Fighting Skin Cancer Prevention, Detection, and the Role of Plastic Surgeons
Fighting Skin Cancer Prevention, Detection, and the Role of Plastic Surgeons

As a plastic surgeon working at a quaternary care hospital, I’ve seen firsthand how early detection and prevention can save lives. Skin cancer is one of the most common types of cancer globally, yet it is often preventable and highly treatable when caught early. In recognition of World Cancer Day in February, I want to help raise awareness about this condition and provide actionable steps for prevention.

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What is Skin Cancer?: Skin cancer occurs when skin cells grow abnormally and out of control. While it can affect anyone, some people are more at risk due to certain genetic, environmental, or lifestyle factors. There are three main types of skin cancer:

  • Basal Cell Carcinoma (BCC): The most common type, often appearing as a pearly bump or flat, flesh-colored lesion. While it rarely spreads, it can damage surrounding tissues if left untreated.
  • Squamous Cell Carcinoma (SCC): Often appears as a scaly, red patch or a sore that doesn’t heal. If untreated, it can spread to other parts of the body.
  • Melanoma: The most serious form of skin cancer, melanoma often starts as a mole that changes in size, color, or shape. It can spread quickly if not detected early.

Risk Factors for Skin Cancer: Understanding risk factors is essential for assessing your risk and taking preventive steps. These factors are divided into modifiable (those you can control) and non-modifiable (those you cannot control).

Modifiable Risk Factors

  1. UV Light Exposure: Frequent exposure to natural sunlight or tanning beds increases the risk.
  2. Smoking: Linked to an increased risk of squamous cell carcinoma.
  3. Arsenic Exposure: Occupational exposure to arsenic or contaminated drinking water is a known carcinogen.
  4. Chronic Inflammation or Skin Injury: Long-standing wounds, scars, or burns may lead to skin cancer, particularly SCC.
  5. Occupational Exposure to Chemicals: Contact with coal tar, paraffin, or certain oils in industrial settings can elevate risk.
  6. HPV Infections: Certain strains of human papillomavirus (HPV) are associated with SCC.

Non-Modifiable Risk Factors

  1. Family History of Skin Cancer: A family history of skin cancer increases your likelihood of developing it.
  2. Certain Genetic Conditions: Conditions like albinism or xeroderma pigmentosum increase sensitivity to UV rays.
  3. Fair Complexion: People with lighter skin, freckles, or light-colored eyes are more prone to skin cancer due to having lower melanin protection.
  4. Numerous Moles or Freckles: A large number of moles, or dysplastic (atypical) moles, are associated with an increased risk of melanoma.
  5. Personal History of Skin Cancer: Those who have had skin cancer before are at higher risk of recurrence.
  6. Age: The risk of skin cancer increases with age, as cumulative UV exposure takes a toll.
  7. Gender: Men are more likely than women to develop skin cancer, particularly SCC and melanoma.
  8. Past Radiation Treatment: People who have undergone radiation therapy for other conditions may be more susceptible.
  9. Immunosuppression: Those with weakened immune systems (e.g., due to organ transplantation or autoimmune conditions) are at higher risk.

Preventing Skin Cancer: While not all risk factors are controllable, many are. Here are key strategies to protect your skin:

  1. Avoid UV Exposure: Minimize spending time in the sun, especially during peak hours (10 a.m. to 4 p.m.), when UV rays are strongest.
  2. Seek Shade: When outdoors, stay in shaded areas whenever possible. Create shaded play areas for children to encourage sun-safe habits from an early age.
  3. Wear Protective Clothing: Wear long sleeves, pants, and wide-brimmed hats to shield your skin. Consider clothing with built-in UV protection for extra safety.
  4. Use Sunscreen: Apply a broad-spectrum sunscreen (SPF 30 or higher) every two hours, even on cloudy days. Reapply after swimming or sweating.
  5. Regular Self-Examination: Check your skin monthly for any changes, such as new or unusual moles, spots, or growths. Pay attention to changes in size, shape, or color.

The Importance of Early Detection: If detected early, most skin cancers are highly treatable. Follow the “ABCDE” rule for identifying melanoma:

  • A: Asymmetry—One half doesn’t match the other.
  • B: Border—Edges are irregular, scalloped, or poorly defined.
  • C: Color—Multiple colors (brown, black, red, white, or blue) in a single spot.
  • D: Diameter—Larger than 6 mm (about the size of a pencil eraser).
  • E: Evolving—Any change in size, shape, or color over time.

The Role of Plastic Surgeons in Skin Cancer Management: Plastic surgeons play a vital role in the diagnosis, treatment, and reconstruction of skin cancer cases. If you are diagnosed with skin cancer, consulting a plastic surgeon can ensure the best possible outcomes, both in terms of cancer removal and aesthetic reconstruction. Here’s how we help:

  1. Surgical Removal: Plastic surgeons are highly skilled in excising skin cancers, ensuring complete removal while preserving as much healthy tissue as possible.
  2. Reconstruction: When skin cancer is removed from sensitive or visible areas (such as the face, neck, or hands), plastic surgeons use advanced techniques to minimize scarring and restore function and appearance.
  3. Sentinel Lymph Node Biopsy (SLNB): For melanoma cases, plastic surgeons may perform a sentinel lymph node biopsy to check if cancer has spread to the lymph nodes.
  4. Skin Grafts and Flaps: If large areas of tissue are removed, we may use skin grafts or local flaps to cover the defect, ensuring optimal healing and appearance.
  5. Follow-Up and Monitoring: Plastic surgeons work closely with dermatologists and oncologists to monitor for recurrence and provide ongoing care.
  6. Patient Education: We educate patients on the importance of regular self-examinations, sun protection, and follow-up care to reduce the risk of recurrence.

If you or someone you know has been diagnosed with skin cancer, seeking early consultation with a plastic surgeon can significantly improve both medical and cosmetic outcomes.

Skin cancer is largely preventable and highly treatable if caught early. By understanding your risk factors, adopting sun-safe habits, and seeking prompt medical attention, you can greatly reduce your chances of developing skin cancer. Plastic surgeons play a critical role in treating skin cancer, ensuring both complete cancer removal and aesthetic restoration. If you notice any suspicious changes in your skin or have concerns, consult a healthcare provider or plastic surgeon without delay.

Together, we can fight skin cancer with knowledge, prevention, and expert care.

Author: Dr Sobia Yasmeen, Consultant Plastic Surgery, The Aga Khan University Hospital

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