This document discusses skin cancer, including its causes, risk factors, symptoms, diagnosis, prevention, and treatment. There are three main types of skin cancer - basal cell carcinoma, squamous cell carcinoma, and melanoma. Skin cancer is often caused by prolonged sun exposure and can be prevented by limiting sun exposure, wearing protective clothing and sunscreen, and getting regular skin checks. Diagnosis typically involves examinations and biopsies of suspicious moles or lesions. Treatment options depend on the cancer type and severity but may include excision, radiation, cryotherapy, photodynamic therapy, Mohs surgery, or chemotherapy.

1. Say YES to protection
Say No to skin cancer
“May” is skin cancer prevention month.
It's time to act now!

2. What is Skin Cancer?
Skin cancer is the abnormal or uncontrolled growth of skin cells
that usually develops on skin that is frequently exposed to the
sun.
There are 3 types of skin cancer:
• Basal cell carcinoma –the most common skin cancer develops
in the cells of the deepest layer of the epidermis, or skin’s
outermost layer. The lesions are seen as red patches, open
sores, reddish pink growths, glossy raised bumps, or scars. It
can develop because of a combination of factors like
prolonged exposure to the sun and short bursts of intense
exposure to harsh sun. It does not normally spread to other
body parts.
What You Need to Know About Melanoma/Skin Cancer (1/3)

3. • Squamous cell carcinoma –the second most common type of
skin cancer develops slowly; however, it can spread to other
tissues, bones, lymph nodes and organs. It develops in the thin,
flat, squamous cells of the epidermis. When the DNA of these
cells changes, they start dividing rapidly, and scaly red, patchy
skin, open sores, or warts appear.
• Melanoma – the most aggressive skin cancer that can quickly
spread to other parts of the body including tissue, bones, lymph
nodes, etc. Melanoma is a cancer of the pigment producing cells
called melanocytes and usually starts off as innocent moles.
What You Need to Know About Melanoma/Skin Cancer (2/3)

4. What You Need to Know About Melanoma/Skin Cancer (3/3)
Causes and Risk Factors for Skin Cancer
• Skin cancer is the most commonly diagnosed cancer in
America, with over 1 million people being diagnosed with it.
Every year, more than 10,000 people die of skin cancer in the
US alone.
• While the specific cause cannot be pinpointed, the most
possible reasons for developing skin cancer include:
• Prolonged exposure to the sun whether for work or recreation
• Exposure to radiation and hazardous chemicals like arsenic
• Genetic factors
• Using tanning beds, even occasionally (such people have a 59%
risk of getting melanoma, are 2.5 times more likely to develop
squamous cell carcinoma and are 1.5 times more likely to get
basal cell carcinoma)

5. Risk Factors
Being a Caucasian
male, especially with
blond hair and
blue/green eyes
Increasing age (especially
if you have spent much
of your life outdoors in
the sun)
Asians and Hispanic people are
at much lower risk, but if they do
get skin cancer, it manifests in a
very aggressive form. Caucasian
are at the highest risk; 1 in every
5 Caucasian Americans will
contract some type of skin
cancer in their lifetime.
Having had
sunburns and/or
heat strokes often
as a child

6. Melanoma
The typical early sign of melanoma is a new spot on the skin, or
changes in the number, size, shape or color of moles you have.
• Asymmetry: the mole cannot be split into two equal halves
• Border: irregular and notched
• Color: uneven shading and multiple colors
• Diameter: are smaller than the size of a pencil eraser
• Evolving or Elevation: change in size, shape, or texture
Squamous Cell Carcinoma
• A firm, red nodule
• Flat sores with scaly crusts
• New sores or raised areas on old scars or ulcers
• A rough, scaly patch on your lip that may develop into an
open sore
• Red sores or a rough patch inside the mouth
• Raised red patches or wart-like sores on or in the anus or
genitals
Symptoms of Skin Cancer (1/3)

7. Basal Cell Carcinoma
• Flat, firm, pale or yellowish areas, like scars
• Raised reddish, itchy patches of skin
• Small, pinkish-red, translucent, shiny, pearl-like bumps, which
may have blue, brown, or black coloration
• Pinkish growths with raised edges and a low area in the middle,
which may contain abnormal blood vessels spread out
• Open sores (which may have oozing or crusted areas) that
don’t heal, or that heal and then return
Diagnosing Skin Cancer
Normally, a physical examination of the skin is enough to diagnose
skin cancer. In the case of melanoma, your EPIC Primary Care
physician can count the number of moles you have, especially on
your right arm; having more than 11 could mean you have over
100 moles on the entire body. This presents a higher than normal
risk of melanoma.
Symptoms of Skin Cancer (2/3)

8. Other tests your EPIC Primary Care doctor may ask for include:
• Routine blood tests: any unusual counts indicate disease
• Punch biopsy: a round piece of skin surrounding a suspicious
mole is removed with a tool that has a circular blade attached
• Excisional biopsy: removal of the whole growth with a tiny bit of
skin that looks normal
• Incisional biopsy: the most irregular potion of the growth is
removed.
• Biopsy is the laboratory examination of a skin or tissue sample
by a trained pathologist to determine if it is cancerous or not.
• EPIC Primary Care provides diagnostic tests including skin
testing for the convenience of our patients; if your physician
suspects skin cancer, the tests can be conducted at our care
centers.
Symptoms of Skin Cancer (3/3)

9. It may not be possible to prevent the onset of skin cancer completely, but we can certainly mitigate the risk factors that are
within our control. Here are some steps you can take to try and prevent or delay the onset of skin cancer, or to keep its
severity low – Limit your time outdoors, especially when the sun is at its hottest (usually sometime between 11 am and 2 pm)
Prevention (1/2)
If your work requires you to be outdoors, protect your skin and head:
Wear a wide
brimmed hat or
scarf
Wear sunglasses Use a sunscreen
with the
appropriate sun
protection factor
Wear light colored
clothing that will
not absorb heat
Stay hydrated at
all times

10. If you have any moles, check them frequently for changes; check
for any changes in your skin or appearance of pinkish red patches,
bumps or warts, and seek medical help immediately
Consult your EPIC Primary Care physician for a skin
test/examination once in 6 months if you are at high risk for skin
cancer
Avoid tanning beds and lotions
Consume foods rich in nutrients (anti-oxidants and vitamins) that
help fight free radicals which are triggered by sun’s rays; these
include yellow and orange colored fruits and veggies, nuts, fatty
fish, citric fruits, leafy greens, seeds, tomatoes, watermelon, and
so on.
Prevention (2/2)

11. Treatment options for skin cancer and precancerous lesions vary depending on the size, type and location of the
lesions. If at the very initial stages, a biopsy that removes the whole growth may suffice. Other methods include:
Treatment for Skin Cancer
Radiation: high-powered
energy beams are used to
kill cancer cells
Cryotherapy: scraping away
cancer cell layers with a
curette after a major
portion of the growth is
removed; an electric needle
destroys the leftover
cancerous cells.
Excision: cutting out the
cancerous tissue along with
some healthy skin around it
Photodynamic therapy:
killing cancer cells with a
combination of laser light
and medicines that sensitize
cancer cells to light
Mohs surgery: used for
larger, recurrent or hard-to-
treat skin cancers, and in
areas where conserving
maximum skin is important
– the nose, for example.
Skin is removed one layer at
a time and examined under
a microscope; when no
more cancerous cells are
detected, the skin removal
is stopped.
Freezing: using liquid
nitrogen to freeze and kill
actinic keratosis and early
skin cancers
Chemotherapy: using drugs
to kill cancer cells especially
in case of metastasis
Biological therapy: using
your own immunity to kill
cancer cells

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