Understanding the Risk of Skin Cancer

Ravneet Bajwa, M.D.
McLeod Oncology and Hematology Associates

Skin cancer is the most common cancer in the United States, according to the National Cancer Institute. It is also one of the easiest cancers to detect because it begins on the skin where you can see it.

You can develop skin cancer anywhere on the skin from the scalp to the bottom of the feet. It is also possible for skin cancer to develop in areas that get little sun such as under a fingernail or inside your mouth.

Skin, the body’s largest organ, helps control body temperature and stores water, fat and vitamin D. It also protects against heat, injury, infection and sunlight. While the skin has several layers, the two main layers involve the epidermis (upper or outer layer) and the dermis (lower or inner layer).

Three kinds of cells make up the epidermis:

  • Thin, flat cells called squamous cells comprise the majority of the epidermis
  • Basal cells – round cells under the squamous cells
  • Melanocytes make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment, causing the skin to darken or tan. Melanoma, which forms in the melanocytes, is a less common type of skin cancer that grows and spreads quickly.

The most common types of skin cancer are squamous cell carcinoma and basal cell carcinoma. These non-melanoma skin cancers can usually be cured.

Risk factors for squamous cell and basal cell carcinoma include:

  • Exposure to natural sunlight or artificial sunlight over extended periods of time
  • A fair complexion – fair skin that freckles and burns easily; blue or green or other light-colored eyes; red or blond hair
  • Previous treatment with radiation
  • A weakened immune system
  • Actinic Keratosis – rough, scaly patch of skin
  • Exposure to arsenic

In addition to the risks listed above, the risk factors for melanoma include:

  • A history of many blistering sunburns, most often as a child or teenager
  • Several large or many small moles
  • A family history of unusual moles
  • A family or personal history of melanoma
  • Being Caucasian

While protecting the skin from the sun has not been proven to lower the chance of developing skin cancer, experts suggest using sunscreen that protects against UV radiation; staying out of the sun for long periods of time, especially when the sun is at its strongest and wearing long sleeve shirts and pants, hats or sunglasses when outdoors.

The best way to find skin cancer is to examine yourself from your scalp to the spaces between your toes and the bottoms of your feet. If possible, have your partner examine hard to see areas like your back. If you get in the habit of checking your skin monthly it will help you notice any changes.

The most common sign of skin cancer is a change in your skin. Skin cancer can appear on the skin in a number of ways:

  • Changing mole or a mole that looks different from others
  • Scaly patch
  • Non-healing sore or sore that heals and returns
  • Dome-shaped growth
  • Brown or black streak under a nail

For melanoma specifically, a simple way to remember the warning signs is to learn the “ABCDE” rule:

  • Asymmetrical. Does the mole or spot have an irregular shape where one half does not match the other half?
  • Border. Is the border irregular or jagged?
  • Color. Is the color uneven?
  • Diameter. Is the mole or spot larger than the size of a pencil eraser – greater than six millimeters?
  • Evolving. Has the mole or spot changed over the past few weeks or months?

You can also have skin cancer and still feel well. Most people who find a suspicious area on their skin don’t have any pain or feel ill. The spot of concern may not itch, bleed or feel painful yet it could still be skin cancer.

Detected early, skin cancer is highly treatable. If you find a spot on your skin that could be skin cancer, see your primary care physician who can assess the area and determine if you need a skin biopsy.

Dr. Ravneet Bajwa cares for patients with Dr. Rajesh Bajaj, Dr. Michael Pavy, Dr. Sreenivas Rao, Dr. Jamie Smith, and Dr. Karim Tazi at McLeod Oncology and Hematology Associates, a division of McLeod Regional Medical Center. A board certified Oncologist, Dr. Bajwa joined McLeod in November 2017 following the completion of her Fellowship in Hematology and Oncology at the University of Florida Department of Medicine in Gainesville, Florida. She received her medical degree in 2010 from Kasturba Medical College, Mangalore of Manipal University in India, and completed her Internal Medicine Residency in 2014 at the University of Florida Department of Medicine.