Targeted interventions including avoiding excessive sun exposure, liberally applying sunscreen before sun exposure, and supporting skin health with scientifically studied nutrients like B-vitamins, Polypodium leucotomos, and red orange complex can protect skin from UV damage.
Causes and Risk Factors
- Exposure to sunlight/UV light is a primary risk factor for all skin cancers.
- All skin cancers are more common in men and with advancing age.
- Numerous freckles and/or moles can increase risk of skin cancer.
Signs and Symptoms
- Basal cell carcinoma, most of which occur on the head or neck
- Nodular: pearly pink or white, dome-shaped lesion
- Superficial: scaly plaques with raised, pearly white borders
- Micronodular and infiltrative: like nodular subtype but more malignant
- Morpheaform: firm, yellowish, ill-defined mass
- Squamous cell carcinoma, found on backs of hands and forearms and the head and neck
- Firm, smooth or scaly raised lesion, often ulcerated
- The “ABCDE guide” is often used to describe melanoma characteristics
- Asymmetrical shape
- Borders that are irregular
- Color that is not the same all over
- Diameter larger than a pencil eraser
- Evolving in shape, size or color
- Skin cancers are diagnosed based on physical exam, patient history, and a variety of diagnostic techniques, including biopsy of skin and lymph nodes, dermoscopy, and imaging tests if the cancer has spread.
- Treatments for non-melanoma skin cancers include Mohs microsurgery (which presents the best cure rates, lowest recurrence rates, and leaves the smallest surgical wounds), electrodessication and curettage, cryosurgery, and radiotherapy.
Novel and Emerging Therapies
- Vismodegib, an FDA-approved drug for advanced basal cell carcinoma, significantly decreased the appearance of new tumors and reduced the size of existing tumors in two phase II clinical trials.
- Daily low-dose aspirin usage reduced melanoma risk by 46% among women in a large Dutch population-based study.
- Tumor treating fields represent a noninvasive technique that has demonstrated efficacy in preventing proliferation of human melanoma cells in preclinical studies.
- Metformin, a first-line drug for type 2 diabetes, has been shown to reduce tumor growth rate in mice injected with human squamous carcinoma cells.
- Perform skin self-exams for early detection
- Reduce UV exposure, including minimizing time spent outside during peak sun hours; heed the National Weather Service’s daily UV index; and wear long sleeves, sunglasses, and wide-brimmed hats
- B-vitamins: Oral niacinamide given to human volunteers significantly reduced immunosuppression from simulated solar UV irradiation compared with placebo. Higher folate consumption was linked to an overall risk reduction (53%) in the incidence of melanoma.
- Polypodium leucotomos: Pretreatment with Polypodium extract before exposure to UV radiation increased the minimal amount of radiation to which skin could be exposed before sunburn in 65% of high-risk melanoma patients in the study.
- Red Orange Complex: Supplementation with red orange complex in human volunteers led to a roughly 35% reduction in intensity of skin redness following UVB exposure, suggesting consumption of red orange complex may mitigate the likelihood of developing sunburn.
- Grape Seed Extract: Participants who consumed grape seed extract had a 74% decreased risk of cutaneous squamous cell carcinoma compared to those that did not.
- Melatonin: Evidence suggests higher urinary levels of a major melatonin metabolite may be associated with reduced skin cancer risk.