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Not As Benign As They May Seem: Non-Melanoma Skin Cancers.

Although summer is the season in which most of us get our maximum exposure to sunlight and its potential for causing skin cancers, winter also provides a heavy dose of sunshine for both those heading south to keep warm and those going to the mountains for skiing or other winter sports.

Once the most dreaded of cancers, melanoma skin cancers can now be cured if detected and treated early enough. Nonetheless, their deadly potential warrants constant vigilance in detecting them. At the other end of the spectrum of skin cancers is the basal cell cancer--a very common form of skin cancer, especially in older persons. Because it does not metastasize to other parts of the body but only erodes tissues with which it comes in contact as it grows, it is easily cured by early detection and removal. In between these two skin cancers, in terms of potential for harm, is the squamous cell cancer, which does metastasize.

Although these non-melanoma skin cancers are not as serious as many other forms of cancer, there is now overwhelming evidence that they can lead to an increased risk of melanoma and certain other non-skin cancers.

European cancer registries have shown an increased incidence of these other cancers following an initial diagnosis of non-melanoma skin cancers, but this could possibly be due to increased medical surveillance of patients with these skin cancers--or it may just be chance. Now, however, a recent follow-up study of more than one million Americans who completed a four-page questionnaire in 1982 shows a definite relationship between the initial diagnosis of non-melanoma skin cancers and subsequent death from other cancers.

As reported in the September 9 issue of the Journal of the American Medical Association, 26,622 men and 21,084 women died of cancer in the 12 years following their participation in the 1982 Cancer Prevention Study--a risk of death 20 to 30 percent higher than that of persons who had not previously had non-melanoma skin cancers. The authors of the study concluded that increased medical surveillance could not account for this increase in cancer deaths, since they counted only persons who had died of these other cancers rather than those with both fatal and nonfatal cancers.

The researchers found an increased risk of the following cancers: in both sexes, melanoma, pharynx, lung, and non-Hodgkin lymphoma; in men only, salivary glands, prostate, testis, bladder, and leukemia; in women only, breast. They found no increase in cancers of the esophagus, stomach, pancreas, ovary, colon, or rectum.

Although they could not determine what is responsible for this association between non-melanoma skin cancers and subsequent development of these other cancers, the authors emphasized the need for increased alertness from both doctor and patient in detecting such cancers in those who have previous histories of non-melanoma skin cancers.
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Publication:Medical Update
Geographic Code:1USA
Date:Dec 1, 1998
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