Pediatric Skin Cancer: An Unexpected and Unfortunate Reality
Summer sun signals family time, a long-awaited break from school, and long days in the sun for many children and their families. While so many good things come to mind when we think of summertime, one unfortunate and frightening reality looms over the hot weather and sunshine: skin cancer. Unbeknownst to many, skin cancer is not simply a problem affecting adults in the United States. It is also a significant issue for children. That sunburn you thought was harmless? Not so, potentially. That mole that you noticed on your child’s shoulder, back, or elsewhere on their body? It is possible that it could be cancerous.
For decades, pediatric melanoma has been on the rise, with increasing prevalence year over year at a rate of approximately 2 percent annually. There are signs of a reduction in this type of cancer among children in recent years; however, the risk still remains and the results may be fatal. The Children’s Hospital of Philadelphia estimates that melanoma constitutes about 3 percent of all cancers in children. As it stands, children and adolescents are more likely to die of skin cancer than any other type of cancer. According to the National Cancer Institute, there are about 300 patients below the age of 20 diagnosed with melanoma every year. As children age, their risk of developing skin cancer spikes substantially, with the highest rates among adolescents aged 15 to 19. In addition, girls are much more likely to develop skin cancer than boys.
Notably, the signs of pediatric melanoma differ from the same type of cancer occurring in adults. As such, it is extremely important for dermatologists and other doctors to be aware of the unique presentation of childhood skin cancer, to thoroughly investigate suspicious moles and other possible indicators, and to accurately diagnose a child’s skin cancer in a timely manner. The silver lining is that early detection prevents 99% of fatalities from the disease.
Three Types of Skin Cancer Affecting Children
Melanoma is a skin cancer caused by sun exposure. It begins in the melanocytes, which give skin its color. Typically found on the face, arms, and legs, areas exposed to the sun, melanoma can spread if it is malignant. Those with lighter skin are at a slightly higher risk of getting this type of cancer. Pediatric melanoma has a unique presentation when compared with adult melanoma, with elements including: a bump, bleeding, a patch of skin without melanin, variable colors, different parts of the same mole, a mole that changes over time, or a mole that spans 6 millimeters or longer (although many times, moles are smaller than this).
On the other hand, basal cell carcinoma comes from the basal cells deep under the surface layer of the skin and is a slow-growing cancer that does not spread unless it is left untreated. It is also a cancer induced by sun exposure but appears on the nose and face or limbs as a light-colored bump, flat sore, or cut. It is the most common skin cancer. Basal cell carcinoma, like squamous cell carcinoma, is a non-melanoma skin cancer.
As the name suggests, squamous cell carcinoma originates from squamous cells in the outer layer of the skin, called the epidermis. It is commonly found on the hands and face, but it can also be found in the lining of the respiratory and digestive tracts. It often looks like a red bump or flat, scaly cut or sore. This type of cancer, too, is unlikely to spread when caught early. In fact, the survival rate for promptly-treated squamous cell carcinoma is almost 100 percent.
What Puts Children at Risk for Skin Cancer?
Since melanoma and non-melanoma skin cancers are more likely to appear on skin exposed to ultraviolet light, those out in the sun or otherwise exposed to ultraviolet light without protection, like sunscreen, are more likely to develop skin cancer. The Centers for Disease Control and Prevention cites light-haired, light-eyed people, those with numerous moles, and those with skin cancer in their family as more likely to get it. Children who use tanning beds during their teenage years are also at higher risk for skin cancer, as are those with a history of sunburns. Ultraviolet light damages cell production and chemicals that prevent the growth of tumors, which result from uncontrolled cell reproduction. Ultraviolet light interrupts the natural balance of cell reproduction and death. If your child takes immune system-suppressing medications, they are also more likely to develop melanoma or another type of skin cancer. HPV is yet another risk factor for pediatric skin cancer.
Recognizing the Signs of Pediatric Skin Cancer
If your child is especially at risk for skin cancer, beware of moles that change shape or color, bleed, itch, or swell. These may be signs of skin cancer in your child. Also noteworthy are new skin growths, raised red bumps, or reddish, dry skin patches. A normal mole looks roundish and symmetrical. When a mole loses its symmetry, meaning one half looks different than the other, it may be cancerous and it is important for a doctor to see it.
Another sign may be the mole’s uneven or faded border or its multi-colored brown, pink, or white shadings. Finally, a mole that grows larger than a couple of millimeters or becomes itchy, bloody, or sore needs screening. Non-melanoma types of skin cancer do not necessarily appear as moles. They may look like sores that do not heal or itchy, bleeding spots. Any painful or strikingly different moles on a young person’s body may indicate a possible issue.
Diagnostic Testing for Possible Skin Cancer in Children
A dermatologist can look at a pediatric patient’s skin and investigate to determine whether it is skin cancer, but a suspicious skin lesion or mole must be biopsied to be sure that it is cancer. Depending on the size and type of skin cancer, a doctor may be able to remove the whole thing and run tests for cancer. Once cancer is diagnosed, a dermatologist may run further imaging tests to see whether the cancer has spread to the lymph nodes, indicating the stage of cancer. Stage I is the most curable because it has not spread. Stage IV is the worst because it means the cancer has spread to other body parts.
What is Used to Treat a Child with Skin Cancer?
The different skin cancer types determine the treatment, as does the cancer’s stage at the time of diagnosis. For some children, a skin cancer diagnosis means surgery. A surgeon may use various surgical methods, including electrodesiccation and curettage (scraping and electrical staunching), Mohs surgery (removing cancer and surrounding healthy tissue), or surgical removal, depending on how deep the growth extends, among other factors. Squamous cells may be deep and require additional treatment, such as radiation and chemicals that kill cancer cells.
On the other hand, skin cancer that is isolated to the skin’s top layer may be shaved off in a procedure called shave excision, or frozen off through cryosurgery. Biological or immunotherapy is yet another option used to treat some pediatric skin cancers, essentially kicking up the child’s immune system to fight off the cancer itself. Other medicines may also be the treatment option of choice based on the child’s situation, cancer location, stage, and other factors.
Mistaken Diagnosis of a Child’s Skin Cancer May be a Matter of Life and Death
A quick diagnosis of a child’s skin cancer is often a matter of life and death. Thus, a delay in diagnosis and treatment can lead to a poor prognosis, meaning a prolonged, harsh treatment to remove and destroy the cancer at an advanced stage. Skin cancer can spread to other parts of the body, such as the organs, which makes it more challenging to treat. So, delaying diagnosis may limit treatment options when cancer spreads in time.
Failure to diagnose is another reason for skin cancer progression in pediatric patients, particularly because the condition is relatively rare and may not be expected at the outset. A physician may look at a child with dark hair, dark skin, and no family history of skin cancer, ruling out the possibility of skin cancer without further testing. Also, if a child’s medical chart is not comprehensive or incomplete, the assumption that no family history of skin cancer exists may be erroneous. A doctor may also make a grave mistake by failing to refer a child to a specialist for further examination of a suspicious mole or skin patch.
Misdiagnosis is another dangerous problem in children affected by skin cancer. For example, a parent may bring their child to their doctor for a scaly, dry, itchy patch on their arm, and the physician diagnoses eczema, sending the child home with topical cream. When the eczema does not clear up with the cream, the parent may return to their child’s doctor, and only then the child undergoes cancer screening. By then, it may be too late. Moreover, the treatment approach is different based on the type of skin cancer. Thus, a pediatric patient may receive the wrong or unnecessary treatment, further threatening their health and their life.
Other negligent actions that may be considered medical malpractice include incompetently reading diagnostic tests leading to cancer misdiagnosis. A pathologist may be the one who is primarily negligent when they misread biopsy results or interpret them improperly, causing a delay in the true diagnosis of melanoma, basal cell, or squamous cell carcinoma. Likewise, a knowledgeable physician should ensure that the biopsy results come from a pathologist qualified to detect skin cancer from abnormal skin samples. If not, they may be similarly liable.
If my Child’s Skin Cancer was Not Diagnosed Properly in NJ, What Should I do?
If your child received an incorrect diagnosis, delayed diagnosis, or missed diagnosis of skin cancer due to a physician’s negligent practices, you may be the victim of medical malpractice and eligible for compensation. Dermatologists, pathologists, and other physicians may be subject to pediatric malpractice lawsuits when they fail to adhere to the acceptable standards of medical care and your child suffers injuries. Not every case of pediatric skin cancer leads to an actionable medical malpractice or wrongful death lawsuit, but some do, which is why it is so important to have your child’s case reviewed by a seasoned attorney who can identify signs that a medical professional breached their duty of care.
As parents, we expect our children’s doctors to safeguard them against unnecessary injury. And yet, harm does come to innocent children and adolescents on a far too common basis. When their lives are hanging in the balance, as is the case with pediatric skin cancer, the cost of negligence is just too high. To speak with an attorney about your legal options following diagnostic errors with a child’s melanoma, basal cell, or squamous cell carcinoma, contact our New Jersey legal team. We offer free consultations by filling out the convenient form on our website or calling 866-708-8617.
