Most Bahamians feel they cannot get skin cancer. This is not true! People of all races and colors get skin cancer. This common cancer develops in people of African, Asian, Latino and Native American descent, and not just white people. All races have heard the diagnosis, "You have skin cancer". When skin cancer develops in dark skin, the cancer is often more advanced by the time it is diagnosed. Researchers are not sure why, but it could be that the cancer is not recognized until the later stages, or it's possible that skin cancer tends to be more aggressive in darker skin. Skin cancer can develop anywhere on the body, including in the lower extremities -- foot and ankle. Skin cancers of the feet have several features in common. Most are painless, and often there is a history of recurrent cracking, bleeding, or ulceration. Frequently, individuals discover their skin cancer after unrelated ailments near the affected site.
Causes
We often view the sun's harmful rays as the primary cause of skin cancer. The condition is often found on parts of the body that receive the most sun exposure. Skin cancers of the feet, however, are more often related to viruses, exposure to chemicals, chronic inflammation or irritation, or inherited traits. Unfortunately, the skin of the feet is often overlooked during routine medical examinations, and for this reason, it important that the feet are checked regularly for abnormalities that might indicate evolving skin cancer.
Types and symptoms
Some of the most common cancers of the feet are basal cell carcinoma, squamous cell carcinoma and malignant melanoma.
Basal cell carcinoma frequently is seen on sun-exposed skin surfaces. With feet being significantly less exposed to the sun, it occurs there less often. This form of skin cancer is one of the least aggressive cancers in the body. It will cause local damage, but only rarely spreads beyond the skin. Basal cell cancers may appear as pearly white bumps or patches that may ooze or crust and look like an open sore. On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers.
Squamous cell carcinoma is the most common form of cancer on the skin of the feet. Most types of early squamous cell carcinoma are confined to the skin and do not spread. However, when advanced, some can become more aggressive and spread throughout the body. This form of cancer often begins as a small scaly bump or plaque, which may appear inflamed. Sometimes there is a history of recurrent cracking or bleeding. Occasionally it begins as a hard projecting callus-like lesion. Though squamous cell cancer is painless, it may be itchy. Squamous cell cancer may resemble a plantar wart, a fungal infection, eczema, an ulcer or other common skin conditions of the foot.
Malignant melanoma is one of the deadliest skin cancers known. This type of skin cancer must be detected very early to increase survival rates. Melanomas may occur on the skin of the feet and beneath a toenail. They are found both on the soles and on the top of the feet. As a melanoma grows and extends deeper into the skin, it becomes more serious and may spread through the body by the lymphatics and blood vessels.
Malignant melanoma has many potential appearances, leading to its nickname, "the great masquerader". This skin cancer commonly begins as a small brown-black spot or bump, however, roughly one third of cases lack brown pigment and thus appear pink or red. These tumors may resemble common moles, however, close inspection will usually demonstrate asymmetry, irregular borders, alterations in color and/or a diameter greater than six millimeters. Melanomas may resemble benign moles, blood blisters, ingrown nails, plantar warts, ulcers caused by poor circulation, foreign bodies or bruises.
When to visit a podiatrist
Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions on the skin of the lower legs and feet. Skin cancers affecting the feet may have a very different appearance from those arising on the rest of the body. For this reason, a podiatrist's knowledge and clinical training is of extreme importance for patients for the early detection of both benign and malignant skin tumors.
To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or "donut-shaped" edges, or scaly areas. It is important for everyone, even people with dark skin, to perform a skin self-exam regularly. It will help you identify anything out of the ordinary with your skin. It may also help to have a skin cancer screening by your doctor or nurse especially if you find a lesion on your skin.
Diagnosis and treatment
Your podiatrist will investigate the possibility of skin cancer both through a clinical examination and with the use of a skin biopsy - a simple procedure in which a small sample of the skin lesion is obtained and sent to a specialized laboratory, where a skin pathologist will examine the tissue in greater detail. If a lesion is determined to be cancerous, your podiatrist will recommend the best course of treatment for your condition.
Prevention
Prevention of skin cancer on the feet and ankles is similar to any other body part. Limit sun exposure and make sure to apply appropriate sunscreen when you are outdoors and your feet and ankles are exposed.
o For more information on skin cancer of the foot, email us at foothealth242@gmail.com or visit www.foothealthfacts.org or www.skincarephysicians.com. To see a podiatrist call or visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates on Albury Lane, telephone 394-5824.

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