Just because you make a point of staying out of the sun or have minimal moles doesn’t mean you can’t get skin cancer. Knowing the real facts about the causes, who gets it, the signs and symptoms to look for, and when to see a doctor is key to reducing your risk of developing melanoma and other types of skin cancer. Here, we set the record straight on common skin cancer misconceptions so you can better protect yourself.
Skin cancer: Fact vs fiction
Skin cancer is a problem that many of its sufferers do not expect themselves to get, says Dr Angeline Yong, an experienced dermatologist with over 15 years of medical practice. Understanding what’s fact versus fiction, she says, can make all the difference.
Myth #1: “Only fair-skinned people get skin cancer”
Fact: Skin cancer can happen to anyone. While it is true that people with darker skin tones are less likely to get it – due to the fact that they produce more melanin that helps to protect the skin – there is still always a possibility. In fact, it has been shown that melanoma tends to be more deadly in people of colour – with multiple studies showing that as compared to fair-skinned people, dark-skinned people are more likely to die from skin cancer. This may be because skin cancer can be harder to detect in people with dark skin, and because they tend to not get checked as often, says Dr Yong. People with darker skin also tend to get skin cancer in different locations than people with fair skin – on their hands and feet, for example.
In general, there are certain people who are at higher risk of developing skin cancer. They include:
- People who are fair skinned
- Those who have a history of extensive sun exposure
- People who have a tendency to freckle or sunburn easily
- Those who have numerous moles on their face and body (typically more than 50)
- People who have a family medical history of skin cancer (this doubles your risk)
- Those who have had skin cancer before
- People with a weakened immune system
It’s safe to say, therefore, that skin cancer is caused by a combination of genetic, external and environmental factors.
Myth #2: “Skin cancer is not a deadly disease”
Fact: There are varying types of skin cancer that differ in their potency, and in their potential to spread and worsen, explains Dr Yong. Basal Cell Carcinoma (BCC) is the most common type, followed by Squamous Cell Carcinoma (SCC).
“Thankfully, with early detection, the five-year survival rate of even the most aggressive form of cancer, melanoma, is roughly 99 percent,” she says.
Generally, the majority of skin cancers are treated by surgical removal in order to completely remove the growth and prevent recurrence. Once the growth is completely removed – as in the case of BCC – the cancer is considered to be “cured”, explains Dr Yong.
Those skin cancers that develop on sensitive areas such as the eyelids and face, lesions that have clinically less well-defined margins and are more aggressive sub-types, are best treated using MOHS micrographic surgery – a very precise surgical technique in which Dr Yong specialises.
“This surgical method achieves the highest cure rate of skin cancer (up to 99 percent) to date, and a 95 percent cure rate for recurrent skin cancers where other treatments have failed,” she says. “This type of surgery also offers optimal skin tissue preservation, which typically results in smaller scars – and is often performed as a single-day outpatient procedure.”
Myth #3: “Skin cancer always presents as a mole”
Fact: While melanoma often appears as a mole or pigmentation that spreads beyond the borders of a typical mole, other types of skin cancer have different characteristics and effects on the skin.
For example, BCC often shows up as a raised, smooth and shiny bump on the skin that can crust or bleed. It’s often mistaken for a sore that doesn’t heal. SCC appears as a red, scaly and thickened patch or raised nodule on the skin that is often ulcerated. It can develop into a large mass that has the potential of spreading into the lymph nodes and other organs.
Myth #4: “Skin cancer only develops on body parts exposed to the sun”
Fact: It can appear anywhere on the skin – even in areas that don’t see regular sun exposure. That’s why it’s vital to get diagnosed by a doctor as soon as you notice any suspicious lesions.
“Even if you don’t spend much time in the sun, you still need to be aware about skin cancer. Anyone who leaves their home and wants to protect their skin in the long term needs to be aware,” says Dr Yong.
Myth #5: “I don’t see any new moles or suspicious lesions, so I don’t need to get checked by a doctor”
Fact: While skin cancers most commonly appear as malignant growths on the outermost layer of the skin, which can be noticed and quickly diagnosed, this may not always be the case. Skin cancer can also present itself in a pre-existing mole, or as a new mole that has appeared out of the blue. That’s why scheduling regular visits to the doctor is key. Depending on your personal risk for skin cancer – a yearly screening is sufficient for majority of people. Otherwise, a visit to the doctor for a skin check every six to 12 months is ideal.
Your doctor can assess your skin during a thorough physical examination using a dermatoscope. However, a visual inspection is simply not enough to ensure an accurate diagnosis. The most precise way of detecting skin cancer is via an incisional or excisional biopsy – whereby a doctor removes either part or all of an abnormal growth. The removed skin is then examined under a microscope and tested to rule out any skin cancer. If the lesion is confirmed to be malignant – your doctor will then discuss with you the next best steps to take in terms of treatment.
Myth #6: “Wearing sunscreen and regular visits to the doctor are the only preventative measures I can take to avoid skin cancer”
Fact: Self-checks are just as important. About half of all melanoma cases are self-detected. So, the best way you can protect yourself is to regularly check your body for moles utilising the ABCDE method:
A: Asymmetrical – does your mole have an irregular shape?
B: Border – does your mole have undefined or jagged borders?
C: Colors – does your mole have a mix of two or more colors?
D: Diameter – is your mole larger than 6mm in diameter?
E: Evolution – does your mole change in appearance or size over time?
“Ideally, you should be conducting frequent self-examinations to catch any changes and abnormalities in your skin – especially if you are a highly active person who enjoys being outdoors. Doing so increases the chances of early detection, which subsequently increases your chances of overcoming the disease,” explains Dr Yong.
“At the end of the day, prevention is key – every individual holds the responsibility to protect themselves on a daily basis. Your skin is your biggest defence against not just dangerous UV radiation, but harmful bacteria as well – so never take it for granted!”
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