Most Bahamians and people of color feel they cannot get skin cancer, but 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 only white people. All races have heard the diagnosis, “You have skin cancer.”
Often when skin cancer is discovered in dark-skinned people it is advanced by the time it is diagnosed. Researchers are not exactly sure why, but it could be that the cancer is not recognized until the later stages, or it’s possibility that skin cancer tends to be more aggressive in darker skin persons. 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 own skin cancer after an unrelated condition near the affected site.
Excessive exposure to the harmful rays of the sun is the primary cause of skin cancer and it can be found on parts of the body that receive the most sun exposure. Skin cancers of the feet, can also be 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 so people are encouraged to check their feet regularly for any changes that might evolve into skin cancer.
Types and symptoms
Some of the most common cancers of the feet are:
Basal cell carcinoma: 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: 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: 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 throughout the body by the lymphatics and blood vessels. This skin cancer commonly begins as a small brown-black spot or bump; however, roughly one third of cases lack brown pigment and may look pink or red. These tumors may resemble common moles; however, a closer look will show asymmetry (uneven sides), irregular borders, changes in color, and/or a size greater than six millimeters. Melanomas may resemble benign moles, blood blisters, ingrown nails, plantar warts, ulcers caused by poor circulation, foreign bodies, or bruises.
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 skin biopsy is a simple procedure in which a small sample of the skin lesion is taken 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 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.
When to visit a podiatrist
For everyone, even people with dark skin, it is important to perform a skin self-exam regularly. Looking at your skin, including your feet will help you identify anything out of the ordinary with your skin that may be of concern. It may also help to have a skin cancer screening by your primary doctor or nurse. When there is a change in the shape, color or size of a skin lesion, it is time to see the podiatrist to have a full checkup and evaluation of the lesion. If you have a concern about skin changes it is time to see the podiatrist.
• For more information, email us at email@example.com or visit www.apma.org. To see a podiatrist, telephone 325-2996 for an appointment, visit Bahamas Foot Centre on Rosetta Street, or call 394-5824 for an appointment; or visit Bahamas Surgical Associates Centre on Hilltop Medical Centre off 4th Terrace Collins Avenue. In Grand Bahama, call Lucayan Medical Centre at 373-7400 for an appointment.