A Chicago-area doctor warned about a rise in skin cancer diagnoses in recent months as she urged people to get their skin checked routinely, with early detection key to survival rates.
Dr. Amy Derick, a dermatologist and Medical Director of Derick Dermatology, said melanoma and other skin cancer diagnoses have "gone up significantly" this year.
"People were not coming in as much for routine care for anything, whether it be skin cancer screenings or mammograms or anything that could be put off, or they thought that could be put off, until now," Derick told NBC Chicago in an interview this week. "We do see that patients are feeling safe to come out and... our numbers for melanoma have gone up significantly in the last six months."
Derick noted that putting off routine checks can be detrimental to the outcomes of such diagnoses.
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"I think that this is just such an important thing to consider that, you know, melanoma is a form of skin cancer and when it's caught early, it's curable - 99% curable," she said. "And... if we can find a melanoma early, the odds of your survival [are] much higher. And so it's very important that people are taking care of their skin and not putting off those sorts of services."
According to the American Academy of Dermatology Association, skin cancer is the most common cancer in the U.S., with melanoma rates "rising rapidly over the past 30 years."
Here's what you should know:
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Who is Most At-Risk?
Derick said that while older patients make up a larger part of skin cancer diagnoses, younger patients should also get checked because diagnoses in those age groups can see outcomes that are "not always so good."
The AAD reports melanoma will affect one in 27 men and one in 40 women in their lifetime. Younger age groups see higher diagnoses in women than men, while those over 50 seeing higher rates in men. The highest rise in cases is seen in people age 80 and older.
According to the American Cancer Society, the average age of melanoma diagnoses is 65, but "melanoma is not uncommon even among those younger than 30." In fact, the agency notes that it is one of the most common cancers in young adults, particularly young women.
Invasive melanoma is expected to be the fifth most commonly diagnosed cancer for both men and women in 2022, according to the association.
Derick also noted that fair-skinned people are more likely to see skin cancer diagnoses "because the skin is protected from the sun by pigment and people who have less pigment are less protected from the sun." But, she added that darker-skinned patients who do develop skin cancers like melanoma are often diagnosed at a later stage.
"So patients with darker skin have a lower survival rate than fair-skin patients. And so if you do have dark skin, it's important to also keep a close eye on your body and your moles and your freckles. And also to be aware that sun protection is helpful for the prevention of skin cancer."
Women may also notice a change in skin during pregnancy.
"Just like you get melasma on your face or that dark line on your belly, that's because the cells that create pigment at those sites are stimulated by estrogen and so those are more active during pregnancy," Derick said, adding that "those are the same cells that become cancerous in melanoma."
Early detection is even more critical for pregnant patients, she said.
"We've seen patients that have come in for melanomas during their pregnancy and it's important to catch those early because if you do, you can cut it out while pregnant with very little risk to the mother or the child," Derick said. "But if it is to the point where it's metastasized or is requiring certain treatments, it's difficult to treat that well while the patient is pregnant."
What Are the Types of Skin Cancer?
Basal cell and squamous cell carcinomas are the most common forms of skin cancer and are highly treatable if detected early enough and given proper treatment, according to AAD.
The American Cancer Society reports that such cancers are most often found in areas exposed to the sun, like the head, neck and arms.
Most skin cancer deaths, however, are from melanoma, which is less commo, but it is more likely to grow and spread.
The American Cancer Society reports that while melanoma accounts for roughly 1% of skin cancer diagnoses, it causes a majority of skin cancer deaths. In 2022 alone, it is estimated that 7,650 people will die of melanoma, with just over 5,000 being men and more than 2,500 being women.
While the five-year survival rate for melanoma is 99% if it is diagnosed before it spreads to lymph nodes, that number drops to 68% once it spreads to lymph nodes, AAD reports. If it gets to other organs and even further lymph nodes, the number reaches just 30%.
"The survival rate for cancer like melanoma is dependent on the time that it's caught," Derick said. "And... people who get skin cancer screenings are more likely to find skin cancers at an earlier stage than people who do not. There's been studies that have shown that, and there are also studies that show if you catch something early it's less likely to kill you."
How Often Should You Get Your Skin Checked?
According to Derick, the answer depends on a variety of factors. Some things to consider include age, sun exposure, whether or not someone is immunocompromised, family history and more.
"I think that it's based on individual risk factors. And so it would be prudent that you go to a dermatology office to have that discussed with each person individually," she said. "It depends on your age, you know, your sun damage or cumulative sun damage too. People who are immunosuppressed or have weakened immune systems are more likely to get skin cancer and people who have a lot of moles or... if you've got a history of skin cancer before, you're much more likely to get another skin cancer. And if you got a different skin cancer like basal cell, you're also more likely to have melanoma."
In Illinois, new legislation that took effect in 2020, requires health insurers to cover such examinations annually.
The legislation states that "an individual or group policy of accident and health insurance shall cover without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement upon the insured patient, one annual office visit" for a whole body skin examination for lesions suspicious for skin cancer.
"This is a benefit of many commercial insurance plans, where you can have a skin cancer screening with absolutely no out-of-pocket costs, no deductible, no co-pay, no co-insurance once a year," Derick said.
What Should You Look For?
Experts say looking for changes or growths in anything on the skin is important.
"Cancers grow and change and a changing lesion is probably the highest risk factor for something that needs to be looked at, something that's asymmetric and that's very dark, something that came out of the blue and something that's symptomatic bleeding or, you know, it just itches all the time or something like that - those sorts of things are important for you to take more seriously," Derick said.
She added that skin cancer, particularly melanoma, can even develop on areas that aren't often exposed to sun.
Here's what the American Cancer Society says you should look for with each type of skin cancer:
Basal Cell
- Flat, firm, pale or yellow areas, similar to a scar
- Raised reddish patches that might be itchy
- Small, pink or red, translucent, shiny, pearly bumps, which might have blue, brown, or black areas
- Pink growths with raised edges and a lower area in their center, which might contain abnormal blood vessels spreading out like the spokes of a wheel
- Open sores (which may have oozing or crusted areas) that don’t heal, or that heal and then come back
- Basal cell cancers are often fragile and might bleed after shaving or after a minor injury. Sometimes people go to the doctor because they have a sore or a cut from shaving that just won’t heal, which turns out to be a basal cell cancer. A simple rule of thumb is that most shaving cuts heal within a week or so.
Squamous Cell
- Rough or scaly red patches, which might crust or bleed
- Raised growths or lumps, sometimes with a lower area in the center
- Open sores (which may have oozing or crusted areas) that don’t heal, or that heal and then come back
- Wart-like growths
Melanoma
- The most important warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape, or color. Another important sign is a spot that looks different from all of the other spots on your skin (known as the ugly duckling sign).
- The ABCDE rule is another guide to the usual signs of melanoma. Be on the lookout and tell your doctor about spots that have any of the following features:
- A is for Asymmetry: One half of a mole or birthmark does not match the other.
- B is for Border: The edges are irregular, ragged, notched, or blurred.
- C is for Color: The color is not the same all over and may include different shades of brown or black, or sometimes with patches of pink, red, white, or blue.
- D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), although melanomas can sometimes be smaller than this.
- E is for Evolving: The mole is changing in size, shape, or color.
- A sore that doesn’t heal
- Spread of pigment from the border of a spot into surrounding skin
- Redness or a new swelling beyond the border of the mole
- Change in sensation, such as itchiness, tenderness, or pain
- Change in the surface of a mole – scaliness, oozing, bleeding, or the appearance of a lump or bump
What Other Preventative Measures Can You Take?
While routine screenings and wearing sunscreen are critical for protection, there are some other preventative measures people can take, experts said.
"While sunscreen works well, that's not as good as trying to avoid being out in the sun unprotected," Derick said. "So we recommend some protective clothing because it's easier. It's also easy for kids to do that. Having a history of sunburns, even once, can increase your risk of skin cancer."
