Bob Neuman grew up at the beach on Long Island, N.Y., playing in the sand and surf almost every day of the summer. Blond and fair-skinned, he remembers his mother covering him with suntan lotion.
Todd Plitt, USA TODAY
Bob Neuman grew up going to the shore of Long Island, New York without using sunscreen has had several precancerous squamous cell skin growths removed from his head.
The sun protection available in the 1940s and 1950s was far less advanced than today, however, and Neuman wonders if that really helped his skin at all.
"I thought I wore a hat when I was a kid," says Neuman, now 67. But in terms of sun damage, from skin cancer and precancers, he says, "my face and my head are the worst."
Neuman today is diligent about regular skin checks.
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He says he feels fortunate that doctors today can catch skin cancer early — finding and removing precancers before they turn malignant.
Skin cancer rates
Annual cases:
Basal and squamous-cell cancers: 2 million
Melanoma: 68,100
Annual deaths:
Basal and sqaumous-cell cancers: 3,090 Melanoma: 8,700
Melanoma survival:
Early stage: 98%
Spread to lymph nodes: 62%
Spread to other organs: 15%
Source: American Cancer Society
Basal and squamous-cell cancers: 2 million
Melanoma: 68,100
Annual deaths:
Basal and sqaumous-cell cancers: 3,090 Melanoma: 8,700
Melanoma survival:
Early stage: 98%
Spread to lymph nodes: 62%
Spread to other organs: 15%
Source: American Cancer Society
In addition to early squamous cell carcinomas — a cancer that's usually curable — he has been treated for half a dozen of these precancers, called actinic keratoses. About one in six Americans develop these lesions, which can appear rough and red, says Darrell Rigel, former president of the American Society for Dermatologic Surgery.
In some cases, precancers go away on their own, especially if people are careful to avoid additional sun exposure, says David Leffell, a professor of dermatology at Yale Medical School. Studies show that only a small number turn into squamous cell cancers, Leffell says.
Doctors have a number of ways to treat precancers.
If a patient has just one or two lesions, doctors may freeze them off with liquid nitrogen, Rigel says. But doctors also may prescribe a cream to treat a broad area, such as the forehead, to prevent new precancers from ever appearing, he says.
One of the most commonly used creams contains a chemotherapy drug, called fluorouracil, which destroys the precancerous cells by blocking essential cellular functions within them. Another cream stimulates the immune system to reject the precancer, the Mayo Clinicsays.
Another alternative is photodynamic therapy, in which creams or injections make the precancers sensitive to light, before they are killed with a laser.
In the short term, the creams can turn a person's skin bright red and raw for seven to 10 days, Rigel says. But when the skin heals, it often looks better than before, with fewer fine lines and wrinkles. Manufacturers are looking into low-dose versions to use cosmetically, he says.
These treatments can get rid of about 80% of precancers, Rigel says. Doctors follow other patients closely.
Some melanomas — a more serious form of skin cancer that kills 8,700 Americans a year — also begin as precancerous moles, called dysplastic nevi, Rigel says. Up to 4% of Americans develop them. Removing all of them can be difficult, as some people may develop dozens.
Says Rigel, "A few years from now, we may have better technology and devices to help you determine when to do a biopsy."
Neuman says his wife, who was treated for an early melanoma, now also goes for regular skin checks.
And Neuman, who's now partly bald, says he never goes out without a hat.
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