly defined subtypes are superficial
spreading, nodular, lentigo maligna, and acral
lentiginous
 Rarely can occur in the eye (iris or retina)

11. Melanoma: Clinical Images
wikipedia.org ;webmd.org; dermnetnz.org

12. ABCDE’s of Melanoma
 ABCDE’s of melanoma
 -Asymmetry
 -Border irregularity
 -Color Variegation
 -Diameter >6mm
 -Evolution
Abbasi, NR et al. JAMA 2004 Dec 8 ;292
(22):2771-6.

13. Some Benign Skin Lesions
webmd.com; mayoclinic.com; medicinenet.com; dermatlas.med.jhmi.edu

14. Treatment of Skin Cancer
 Prevention and early detection are key factors in patient
success
 Topical creams/chemotherapeutic agents (5-fluorouracil,
imiquimod, etc.)
 Radiation in rare instances
 Surgery is the mainstay
 Electrodessication and curettage
 Traditional excision
 Mohs micrographic surgery
 Advanced melanoma treatments (interferon,
chemotherapy)

15. Prevention of Skin Cancer
 Sun avoidance
 Sunscreens
 SPF = sun protection factor, a measure of UVB protection
 UVA blockers of significance are avobenzone, titanium dioxide,
zinc oxide
 Sunscreens should be applied liberally and reapplied every 2-3
hours if skin is getting wet
 Protective clothing

16. Conclusions
 Skin cancer is a common problem whose incidence is
increasing in the US
 Understanding the appearance of skin cancer aids the
public in early detection
 While most forms of skin cancer are treatable,
disease can and does present in advanced states
 Since skin cancer is largely preventable, physicians
and the lay public must strive to increase awareness
and modify destructive behaviors

17. For more information
Call (908) 273.4300
Visit: summitmedicalgroup.com
Connect with us on
Facebook/SummitMedicalNJ
Twitter: @SummitMedicalNJ