Location Is Key for Skin Cancer

7/15/2016

From 40 to 50 percent of Americans who live to age 65 will eventually develop at least one skin cancer. It’s by far the most common type of cancer, although most are nonmelanoma cancers that are unlikely to spread to other organs of the body or cause death. Melanoma is the least common skin cancer, accounting for only four percent of the total. Yet more than 10,000 Americans will die of melanoma this year.

What does LOCATION have to do with it?

WHERE YOU LIVE

It’s pretty simple: the closer you live to the equator, the higher your risk of skin cancer. If you live close to the beach and go there frequently, your risk is even higher.

The number one risk factor for skin cancer is exposure to ultraviolet radiation. UV rays come primarily from the sun but also from tanning beds. If you live in a high-risk area, you can lower your risk by protecting yourself from the sun.
  • Stay inside during the mid-day hours when UV rays are at their peak. 
  • Wear protective clothing and a broad-brimmed hat to protect your head, face and ears. 
  • Apply sun screen with an SPF of 15 or higher every day.
If you live in a low-risk area, the rules are the same–protect your skin. Ultraviolet rays are present and dangerous even on cloudy days.

WHERE YOUR ANCESTORS LIVED

It’s not just about you; it’s also about your family background.
If your ancestors came from a northern climate such as Ireland, Scotland or Scandinavia, you probably have fair skin and maybe freckles. You may complain that your skin tends to burn rather than tan. And you have a higher risk of skin cancer–particularly if you live in a sunny place like Florida or Arizona.

WHERE ON YOUR SKIN ARE CANCERS MOST LIKELY?

For nonmelanoma skin cancers, risk is directly correlated with cumulative exposure to ultraviolet radiation. The more time you spend in the sun over your lifetime, the greater your risk. That’s why many skin cancers develop late in life.

You may have noticed that freckles, sun spots and other skin blemishes that develop later in life are most prominent on your skin that has been most exposed–the top of your head (if your hair is thinning), your forehead, face, neck, ears and hands. These are also the locations where skin cancers are likely to develop.

The five most common sites: 
  • face
  • scalp
  • ears 
  • neck
  • hands
Even the area behind your ears is vulnerable; the sun can find this spot easier than you can. As you are checking your body for new or suspicious growths, those are the places to look. And those are the places to protect against the sun. Be sure to apply sun screen daily to your face and hands. A baseball cap will cover your scalp but not your ears or neck. That’s why a broad-brimmed cap is recommended.

HOW ABOUT MELANOMA?

For melanoma, the most serious skin cancer, exposure to ultraviolet radiation is a risk factor...but in a less direct way. Frequent severe sunburns, particularly in youth, may pose a greater danger than cumulative exposure over a lifetime. As a result, the location of the cancer is not quite so easy to pinpoint.

Nevertheless, about one third of melanomas occur on the neck. For men, that is a particularly likely area, along with the upper back, chest and anywhere on the trunk. For women, the most common melanoma sites are the lower legs, upper back and arms.

Individuals with numerous moles on their body have a high risk of skin cancer. Cancer often grows out of one of these moles. While exposure to ultraviolet rays, whether from the sun or tanning parlors, is a crucial risk factor for skin cancer, it is not the only one. You also have a high risk if you have a compromised immune system or are taking immunosuppressive drugs. Smoking more than triples the risk of squamous cell carcinoma. 

All skin cancers, even melanoma, are curable if detected and removed at an early stage. So it’s important to examine your skin on a regular basis and learn to recognize the signs. As one dermatologist put it, “There are many lesions on your skin. Most are harmless. The cancer is usually the new guy on the block who appears out of the blue and doesn’t quite fit in with the others.”

Learn your ABCDEs:

• Asymmetrical lesion with
• Borders that are irregular and a
• Color that is variegated or changing.
• Diameter is greater than that of a pencil, and the surface of the lesion is
• Evolving or changing.

You are not expected to diagnose your own skin cancer, but you should learn to spot suspicious lesions and show them to your doctor. Map out all of the neighborhoods of your body and try to keep track of the spots, freckles, moles and other lesions. When a new one appears or if there is a change in an old one, it’s time to take action.



REFERENCES:
American Cancer Society, “Skin cancer facts,” last medical review April 13, 2015.
Adelina Espat, “Skin cancer: uncover that mole,” M.D. Anderson Cancer Center.
Dana-Farber, “What are the most common sites for melanoma?” Insight (blog), July 16, 2014.
Laird Harrison, “Sun exposure i n adulthood can be risky,” Medscape Medical News, March 23, 2015.
Steven C. Lee, “Salivary gland neoplasms,” Medscape Reference, updated March 6, 2015.
Sarah Lewis, PharmD, “8 most common places to get skin cancer,” HealthGrades.com, medically reviewed by William C. Lloyd III, M.D., FACS, June 6, 2015.
Sarah Lewis, PharmD, “5 unexpected places to check for skin cancer,” HealthGrades.com, medically reviewed by William C. Lloyd III, M.D., FACS, June 4, 2015.
Marcus M. Monroe, M.D., “Cutaneous squamous cell carcinoma,” Medscape Reference, July 10, 2015.
Skin Cancer Foundation, “Skin cancer facts,” last updated February 5, 2016.
Rebecca Tung, “Melanoma,” Cleveland Clinic Center for Continuing Education, August, 2010.
Chris D. Tzarnas, M.D., and Carl H. Manstein, M.D., MBA, “Case challenge: a pigmented nodular growth on the ear,” Medscape Dermatology, December 19, 2014.

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