Skin Cancer Basics


Skin cancer is a disease that involves the abnormal growth of skin cells, sometimes on skin commonly exposed to the sun. Unrepaired skin that is damaged by the sun can grow out-of-control and could trigger mutations. These mutations lead the skin cells to multiply and grow more quickly and form tumors. These tumors may be malignant (grows uncontrollably) or noncancerous (benign), which do not spread or cause harm. Basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma are the 3 most common types of skin cancers. It is important to remember however, that the vast majority of these “skin cancers” are not aggressive or malignant. That being said, sun exposure should not be treated like the plague as sunlight is important for so many body functions.

What are Some Common Causes of Skin Cancer?

The most common causes and risk factors for skin cancer include:
➢ UV Radiation Exposure: TProlonged or excessive exposure to UV radiation from the sun is said to be the leading cause of skin cancer. Intense and intermittent sun exposure, sunburns, and tanning can increase the risk.

➢ Tanning Beds: The use of tanning beds and sunlamps, which emit artificial UV radiation.

➢ Fair Skin: People with fair skin, light hair, and light-colored eyes are more susceptible to the damaging effects of UV radiation.

➢ Family History: A family history of other skin cancers can increase an individual's risk of developing the disease.

➢ Personal History of Skin Cancer: Individuals who have had a previous diagnosis of skin cancer are at higher risk.

➢ Weakened Immune System: Individuals with weakened immune systems, such as organ transplant recipients, HIV/AIDS patients, or those undergoing immunosuppressive therapy, are at higher risk of developing skin cancer.

➢ Exposure to Certain Chemicals: Occupational exposure to certain chemicals, such as arsenic, coal tar, and some pesticides, increases risk.

➢ Age: The risk of skin cancer increases with age, with the highest incidence rates in individuals over 50 years old.

How Is Skin Cancer Diagnosed?

Identifying skin cancer involves recognizing changes in the skin, moles, or lesions that may indicate the presence of abnormal or cancerous cells. Here are some key signs and characteristics to look for when identifying potential skin cancer:
➢ Asymmetry: One half of a mole or lesion does not match the other half in size, shape, or color.

➢ Border: The borders of a mole or lesion are irregular, scalloped, or poorly defined, rather than smooth and even.

➢ Color: The color of a mole or lesion is not uniform and may include shades of brown, black, red, white, or blue.

➢ Diameter: The diameter of a mole or lesion is larger than the size of a pencil eraser (6mm) or is growing in size.

➢ Evolution: Any changes in size, shape, color, texture, or elevation of a mole or lesion over time.

➢ Itchiness or Pain: Moles or lesions that become itchy, painful, tender, or bleed without apparent cause.

➢ Scaling or Crusting: Moles or lesions that develop scaling, crusting, oozing, or bleeding on the surface.

➢ New Growth: The appearance of a new mole, bump, sore, or spot on the skin that does not heal or resolve.

➢ Changes in Existing Moles: Any changes in existing moles, such as sudden enlargement, darkening, or irregularity in shape or border.

➢ Location: Skin cancer can develop on any part of the body, including areas not typically exposed to the sun, so it is essential to check all areas, including the palms, soles, scalp, nails, and genital region.

The TOP-3 Most Common Skin Cancers:

1. Basal Cell Carcinoma (BCC): Basal cell carcinoma is the most common type of skin cancer, accounting for approximately 80% of all skin cancer cases. It typically develops on sun-exposed areas of the skin, such as the face, neck, and hands. Basal cell carcinoma usually grows slowly and is uncommon to spread to other parts of the body, but early detection and treatment are important to prevent complications.

2. Squamous Cell Carcinoma (SCC): Squamous cell carcinoma is the second most common type of skin cancer, representing about 18% of all skin cancer cases. It often appears as a red, scaly bump or patch on the skin, commonly on areas exposed to the sun. Squamous cell carcinoma has a higher risk of spreading to other parts of the body compared to basal cell carcinoma.

3. Melanoma: Melanoma is less common than basal cell and squamous cell carcinomas and accounts for about 1 to 2% of all skin cancer cases. Melanoma usually appears as an abnormal mole or dark spot on the skin that may have irregular borders, asymmetry, uneven coloration, or changes in size.

Most Common Sites for Skin Cancer?

▪ Basal cell carcinoma: Basal cell carcinoma is the most common type of skin cancer, and it is strongly associated with chronic sun exposure. Basal cell carcinoma typically develops on areas of the skin that are frequently exposed to the sun, such as the face, neck, and hands. Prolonged exposure to UV radiation can lead to DNA damage in the basal cells of the skin, which can trigger the development of basal cell carcinoma.

▪ Squamous cell carcinoma: Squamous cell carcinoma is the second most common type of skin cancer and is also closely linked to sun exposure. Like basal cell carcinoma, squamous cell carcinoma often develops on sun-exposed areas of the skin, such as the face, ears, neck, and hands.

▪ Melanoma: Melanoma can occur on any part of the body, including areas that are not typically exposed to the sun. However, certain areas of the body are more commonly affected by melanoma due to sun exposure and other factors. The most common parts of the body for melanoma to develop include:
1. Back in Men and Legs in Women: The back is one of the most common sites for melanoma in men, while the legs are a common location for melanoma in women.
2. Legs and Feet: Melanoma can occur on the lower legs and feet, to include the soles of the feet, toenails, and tops of the feet are potential sites for melanoma. Melanoma can also develop on less common sites of the body, such as the palms of the hands, soles of the feet, under the nails, and in mucous membranes.
3. Torso: Melanoma can develop on the chest, abdomen, and back. The trunk is a common location for melanoma in both men and women.

Approximately 87% of all SCC cases occur in regions of the body that have significant sunlight exposure, such as the head and neck, while 82.5% of BCC occur in those similar regions. But only about 10 to 25% of melanomas are found in the head and neck regions. This indicates that SCC and BCC are linked to sun exposure, but melanoma is much less so.

Health Benefits of Sun Exposure and Vitamin D:

Vitamin D and sun exposure play a vital role in various bodily functions and overall health. Despite the below listed benefits, vitamin D deficiency is one of the most common nutritional deficiencies worldwide. For example, nearly 42% of adults in the United States have vitamin D deficiency and nearly 1 billion people worldwide have vitamin D deficiency. Even worse are the vitamin D deficiency rates in Hispanic adults and African American adults, with 63% and 82% respectively.
❖ Bone Health: Vitamin D is essential for calcium absorption and bone mineralization. It helps maintain strong and healthy bones, reducing the risk of osteoporosis and fractures.

❖ Immune System Support: Vitamin D plays a role in immune function, helping the body fight off infections and diseases. Adequate levels of vitamin D may help reduce the risk of respiratory infections, colds, and flu.

❖ Mood Regulation: Vitamin D is believed to play a role in mood regulation and may help reduce the risk of depression, anxiety, and seasonal affective disorder (SAD).

❖ Cardiovascular Health: Adequate vitamin D levels may help lower the risk of cardiovascular diseases, such as heart attack, stroke, and high blood pressure.

❖ Cancer Prevention: Some studies suggest that maintaining optimal vitamin D levels may reduce the risk of certain types of cancer, such as colorectal, breast, prostate, and pancreatic cancer.

❖ Muscle Strength: Vitamin D is important for muscle function and strength. Adequate levels of vitamin D may help improve muscle performance and reduce the risk of falls and fractures.

❖ Weight Management: Some research suggests that vitamin D may play a role in weight management and metabolism. Adequate vitamin D levels may help support healthy weight maintenance.

❖ Skin Health: Vitamin D is important for skin health and may help reduce the risk of certain skin conditions, such as eczema, psoriasis, and acne.

❖ Brain Health: Vitamin D may have neuroprotective effects and is believed to play a role in cognitive function and brain health. Adequate vitamin D levels may help reduce the risk of neurodegenerative diseases.

❖ Diabetes Prevention: Some studies suggest that maintaining optimal vitamin D levels may reduce the risk of developing type 2 diabetes and help improve insulin sensitivity.

❖ Pregnancy Health: Adequate vitamin D levels are important during pregnancy for fetal development, bone health, and overall maternal health. Vitamin D supplementation may be recommended for pregnant women with low levels.

❖ Autoimmune Disease Prevention: Some research suggests that vitamin D may play a role in autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease. Adequate vitamin D levels may help reduce the risk of autoimmune conditions.

Is Sunlight/Vitamin D protective Against Cancers?

Vitamin D has been the subject of numerous studies investigating its potential role in cancer prevention and progression. Some studies suggest that adequate levels of vitamin D may have a protective effect against certain types of cancer. Here are some key points to consider regarding the protective effects of vitamin D against cancer:
· Mechanisms of action: Vitamin D is known to play a role in numerous physiological processes, including cell growth, immune function, inflammation, and apoptosis (programmed cell death). These mechanisms are important in regulating cell proliferation and differentiation, which are key factors in cancer development.

· Cancer risk reduction: Some studies have suggested that maintaining adequate levels of vitamin D may be associated with a reduced risk of developing certain types of cancer, such as colorectal, breast, prostate, and pancreatic cancer. One study showed that blood levels of 25(OH)D that were above 60 ng/ml had one-fifth the risk of breast cancer compared to those with less than 20 ng/ml; generally, require dietary supplements of 4,000 to 6,000 international units (IU) per day, less with the addition of moderate daily sun exposure wearing very minimal clothing. One should be under the supervision of a medical professional for intake of vitamin D3 that exceeds 10,000 IU per day and/or serum levels exceeding 125 ng/ml. These could be linked to adverse side effects, such as nausea, constipation, weight loss, heart rhythm problems and possibly kidney damage.

· Cancer progression: In addition to potential cancer prevention benefits, vitamin D may also have an impact on cancer progression and prognosis. Some research has suggested that higher vitamin D levels may be associated with improved outcomes in certain cancer types, such as colorectal and breast cancer.

· Individual factors: The relationship between vitamin D and cancer risk may vary depending on individual factors such as genetics, lifestyle, sun exposure habits, geographic location, and overall health status. Factors such as age, gender, race, and underlying medical conditions can also influence the impact of vitamin D on cancer risk.

Final Thoughts:

Finding a balance between sunlight exposure for vitamin D synthesis and the risk of overexposure leading to skin damage, sunburn, and an increased risk of skin cancer is essential for maintaining overall health and well-being. Melanoma accounts for only about 1% of skin cancers but causes a large majority of skin cancer deaths. That being said, it should be remembered however that some skin lesions can be melanomas and as such, require immediate removal. Here are some guidelines to help strike a balance between sunlight exposure and protecting your skin:
❖ Optimal Sun Exposure: Sunlight is the primary source of vitamin D, which is essential for bone health, immune function, and overall well-being.

❖ Timing: Try to get sun exposure during the early morning or late afternoon when the sun's rays are less intense to reduce the risk of sunburn and skin damage.

❖ Sun Protection: When spending extended time outdoors, wear protective clothing (including hats and sunglasses), seek shade, and avoid excessive sun exposure.

❖ Skin Type: Individuals with fair skin, light hair, and a history of sunburns are more susceptible to skin damage and should take extra precautions when exposed to the sun.

❖ Avoid Tanning Beds: Artificial UV radiation from tanning beds can increase the risk of skin cancer and premature skin aging. It is best to avoid tanning beds altogether.

❖ Regular Skin Examinations: Perform regular self-examinations of your skin to monitor moles, spots, or changes that may indicate skin cancer. Seek medical attention if you notice any concerning changes.

❖ Supplementation: In cases where individuals have limited sun exposure or are at risk of vitamin D deficiency, supplementation may be recommended to ensure adequate vitamin D levels.


References:

Melanoma of the Head and Neck | Johns Hopkins Medicine
Melanoma of the Head and Neck - StatPearls - NCBI Bookshelf (nih.gov)
https://open.substack.com/pub/robertcameron/p/dermatology-updated-bad-medical-advice?utm_campaign=post&utm_medium=web
https://www.universityofcalifornia.edu/news/could-vitamin-d-lower-your-risk-breast-cancer



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Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The contents of this website are based upon the views of Dr. Walker and his experience. This product is not intended as medical advice nor to diagnose, treat, cure or prevent any disease. The information is likewise not to replace the advice of a qualified health care provider. The information provided herein is intended as a sharing of general knowledge only and is not intended to be, nor is it, medical advice or a substitute for medical advice. That being said, please consult your healthcare provider before using supplements or providing supplements to children under the age of 18. If you have or suspect you have, a specific medical condition or disease, please consult your healthcare provider.

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