Cancer
What you should watch for . .
Head & Neck Cancer
Skin Cancer
Head and Neck Cancer —
More than 55,000 Americans will develop cancer of the head and neck (most of which is preventable) this year; nearly 13,000 of them will die from it.
Find It Early and Be Cured
Tobacco is the most preventable cause of these deaths. In the United States, up to 200,000 people die each year from smoking-related illnesses. The good news is that this figure has decreased due to the increasing number of Americans who have quit smoking. The bad news is that some of these smokers switched to smokeless or spit tobacco, assuming it is a safe alternative. This is untrue – they are merely changing the site of the cancer risk from their lungs to their mouth. While lung cancer cases are down, cancers in the head and neck appear to be increasing. Cancer of the head and neck is curable if caught early. Fortunately, most head and neck cancers produce early symptoms. You should know the possible warning signs so you can alert your doctor to your symptoms as soon as possible. Remember – successful treatment of head and neck cancer can depend on early detection. Knowing and recognizing the signs of head and neck cancer can save your life.
Here’s What You Should Watch for:
A lump in the neck…Cancers that begin in the head or neck usually spread to lymph nodes in the neck before they spread elsewhere. A lump in the neck that lasts more than two weeks should be seen by a physician as soon as possible. Of course, not all lumps are cancer. But a lump (or lumps) in the neck can be the first sign of cancer of the mouth, throat, voicebox (larynx), thyroid gland, or of certain lymphomas or blood cancers. Such lumps are generally painless and continue to enlarge steadily.
Change in the voice…Most cancers in the larynx cause some change in voice. Any hoarseness or other voice change lasting more than two weeks should alert you to see your physician. An otolaryngologist is a head and neck specialist who can examine your vocal cords easily and painlessly. While most voice changes are not caused by cancer, you shouldn’t take chances. If you are hoarse more than two weeks, make sure you don’t have cancer of the larynx. See your doctor.
A growth in the mouth…Most cancers of the mouth or tongue cause a sore or swelling that doesn’t go away. These sores and swellings may be painless unless they become infected. Bleeding may occur, but often not until late in the disease. If an ulcer or swelling is accompanied by lumps in the neck, be very concerned. Your dentist or doctor can determine if a biopsy (tissue sample test) is needed and can refer you to a head and neck surgeon to perform this procedure.
Bringing up blood…This is often caused by something other than cancer. However, tumors in the nose, mouth, throat or lungs can cause bleeding. If blood appears in your saliva or phlegm for more than a few days, you should see your physician.
Swallowing problems…Cancer of the throat or esophagus (swallowing tube) may make swallowing solid foods difficult. Sometimes liquids can also be troublesome. The food may “stick” at a certain point and then either go through to the stomach or come back up. If you have trouble almost every time you try to swallow something, you should be examined by a physician. Usually a barium swallow x-ray or an esophagoscopy (direct examination of the swallowing tube with a telescope) will be performed to find the cause.
Changes in the skin…The most common head and neck cancer is basal cell cancer of the skin. Fortunately, this is rarely a major problem if treated early. Basal cell cancers appear most often on sun-exposed areas like the forehead, face, and ears, although they can occur almost anywhere on the skin. Basal cell cancer often begins as a small, pale patch that enlarges slowly, producing a central “dimple” and eventually an ulcer. Parts of the ulcer may heal, but the major portion remains ulcerated. Some basal cell cancers show color changes. Other kinds of cancer, including squamous cell cancer and malignant melanoma, also occur on the skin of the head and neck. Most squamous cell cancers occur on the lower lip and ear. They may look like basal cell cancers and, if caught early and properly treated, usually are not much more dangerous. If there is a sore on the lip, lower face, or ear that does not heal, consult a physician. Malignant melanoma classically produces dense blue-black or black discolorations of the skin. However, any mole that changes size, color, or begins to bleed may be trouble. A black or blue-black spot on the face or neck, particularly if it changes size or shape, should be seen as soon as possible by a dermatologist or other physician.
Persistent Earache…Constant pain in or around the ear when you swallow can be a sign of infection or tumor growth in the throat. This is particularly serious if it is associated with difficulty in swallowing, hoarseness or a lump in the neck. These symptoms are best evaluated by an otolaryngologist.
Identifying High Risk of Head and Neck Cancer
As many as 90 percent of head and neck cancers arise after prolonged exposure to specific factors. Use of tobacco (cigarettes, cigars, chewing tobacco or snuff) and alcoholic beverages are closely linked with cancers of the mouth, throat, voice box and tongue. (In adults who neither smoke nor drink, cancer of the mouth and throat are nearly nonexistent.) Prolonged exposure to sunlight is linked with cancer of the lip and is also an established major cause of skin cancer.
What You Should Do…All of the symptoms and signs described here can occur with no cancer present. In fact, many times complaints of this type will be due to some other condition. But you can’t tell without an examination. So, if they do occur, see your doctor—and be sure.
REMEMBER: When found early, most cancers in the head and neck can be cured with relatively little difficulty. Cure rates for these cancers could be greatly improved if people would seek medical advice as soon as possible. So play it safe. If you think you have one of the warning signs of head and neck cancer, see your doctor right away.
BE SAFE: See your doctor early! And practice health habits which will make these diseases unlikely to occur.
Skin Cancer —
The skin is the largest organ in our body. It provides protection against heat, cold, light, and infection. The skin is made up of two major layers (epidermis and dermis) as well as various types of cells. The top (or outer) layer of the skin—the epidermis— is composed of three types of cells: flat, scaly cells on the surface called squamous cells; round cells called basal cells; and melanocytes, cells that provide skin its pigment or color and protect against skin damage. The inner layer of the skin—the dermis—is the layer that contains the nerves, blood vessels, and sweat glands.
What Is Skin Cancer?
Skin cancer is a disease in which cancer (malignant) cells are found in the outer layers of your skin. There are several types of cancer that originate in the skin. The most common types are basal cell carcinoma (70 percent of all skin cancers) and squamous cell carcinoma (20 percent). These types are classified as nonmelanoma skin cancer.
Melanoma (5 percent of all skin cancer) is the third major type of skin cancer. It is less common than basal cell or squamous cell skin cancer, but potentially much more serious. Other types of skin cancer are rare.
Basal Cell Carcinoma
Basal cell carcinoma is the most common type of skin cancer. It typically appears as a small raised bump that has a pearly appearance. They are most commonly seen on areas of the skin that have received excessive sun exposure. These cancers may spread to the skin around the cancer but rarely spread to other parts of the body.
Squamous Cell Carcinoma
Squamous cell carcinoma is also seen on the areas of the body that have been exposed to excessive sun (nose, lower lip, hands, and forehead). Often this cancer appears as a firm red bump or ulceration of the skin that does not heal. Squamous cell carcinomas can spread to lymph nodes in the area.
Melanoma
Melanoma is a skin cancer (malignancy) that arises from the melanocytes in the skin. These cancers typically arise as pigmented (colored) lesions in the skin with an irregular shape, irregular border, and multiple colors. It is the most harmful of all the skin cancers because it can spread to other sites in the body. Fortunately, most melanomas have a very high cure rate when identified and treated early.
Who Gets Skin Cancer?
Skin cancer is a disease that has shown a steady increase over the last 20 years. Fortunately, with early diagnosis and treatment it remains a very curable disease. A variety of factors have been identified which place a person at a higher risk to develop skin cancer (see “Am I at risk?”).
How Is Skin Cancer Diagnosed?
The most important first step is early diagnosis. The vast majority of skin cancers can be cured if diagnosed and treated early. Aside from protecting your skin from sun damage, it is important to recognize the early signs of skin cancer.
— Skin sores that do not heal
— Bumps or nodules in the skin that are enlarging
— Changes in existing moles (size, texture, color)
If you notice any of the factors listed above see your doctor right away. If you have a spot or lump on your skin, your doctor may remove the growth and examine the tissue under the microscope. This is called a biopsy. A biopsy can usually be done in the doctor’s office after numbing the skin with a local anesthetic. Examination of the biopsy under the microscope will tell the doctor if the skin lesion is a cancer (malignancy).
How Is Skin Cancer Treated?
There are varieties of treatments available (including surgery, radiation therapy, and chemotherapy) to treat skin cancer. Treatment for skin cancer depends on the type and size of cancer, your age, and your overall health.
Surgery is the most common form of treatment. This generally consists of an office or outpatient procedure to excise the lesion and check edges to make sure all the cancer was removed. In many cases, the site is then repaired with simple stitches (primary closure). In larger skin cancers, your doctor may take some skin from another body site to cover the wound and promote healing. This is termed skin grafting. In more advanced cases of skin cancer radiation therapy or chemotherapy (drugs that kill cancer cells) may be used in conjunction with surgery to improve cure rates. Your overall treatment will be individualized based on the type and size of skin cancer, your age, and your overall health.
How Can I Lower My Risk?
The single most important thing you can do to lower your risk of skin cancer is to avoid direct sun exposure. Sunlight produces ultraviolet (UV) radiation that can directly damage the cells (DNA) of our skin. People who work outdoors (farmers, construction, boating, outdoor sports) are at the highest risk of developing a skin cancer. The sun’s rays are the most powerful between 10 am and 2 pm, so you must be particularly careful during those hours.
If you must be out during the day, wear clothing that covers as much of your skin as possible including a wide-brimmed hat to block the sun from your face, scalp, neck, and ears. In addition to protective clothing, the use of a sunscreen can reflect light
away from the skin and provide protection against UV radiation. When selecting a sunscreen, choose one with a Sun Protection Factor (SPF) of 15 or more. Sunscreen products do not completely block the damaging rays but they do allow you to be in the sun longer without getting sunburn.
In addition to being sun-smart, it is critical to recognize early signs of trouble on your skin. The best time to do self-examination is after a shower in front of a full-length mirror. Note any moles, birthmarks, and blemishes. Be on the alert for sores that do not heal or new nodules on the skin. Any mole that changes in size, color, or texture should be carefully examined. If you notice anything new or unusual, see your physician right away. Catching skin cancer early can save your life.
SIDEBAR: Am I at risk?
People with any of the factors listed below have a higher risk of developing skin cancer and should be particularly careful of sun exposure.
— Long term sun exposure
— Fair skin (typically blonde or red hair with freckles)
— Place of residence (increased risk in more Southern climates)
Presence of moles particularly if you notice irregular edges, uneven coloring,and increase size >6 mm
— Family history of skin cancer
— Use of indoor tanning devices
— Severe sun burns as child
— Nonhealing ulcers or nodules in the skin
