Protect Your Family from Skin Cancer

I thought I had an ordinary pimple on my forehead. But this one would go away for a while, come back, and sometimes bleed. With two kids under the age of 4, I didn't have time to worry about a weird zit. So I kept ignoring it, even though I was overdue for a checkup with my dermatologist.

When I finally made it to the doctor's, she immediately zeroed in on the spot and took a biopsy. A few days later she called me with the news: It was basal cell carcinoma, a cancer that arises in the deepest layer of the epidermis. I was completely stunned. Maybe I was naive, but I never thought I'd get diagnosed with skin cancer, certainly not at age 33. I figured that happened only if you'd spent your life frying away in tanning salons -- something I'd never done.

"Most young people don't believe they'll get skin cancer," says Rhonda Pomerantz, MD, a clinical professor of dermatology at New York University (and my dermatologist). But it is the most common form of cancer in the United States with more than 1 million cases diagnosed each year. And more people are getting it at an earlier age: The percentage of women under age 40 who are diagnosed with basal cell carcinoma -- the kind of cancer I had -- has tripled in the last 30 years.

I probably shouldn't have been surprised. After all, I have many of the risk factors: I'm fair-skinned with blond hair and blue eyes, and I have a family history of skin cancer. (My mother has been getting precancerous growths removed for years.) And while I hadn't sunbathed in a long time, I did spend plenty of my teen years lying on the beach attempting to get a golden tan -- and often ended up with a sunburn instead. I didn't know then that getting five or more sunburns in your life doubles your risk for skin cancer.

After my initial shock I learned that in some ways the news was good: I didn't have melanoma, the type most people think of when you hear the words "skin cancer." Melanoma arises in the pigment-producing cells of the skin, known as melanocytes, and is rarer than basal cell or another kind of skin cancer called squamous cell carcinoma. However, it is much more deadly. If not caught early, melanoma can quickly spread to the lymphatic system; once there, it's often difficult to treat. In fact, more than 8,000 Americans will die from it this year.

Basal cell cancer, on the other hand, is seldom if ever fatal. "It usually doesn't metastasize," says David Becker, MD, an assistant professor of dermatology at Weill Cornell Medical College in New York. "But it can be locally destructive. It will grow and eat into the fat, muscle, and bone, and invade neighboring tissue." Squamous cell carcinoma -- which arises in the cells that compose the skin's upper layer -- falls somewhere between basal cell and melanoma in destructiveness. While less dangerous than melanoma, squamous cell carcinoma can spread to other parts of the body and tends to grow more rapidly than basal cells.