Christiane Querfeld, M.D., Ph.D., chief of the Division of Dermatology and director of the Cutaneous Lymphoma Program at City of Hope.
NonMelanoma Skin Cancers
The most common forms of skin cancer, squamous cell and basal cell carcinoma, are caused by sun exposure and tend to occur later in life. Querfeld says to keep an eye out for “red, scaly lesions, sometimes crusted. They can be sore, and can grow.” These lesions are mostly found in sun-exposed areas such as the face, head, ears, arms and legs. Precancerous lesions are called actinic keratosis.
There are several options for treatment. “Immune-modulating treatments can be applied topically as a cream,” Querfeld says. “Photodynamic therapies can be applied to the skin that sensitize the cancerous cells to light. Patients are then given light-exposure therapy with a special blue light. It makes the patient look like they have a severe sunburn for two days, but it treats the whole area.”
Possibility of Recurrence
Following treatment, it is important to monitor the affected areas to make sure the cancer doesn’t return. “Even after we treat the cancer, the area is not completely healthy,” Querfeld says. “This is called field cancerization. There are still atypical keratinocytes or lesions that are technically not cancer, but cancer can develop again. When you have a skin cancer, you will likely develop another cancer.”
The Dangers of Melanoma
Sun exposure is the greatest risk factor for contracting melanoma, but younger patients with genetic predisposition can also develop this deadliest form of skin cancer. To spot melanoma early, Querfeld says to “look for any dark spot that’s enlarging. Any mole that’s irregular, bleeding, growing, showing different colors or has irregular borders.”
Querfeld also recommends a yearly trip to the dermatologist for a mole check for everyone. “If patients have many moles, or already had atypical moles removed, then twice a year.”
Actually a blood cancer that travels to the skin, cutaneous lymphoma has a favorable prognosis if caught early. “There is a risk of about 10 to 15 percent that those patients may have progression, meaning the lymphoma will spread from the skin to organs inside the body or lymph nodes.” It’s important to have any unusual skin condition evaluated promptly by a dermatologist because cutaneous lymphoma can mimic skin conditions like psoriasis and eczema.
There are several treatment options for cutaneous lymphoma, including immunotherapies and biologic therapies. In its early stages, skin-directed regimens of light therapies and immune-modulating agents applied as creams are used.
Don’t Forget Your Sunscreen
Of course, it’s always best to stop cancer before it starts. For skin cancer that means sunscreen. Querfeld recommends using sunscreen with an SPF of 30 or higher, and reapplying often. “If they are waterproof, it’s only for a short time. Patients think they are protected throughout the day, but I recommend reapplying multiple times throughout the day,” she says. With proper preventive care and early detection, most often skin cancer is a disease that is not only treatable, but avoidable.