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Cancer Genetics

Skin Cancer and Available Therapies

01/07/1999

Question:

How unusual is skin cancer found in someone under the age of 25? Are there current vaccinations available and would get access to the vaccination?

Answer:

There are three main types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. BCC is the most common form of skin cancer in humans. It is mainly caused by sun exposure, and therefore it is more common in people who spend a lot of time in the sun. It is also more common in light-skinned people and in people who have a lot of moles or freckles as a child.

SCC is the second most common form of skin cancer in humans. SCC occurs mostly in people over 40, with the average age at onset in men being 68 years and in women 72 years. It is also more common in fair-skinned individuals.

Risk factors for melanoma are increasing age, fair skin, and a history of sun burns in childhood or early adolescence. People with dysplastic nevi or large, raised, irregular moles (greater than 6 millimeters in diameter) are also at an increased risk for melanoma.

It is difficult to determine the chances of a person developing skin cancer based on their age alone, since there are many other factors that will determine their risk. BCC was once uncommon in people under age 40, but due to changes in lifestyle and fashion it is now more common in people in their 20's and 30's. For SCC and melanoma, increased age is a risk factor and therefore the risk of a 25 year old developing SCC or melanoma is relatively low. However, studies have shown that people who spend a lot of time in the sun early in life without protection have an increased chance of developing skin cancer later in life.

Skin cancer may be a sign of a hereditary susceptibility to cancer or a specific syndrome, particularly if the skin cancer occurs at an early age. A detailed family history and appropriate genetic counseling would be necessary for evaluation.

As with all cancer treatment, the treatment of skin cancer depends upon the type of cancer and the stage (early vs. late stage) at which it was diagnosed. BCC and SCC have a relatively low chance of spreading to other parts of the body (metastasizing) and therefore the treatment for these types of skin cancer usually includes excision of the cancer and in some cases radiation to the affected area. In cases of BCC and SCC that have spread, chemotherapy is recommended.

Melanoma has a higher chance of spreading to other parts of the body than SCC and BCC. Depending upon the stage at which the melanoma is found, the treatment can include removing the tumor and surrounding tissues, including the lymph nodes. In more advance stages, chemotherapy and other systemic treatments are used.

At this time there are no vaccines available to prevent a skin cancer from occurring. The best way to protect against developing skin cancer is to reduce the amount of time spent in the sun, and wearing sunblock of SPF 15 or higher. People who may have other risks factors for skin cancer such as dysplastic moles should have regular skin examinations with a qualified dermatologist.

References: American Cancer Society Textbook of Clinical Oncology, 2nd edition. 1995.

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Response by:

Rebecca J Nagy, MS, CGC Rebecca J Nagy, MS, CGC
Formerly, Clinical Instructor of Genetics
School of Medicine
Case Western Reserve University

Judith A Westman, MD Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University