Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
Skin cancer can be a real issue for folks who spend a lot of time in the sun.
Sommer said, “So the poll in the office, I asked the girls, I’m like, what should we talk about? And they just said, we’ve been getting a lot of phone calls for dermatology issues. So skin cancer, we’ve talked about it before. Both the surgeons are able to remove skin cancer on the body. A lot of times people go to dermatologists, they have a biopsy, and then they end up needing a bigger area removed, and they come to us. So I figured in Florida, you’re always in the sun. Right now the weather’s a little cooler. So have you got your skin checked? Now’s a good time to do it before we get into the summer months and spend a lot more time outside.”
What is skin cancer?
Sommer said, “It’s an abnormal growth of skin cells, and it usually occurs after recurring exposure to the sun. However, and I know I’ve talked about this before, it can be in areas that are not exposed to the sun. So that is why, a lot of times when you see dermatologists, they will ask you to get naked. There’s a reason because skin cancer can occur in areas that you can’t see.”
One type of skin cancer is basal cell.
Sommer explained, “It’s the type of cancer that begins in the basal cells of the skin. The cell produces new skin cells as the old one dies. Basal cell usually appears on the head and the neck and areas that are exposed to the sun the most. These lesions can be shiny. They even can look like the skin, like an extension of your skin, a raised area, and can almost look translucent. Sometimes they can bleed or scab, and then they can change, the lesion can get dark spots in it, like black, brown or like a bluish hue. Then they also can be flat and scaly and have like a little waxy texture to them. So chronic sun exposure, like tanning beds and frequent sunburns, this is who are most at risk for getting this type of skin cancer. It is probably a very common one, especially down here. We see it a lot. Fair skin, if you’re very light, if you have freckles, if you burn easily, you are more at risk for basal cell skin cancer.”
Exposure to arsenic and contaminated well water can actually increase your risk for skin cancer, as well as immune suppressing drugs and family history.
What is the treatment for basal cell skin cancer?
Sommer said, “Removal. So you need to have the lesion removed. This skin cancer, it is very rare that it will spread to the lymph node, where then it can spread to other parts of the body, like your bone, your lungs. So this is like the skin cancer you want to get if you have to, between the three. Now, if left untreated, it could cause a lot of damage to the skin. But we did have a patient that we really thought had a squamous cell carcinoma. I don’t know how long he let it go for, but he ended up needing a huge surgery to repair it, because he thought it was a wound that wasn’t healing. He thought he scratched himself, and it turned into this big, huge, non healing wound, and it happened to be a basal cell carcinoma, which in the long run was good because it didn’t spread anywhere else, but if you have a lesion that’s growing that doesn’t look good, no matter what, you need to get it removed.”
What is squamous cell cancer?
Sommer said, “This is a more aggressive skin cancer. It can spread to other parts of the body. Chronic sunlight, UV radiation exposure, those tanning beds that we thought were wonderful years ago, can lead to squamous cell skin cancer, and this can be found at any part of your body, including your private parts. So that is why, again, when somebody says, if you go to the dermatologist, they say, get naked, there’s a reason. So it can occur in those areas again that you can’t see and it doesn’t mean that you did anything bad. It’s just there.”
What is the treatment for squamous cell skin cancer?
Sommer said, “Again, removal of the lesion. Now, how deep will determine how much will need to be removed. So a lot of times, you can come to us, a lot of times patients, they are our patients, and they call and they’re like, I have this bump that’s changing. It’s growing. It’s bleeding. It’s this, it’s that. We have them come in and we take a biopsy, that’s how you start. We send it off to the pathologist, and he or she will let us know if the borders are clear, like the margins are clear, and sometimes they’re not, which means that the cancer is going deeper into the tissue where a bigger area needs to be excised.”
Melanoma is the third type of skin cancer.
Sommer said, “Melanoma and squamous cell both together can wreak havoc and cause a lot of problems. So those two, they’re both ugly. I can’t say one is better than the other. Neither one is better to have than the other. They’re both bad. Melanoma occurs within the cells that produce melanin that gives your skin the pigment, when you have people that have pigment in their skin, that’s melanin, and it’s abnormal growth of melanin that causes melanoma. Again, excessive exposure to the sunlight increases your risk for melanoma. The risk of melanoma among people who are under the age of 40 is increasing, especially in women. It can be found also in the soles of your feet, your palms, your hand, your fingernails, back, neck, arms and face and just so you know, Bob Marley died of a type of melanoma in his fingernail. I don’t know if anybody knows that. Yes, he had melanoma in his fingernail.”
Is there a difference between basal cell, squamous cell and melanoma?
Sommer said, “Melanoma and squamous cell, you will notice the changes will happen more rapidly than with basal cell. Basal cell’s kind of a slower growing change, like you’ll see it, and it’ll change over time, where a lot of times melanoma and squamous cell, they’re kind of a little bit more rapid in growth so and change, like you notice it frequently, so just something to be aware about. But we can look at normal moles versus unusual moles. So normal moles are uniform in color. They’re usually tan, brown or black, and they have a distinct border, meaning they’re round or like a square, as long as their border is even. Unusual moles, you think about A, B, C, D, E. A is for asymmetrical. The shape is irregular and it might look like two different halves and then within those halves are multiple different colors. So B is for border. Look for notched or scalloped borders. It’s not a round, smooth border. It kind of looks like a map. C is for change in color. When they start to when you start to have brown, black, just multiple different colors or shades within the mole, and especially if it wasn’t there before, like, if you’ve had a mole for a long time, and then you notice the color starts to change, that’s a concern.”
D is for diameter.
Sommer said, “A mole that is larger than a quarter inch. So if you have a mole and it starts to grow and it gets really large, that’s another reason that you need to go get that looked at. There’s something going on with that.”
E is for evolving.
Sommer said, “Which brings us to everything that we just talked about, change of the size over time, the size, the color, the change in the shape and itchy or bleeding. My dad is the perfect example. He said he bumped his arm and cut it. What I think he did, he had squamous cell, but I think he already had the squamous cell, and he injured that area so it wouldn’t heal. So he ended up going to the dermatologist and he had squamous cell on his arm.”
Sunscreen is really one way to help prevent skin cancer.
Sommer said, “Down here, you really should be putting it on every day. I know that sounds like it’s crazy, but it should just be part of we talked about skincare before, and everybody that walks out of our office, I’m like, you need to wear skin sunscreen every day. I know that’s crazy, but we’re in the sun every day, we can’t get away from the sun down here ever, except for maybe the month of January this year.”
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