Today the public has more information than ever before about the dangers of ultraviolet radiation and, yet, the statistics surrounding skin cancer is staggering. It is alarming, in fact, because it is a type of cancer that is quite preventable – yet, the numbers climb.
As we just came out of Melanoma Awareness month (May), I am sure happy that a few more people have a better awareness as we head into warmer months. The question is, if we as the industry know what to look for in our clients, can we recognize warning signs and alert our clients so they can get a medical assessment for suspicious lesions?
TYPES OF SKIN CANCER
There are three major types of skin cancer, melanoma, basal cell carcinoma, and squamous cell carcinoma. Less common skin cancers include kaposi sarcoma, merkel cell carcinoma, and sebaceous gland carcinoma.
Melanoma is the most dangerous type of skin cancer, with Australia and New Zealand scoring the highest rates of melanoma in the world.
According to the Skin Cancer Foundation, “If melanoma is recognized and treated early, it is almost always curable, but if it is not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. While it is not the most common of skin cancers, it causes the most deaths. Melanoma kills an estimated 9,320 people in the United States annually. Of those, 5,990 will be men and 3,330 will be women.”
WARNING SIGNS OF MELANOMA
If there is a spot that just looks different compared to all the other spots on the skin (the ugly duckling), it is a sign that the spot might be worth getting checked. The ABCDE rules stand for:
When moles change – in particular: turn darker, start to bleed, or show other secretions or start to itch or develop a satellite lesion – a doctor should be consulted. Moles on palms of hands, soles of feet, and on genitalia show a higher incidence of malignancy.
Squamous cell carcinoma and basal cell carcinoma have the following warning signs over and above that of melanoma:
Squamous basal carcinoma and basal cell carcinoma are typically found on the face – commonly the ears, nose, or lips. One of my physician clients shares with me that he sees it most commonly in patients who are farmers and those who enjoy activities like fishing, hunting, and golfing.
Some people carry a higher risk of developing skin cancer in their lifetime and other risks are brought about by lifestyle choices. Factors that may increase the risk of skin cancer are:
Treatments include surgery, long-term medications, chemotherapy, immunotherapy, standard excision (with reoccurrence rate as high as 50%), and radiation. These treatments often leave the individual disfigured if the disease is not fatal.
Since skin cancer is so preventable, it is obvious to focus on prevention. As aestheticians, we can play a proactive role in making clients aware of what we see, especially in those areas they may not be able to see on their skin very well. While we are at it, don’t you think it makes sense to give them information about how they can protect themselves and their families from developing skin cancer – especially if they carry risk factors?
Here is a list of skin cancer prevention tips to share with clients, as recommended by the Skin Cancer Foundation:
Clients may also want to consider photosensitizing medications.
As you can see, there are more reasons than pigmentation and aging as our motivation to preach sun protection to clients. Like me, you too probably feel like a stuck record on this topic at times, but don’t give up. If you can help one person prevent skin cancer, collectively we can help many, and that is just one reason I love my work.
Cole, Gary W. “Skin Cancer (Nonmelanoma Skin Cancer or Keratinocyte Cancer).”
“Melanoma.” Skin Cancer Foundation. https://www.skincancer.org/skin-cancer-information/melanoma.
“Melanoma.” Wikipedia. https://en.wikipedia.org/wiki/Melanoma.
“Signs and Symptoms of Melanoma Skin Cancer.” Cancer.org. https://www.cancer.org/cancer/melanoma-skin-cancer/detection-diagnosis-staging/signs-and-symptoms.html.
“Skin Cancer.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605.
René Serbon, corneotherapy expert, industry educator, and speaker, gives skin care professionals a true point of difference in the industry. How? By handing them the ultimate drawing card: knowledge about the skin wrapped in savvy business strategy. Her keynotes and in-depth trainings educate on skin anatomy, physiology, and how to match cosmetic chemistry to specific skin conditions, as well as help clinic owners and solo aestheticians blow the roof off their in-clinic results and business growth by 30% a year or more. Serbon is CIDESCO and CIBTAC certified, one of the world’s few Pastiche educators, and proudly serves on the International Association of Applied Corneotherapy (IAC) educational board. She personally swapped grooming services for corrective skin care the day she opened her appointment book and saw 10 hours of back to back waxing, hence her motto: “There’s life after waxing.”
While it seems logical that people who live in sunny, warm states – like Florida, California, or Texas – would have the highest incidence of skin cancer, the facts prove otherwise. The Centers for Disease Control reports that those who live in Utah, Delaware, Vermont, Minnesota, and Idaho have some of the highest rates of skin cancer. Why? It is most likely because they have only occasional exposure to the sun, leaving them at greater risk of sunburn – even during the cold, winter months – which predisposes them to various forms of skin cancer.
Nonmelanoma skin cancer (NMSC) is the most common form of skin cancer, regardless of where individuals reside. An estimated 3 million people are diagnosed with NMSC annually, according to research published in the Journal of American Medical Association Dermatology. The incidence of the two most common types of NMSC, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), have increased significantly over the last two decades. A study published by the Mayo Clinic in June 2017 found that diagnoses of SCC grew by 263 percent and BCC by 145 percent between 2000 and 2010.
While many patients have NMSC on the head and neck, it can occur on any part of the body. Additionally, although skin care professionals cannot treat or diagnose NMSC, understanding the treatment options available can be beneficial. It can aid professionals in encouraging clients with NMSC to visit a licensed physician for treatment and diagnosis and help with understanding and communicating with these clients in general.
There are a number of options available to treat NMSC.
Excision is one of the more common treatment options and involves surgical removal of cancer cells and surrounding healthy tissue, which is referred to as the margin. According to the American Academy of Dermatology Guidelines of Care, excision is an effective treatment for both primary and recurrent tumors. For small (less than 20 millimeters in size), primary, well-defined NMSC, this procedure can have up to a 95 percent cure rate. Excisions usually heal well with proper suturing. However, some areas of the body are prone to slow healing and scarring. Sometimes, other medical conditions can make these problems worse.
Electrodesiccation and Curettage
This is a procedure in which cancerous cells are removed using a curette. The area is then treated with an electric current that helps control bleeding and destroys any remaining cancer cells. Electrodesiccation and curettage is best suited for small primary lesions in non-cosmetically sensitive areas.
Mohs Micrographic Surgery
Mohs surgery has become the “gold standard” treatment of NMSC. This surgery entails removing a skin lesion one layer at a time and studying each layer and its margins under a microscope for the presence of cancer cells. With Mohs surgery, practitioners can examine the tumor’s margin, reducing the chance of recurrence of NMSC. Mohs surgery is very effective for many patients, and with the proper reconstructive techniques, usually results in excellent cosmetic outcomes. However, in certain cases, patients may require multiple reconstructive procedures that result in additional costs, additional recovery time for the patient, and increased risks of complications.
Various types of radiation therapy, including brachytherapy, orthovoltage, and electron beam treatment, have been used for decades to treat NMSC. However, these treatments can be cumbersome for both providers and patients. During radiation treatment, patients must be alone in the treatment room while healthcare professionals remain far enough away to reduce their risk of radiation exposure. In addition, traditional radiation regimens usually consist of daily treatment sessions for up to six weeks, which can present logistical challenges and significant inconvenience to patients.
Electronic brachytherapy (eBx) is a new form of low-energy radiation therapy that is clinically proven to be safe and effective for appropriate patients. It is a great option for patients who are over the age of 70, since younger patients have a slightly higher risk of developing secondary cancers from radiation treatment. This therapy is recommended for patients with lesions in anatomically challenging locations or patients who may have medical comorbidities (such as dementia or Parkinson’s disease) that may make surgery difficult to handle. It is also an option for patients who may be tired of undergoing multiple surgical procedures or those who prefer not to have surgery for personal reasons. Compared to traditional radiation, eBx is painless, non-invasive, and involves a shorter course of treatment.
Regardless of where the spa is located or the amount of sun clients encounter, it is important for them to visit their dermatologist to manage sun damage to their skin and address any precancerous legions before they progress. Even with regular follow-ups, skin cancer may occur. There are many treatment options to consider after a skin cancer diagnosis is made and having a close relationship with a dermatologist will ensure that clients catch it early and find the best treatment for their unique needs.
It is estimated that one American dies every hour from skin cancer.1 Even though the rate of many other common cancers is falling, the incidence of melanoma continues to increase significantly and at a faster rate than any of the seven most common cancers.2 Each year there are more new cases of skin cancer than the combined incidence of breast, prostate, lung, and colon cancers.3
There is an old myth that massage therapy and other skin care treatments can encourage cancer metastasis. While this statement is untrue, what exactly is metastasis? Metastasis is the manner by which cancer cells spread to other parts of the body. Twenty to 30 percent of people who are initially diagnosed with early-stage breast cancer will develop metastatic breast cancer, also called stage IV breast cancer. Metastatic breast cancer can occur five, 10, or even 15 years after the original diagnosis and even after successful treatments. Unfortunately, there is no cure for this type of cancer as most treatments are directed at controlling the spread of the disease and increasing the quality of life.
The number of people affected by melanoma, the most deadly skin cancer in the United States, is consistently rising. It is commonly diagnosed in people under age 30. Dr. Hui Tsou, dermatopathologist and assistant medical director of Acupath Laboratories, offers five tips that skin care professionals can share with clients to help detect melanoma while it is still treatable.
Skin cancer is the most common cancer in the U.S. with more than two million Americans diagnosed annually. Basal cell carcinoma and squamous cell carcinoma make up the majority of these cases. The third type, melanoma, arises from pigment producing cells called melanocytes. The ability to spread widely to other parts of the body is a unique characteristic of melanoma that the other skin cancers do not readily possess. This characteristic makes melanoma the deadliest, accounting for only four percent of skin cancers but 80 percent of skin cancer-related deaths. The number of new cases of melanoma is increasing steadily and dramatically. In the U.S. alone, the incidence of melanoma has tripled over the past three decades. In 2010, approximately 70,000 new cases were diagnosed.