Five Questions About Skin Cancer

March 08, 2011

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We get answers from two dermatologists about how to protect yourself

Can squamous cell carcinoma ever become malignant melanoma?

Dr. Michael Kaminer, a skin cancer surgeon and dermatologist at SkinCare Physicians who holds a 2 handicap: Squamous cell carcinoma does not ever become melanoma. They're two totally separate types of skin cancer and don't cross over. Their only similarities are that sun exposure and frequent sunburns can contribute to both.Dr. Jeffrey Benabio, a San Diego-based dermatologist and skin care expert at Livestrong.com who works with many golfers: Squamous cell carcinoma and melanoma arise from two different cells. They both arise in the skin and are caused by sun damage, but otherwise they're completely separate. Squamous cell carcinoma and melanoma cannot turn into one another. We often talk about skin cancer as not serious (basal cell carcinoma) sometimes serious (squamous cell carcinoma) and potentially deadly serious (melanoma), but in truth they can all be serious or all be easily cured depending on the stage and location.

What are the different types of skin cancer? Are they all malignant?

Benabio: The three main types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. They are all, by definition, malignant.Kaminer: Skin cancer is always malignant, and there are dozens of types. The three most common, and the ones most associated with sun exposure, are basal cell carcinoma, squamous cell carcinoma, and melanoma. Of the three, only basal cell carcinoma does not spread to other parts of the body. Both melanoma and squamous cell carcinoma can metastasize and kill people.

What are the most common causes of skin cancer?

Kaminer: Basal cell carcinoma only comes from sun exposure. And squamous cell carcinoma on the head, neck, arms and legs is almost always caused by excessive sun exposure. Melanoma has multiple causes, including genetics. But melanoma can also be caused by excess sun exposure, including multiple peeling sunburns as a child.Benabio: Excess sun is the most common cause of all skin cancers. But there are differences in types of exposure. Blistering sunburns seem to be the most common risk for basal cell carcinoma and melanoma. But chronic, long-term sun exposure (i.e., golfers and people who work outdoors) is a more common risk factor for squamous cell carcinoma.

Can people check themselves for skin cancer?

Kaminer: You should check yourself every three months, and have your spouse or significant other do it for you as well. Spouses are some of the best skin cancer detectors in the world. If you have a new lesion or growth, or a new spot on the face that bleeds, you should go to the dermatologist. And dermatologists preach about the ABCD's of melanoma as a way to determine if a mole might be cancerous: asymmetry, border, color and diameter. But bottom line: visit a dermatologist if you see something that looks new or funny.Benabio: All golfers should review the ABCD's of melanoma, which have been published extensively. And get examined by a physician if you detect any new or changing mole, any wound that does not heal over two weeks, or any growth that spontaneously bleeds, hurts, or grows rapidly.Note: If you're not squeamish, click here to view photosof various skin spots and skin cancers.

What's the best thing a golfer can do to minimize the risk of getting skin cancer?

Kaminer: Wear a hat (it could be wide-brimmed like Sabbatini's, or a conventional baseball cap), and as much sun-protective clothing as you're comfortable with. Pants and long sleeve shirts are great, but most golfers won't wear them during warm days. That's fine, as long as you apply sunscreen with an SPF of at least 30, 15 minutes before your tee time. And reapply at the turn. I find that spray sunscreens (again, with SPF 30 or higher) are the best way to protect the neck, arms and legs. And it's always good to wear sunglasses -- they not only protect your eyes, but also protect the skin around your eyes to reduce skin cancer risk there.

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