With more than 3.5 million skin cancers diagnosed annually in the United States, the Centers for Disease Control has officially declared May as Skin Cancer Awareness Month. With its ability to develop anywhere on the body, many assume if a certain area is protected from the sun that it’s safe, but according to the American Podiatric Medical Association, that assumption is not always correct. In many cases, skin cancers derive from exposure to the sun’s harmful UV rays, but skin cancers of the feet are most often related to “viruses, exposure to chemicals, chronic inflammation or irritation, or inherited traits.”
Additionally, while it’s important to attend yearly visits to the doctor to check for any skin abnormalities, most general practitioners tend to overlook the feet, which is why it’s important to schedule yearly visits with a podiatrist, too. Almost always, skin cancer can be cured if it’s found and treated in its early stages, and since skin cancer can often resemble a fungal infection, plantar wart, ulcer, hematoma, or other common skin conditions of the foot, most people don’t know to seek treatment until it’s too late.
According to Health and Age, survival rates are dramatically lower when melanoma is found on the foot because it often goes unnoticed until it becomes a serious problem. If not caught in the early stages, the fatality rate is about 50% within 5 years of diagnosis.
Common cancers of the feet include:
- Basal Cell Carcinoma
- Squamous Cell Carcinoma
- Malignant Melanoma
What should you look for?
While many have been told to pay attention to their bodies and perform self-examinations, most people don’t know exactly what they’re looking for. Thankfully, the American Academy of Dermatology has developed an easy-to-use checklist to make it easier to identify abnormal skin lesions, known as the ABCDEs of Melanoma.
- Asymmetry – If the lesion is divided in half, the two sides do not look alike.
- Borders – Borders look scalloped, uneven, or irregular.
- Color – Varies from one area to another, in different shades.
- Diameter – The lesion is wider than than 6 mm (may be smaller when diagnosed).
- Evolving – Lesion that looks different from others, and/or changes in size and color.
The 3 most common areas to find skin cancer on your feet are:
- Soles of feet
- Between toes
- Under toenails
While the ABCDE’s are a great reference to utilize when performing self-examinations, they should NOT replace your annual visits to the doctor.
Other warning signs specifically for skin cancer of the foot:
- A sore that does not heal
- Spread of pigment from the border of a lesion to surrounding skin
- Redness or a new swelling beyond the border of a lesion
- Change in sensation such as itchiness, tenderness, or pain
- Change in the surface of a mole including scaliness, oozing, bleeding, or the appearance of a bump or nodule
If you notice something abnormal on your foot or ankle, specifically moles and freckles since they’re not commonly found on the soles of feet, it’s important to schedule an appointment with a podiatrist as soon as possible. Podiatrists are trained to recognize abnormal skin conditions of the foot and ankle, and since skin cancers can have very different appearances, a podiatrist’s knowledge and training is vitally important for early detection.
Diagnosis and Treatment:
The initial diagnosis of skin cancer is determined through a clinical examination and a skin biopsy. The biopsy involves taking a small sample of the skin lesion and sending it to a laboratory where a skin pathologist can examine the tissue. If the lesion is determined to be cancerous, a podiatrist will then recommend the best course of treatment for you.
“A couple of years ago, I had a patient come in complaining about heel pain from a growth on the bottom of his foot,” Dr. Marc Borovoy, a podiatric physician shares. “There was nothing inherently abnormal about the lesion, but after reviewing his medical history, I decided to perform a skin biopsy. The next day, I had to call the patient and let him know it was skin cancer.”
“Unfortunately, it’s more common than most people think and it’s not always obvious, even if you do follow all of the steps they tell you to,” he continues. “I always tell my patients how important it is to schedule regular follow-ups with [podiatrists] because we have the ability to examine the foot and ankle in greater detail. For most people, it can be extremely difficult to examine their feet on a weekly basis simply because of the location.”
Skin Cancer Prevention:
Prevention of skin cancer on the feet and ankles is similar to any other body part, so it’s important to follow these precautions:
- Flip flops do not provide protection against the sun, so be sure to wear water shoes or socks and shoes.
- If any of your skin is unprotected by clothing or shoes, be sure to use adequate sunscreen (we recommend reviewing EWG’s Guide to Sunscreens).
- Inspect all areas of the feet daily, including underneath your toenails, between your toes, and the soles of your feet.
- If you wear nail polish, it’s important to remove it, so that you can inspect underneath the toenails.
- Avoid UV rays
Remember, skin cancer in the foot or ankle will often go unnoticed in its early stages, so it’s important to follow the aforementioned preventive steps, as well as routinely seeing your podiatrist, to seek treatment before it progresses to a more advanced stage.
If you or someone you know happens to notice any suspicious or abnormal lesions, it’s important to seek treatment as soon as possible to ensure a proper diagnosis and plan of care. Dr. Marc Borovoy and Dr. John Miller are experts in all areas of foot and ankle care, and will be happy to assist you with any problems you may be experiencing, including skin cancer diagnosis. You can request an appointment on our website or feel free to call us at (248)348-5300.