Make us your home page
Instagram

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Cover story

Skin cancer can surface in unusual places, so be vigilant in checking

Conner Fenlon noticed he had a small bald spot on the back of his head, near the top, when he was in high school. He figured it was a sort of birthmark and never gave it much thought.

Then, last year, Fenlon decided to participate in a fundraiser for the Pediatric Cancer Foundation and agreed to have his head shaved. With the area no longer blocked by surrounding hair, friends noticed and commented that it was red and inflamed.

That got Fenlon's attention.

He went to a dermatologist and found out that the bald spot, about the size of two quarters, was imbedded with basal cell skin cancer and would have to be surgically removed.

"To think it was there, and I didn't know what it was," said Fenlon, who is now 25, lives in Tampa and works as a substitute teacher, "it definitely scared me."

The three most common types of skin cancer — squamous cell carcinoma, basal cell carcinoma and melanoma, the deadliest form of skin cancer — are usually found on skin that gets a lot of sun.

About "60 to 70 percent of skin cancers are related to ultraviolet sun exposure," said Dr. Amy Ross, a Morton Plant Hospital dermatologist. That's why most skin cancers are found on the face, head, chest, neck and arms, areas that, especially for Floridians, may get chronic sun exposure.

But skin cancers are also found on areas of the body that get very little or no sun or in areas that most of us neglect to check or never even think to look for something suspicious.

Melanoma is particularly good at hiding. It is most commonly found on the back, where few people routinely check for changes related to skin cancer. According to a new American Academy of Dermatology survey, only 36 percent of respondents examined their backs for signs of skin cancer. Even fewer said they asked someone to help check areas that were difficult to see.

While basal cell and squamous cell carcinomas are often easily found on skin exposed to the sun, melanoma often appears on the bottoms of feet, between the toes, on the palms, under fingernails and toenails, on the scalp beneath a full head of hair, inside the ear, behind the eye on the retina and on the genitals and other intimate parts of the body. When melanoma occurs in someone with a dark complexion, such as African-Americans, it's more likely to be found in an area not exposed to the sun.

Fenlon's skin cancer was surprising because he has always avoided the sun and never goes outside without covering up with clothing and a hat because he hates the feel of sunscreens.

"He was very fortunate to have had his head shaved," said Dr. C. Wayne Cruse, a Moffitt Cancer Center plastic surgeon and surgical oncologist who took care of Fenlon. Cruse said the cancer was caught relatively early and arose from a skin lesion that had probably been on Fenlon's head since birth. The lesion Cruse removed was about the width of a golf ball and was fairly deep. The scar after surgery was about the width of a tennis ball.

"Another year," Cruse said, "and he would have had a much bigger operation." As a result of Fenlon's diagnosis, the Pediatric Cancer Foundation now has experts on hand to inspect the skin of those who have their heads shaved.

Doctors say that most adults should have a total body skin exam at least once a year, especially if they have a history of severe, blistering sunburns as a child, have a family history of skin cancer or have used tanning beds.

Between visits, you should regularly check yourself with the help of a mirror. Look for anything new or unusual on your skin, including pearly or waxy bumps; a firm, red nodule; a flat, scaly crusted lesion; moles and freckles that change in size, color or that bleed or itch; a red, white, blue or blue-black lesion with irregular borders; or a dark spot in an unusual place, such as on your palms, soles, fingers, toes or scalp, or in your mouth or nose.

If found early, many skin cancers are curable. "Unfortunately people will neglect lesions for years and come in to see us when they are bleeding or it's causing some problem they can no longer ignore," Ross said. "Something that we could have cured is now life-threatening or the surgical treatment will be disfiguring, something that never should have happened."

Contact Irene Maher at imaher@tampabay.com.

PREVENTING, DETECTING SKIN CANCER

Your best defense against skin cancer is prevention and alerting your doctor to skin changes early, when the chances for cure are highest. Dr. Susan Weinkle, a Bradenton-based dermatologist, says it's important to remember, if you are going out in the sun, that sunscreen is not "one and done. It must be reapplied about every two hours or more frequently if you get wet or are sweating a lot."

And, don't forget to enlist help to apply sunscreen to your back.

Other recommendations:

• Avoid the sun between 10 a.m. and 4 p.m.

• Liberally apply water-resistant sunscreen with an SPF of at least 15 (the American Academy of Dermatology recommends an SPF of 30 or higher) and reapply it often.

• Wear sunglasses that block UVA and UVB rays.

• Avoid tanning beds.

• Be aware of medications, like the antibiotic tetracycline or the pain killer ibuprofen, that may make skin more sensitive to the sun.

• Wear protective clothing made of special fabric that blocks UVA and UVB rays.

• Wear a broad-brimmed hat that protects the face, ears and neck.

• Check your skin often and don't ignore changes.

ONLINE RESOURCE

For more information about skin cancer, visit the American Academy of Dermatology's website at tbtim.es/i44.

Skin cancer can surface in unusual places, so be vigilant in checking 05/14/15 [Last modified: Thursday, May 14, 2015 10:09am]
Photo reprints | Article reprints

© 2017 Tampa Bay Times

    

Join the discussion: Click to view comments, add yours

Loading...
  1. Jones: Bucs need success to get national respect

    Bucs

    Tampa Bay Times columnist Tom Jones offers up his Two Cents on the world of sports.

    No respect

    Tampa Bay Buccaneers head coach Dirk Koetter walks the field during the second day of mandatory minicamp at One Buccaneer Place in Tampa, Fla., on Wednesday, June 14, 2017. LOREN ELLIOTT   |   Times
  2. Hopes fade after landslide destroys Chinese village (w/video)

    World

    Crews searching through the night in the rubble left by a landslide that buried a mountain village under tons of soil and rocks in southwestern China found 15 bodies, but more than 110 more people remained missing.

    Vehicles and people line a road leading to the site of a landslide in Xinmo village in Mao County on Saturday in southwestern China’s Sichuan Province. More than 100 people remained missing after the village was buried under tons of rocks and soil.
  3. Rookie Jake Faria dissatisfied with performance in Rays' loss to Orioles

    The Heater

    ST. PETERSBURG — The rookie pitcher walked to his locker Saturday after tossing the fourth quality start in as many tries to begin his career. He held the potent Orioles bats to three runs and for six innings gave his team a chance to win.

    Orioles third baseman Manny Machado tags out the Rays’ Mallex Smith at third after a rundown in the first inning.
  4. Thousands converge in two St. Pete locations celebrating LGBT rights

    Human Interest

    ST. PETERSBURG — Tom Rockhill didn't know what to expect Saturday, but by noon people were knocking on the door of his bar Right Around the Corner in Grand Central.

    (From left to right) Emma Chalut 18, gets a rainbow sticker on her cheek from her sister Ellie, 15 both of Jacksonville before the annual St. Pete Pride parade in downtown St. Petersburg on Saturday. This year the route was changed from the Grand Central and Kenwood area to Bayshore Drive.
[EVE EDELHEIT   |   Times]
  5. Retired Florida Supreme Court Justice Parker Lee McDonald dies

    TALLAHASSEE — A former Florida Supreme Court justice, who wrote a decision that prevented lawyers from excluding jurors because of their race, has died.

    Former Florida Supreme Court Justice Parker Lee McDonald died Saturday, the court said in a statement. He was 93.