Patient Education

Skin Cancers

Skin cancer is the most common form of human cancers, affecting more than one million Americans every year. One in five Americans will develop skin cancer at some point in their lives. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.

The vast majority of skin cancers are composed of three different types: basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal Cell Carcinoma (BCC)

This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to solar radiation, it damages the body's natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread).

Basal cell carcinomas can present in a number of different ways:​​

  • Translucent, pearly and dome-shaped growths.
  • A sore that repeatedly heals and re-opens.
  • A thin, scaly pink patch.

Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.

Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

Diagnosing basal cell carcinoma requires a biopsy.

Treatments for basal cell carcinoma include:

  • Cryosurgery — Some basal cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
  • Curettage and Desiccation — A good preferred method for Superficial Basal Cell Carcinoma, this treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
  • Mohs Micrographic Surgery — The preferred method for facial tumors, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor and the best cure rates are obtained.
  • Prescription Medicated Creams — These creams can be applied at home. They stimulate the body's natural immune system over the course of weeks. Creams are only used for Superficial BCC.
  • Radiation Therapy — Not an ideal treatment. Radiation therapy is only used for difficult-to-treat tumors, either because of their location, severity or persistence.
  • Surgical Excision — In this treatment the tumor is surgically removed and sutured. A very common treatment.

Squamous Cell Carcinoma (SCC)

Squamous cells are found in the upper layer (the surface) of the epidermis. They look like fish scales under a microscope. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.

Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. Like basal cell carcinoma, squamous cell carcinoma is diagnosed via a biopsy.

Squamous cell carcinomas can present in a number of different ways:

  • A sore or ulcer that repeatedly heals and re-opens.
  • Clusters of slow-growing scaly lesions that are red or pink.
  • A firm bump.
  • Squamous cell carcinomas are most often reddish in color

Treatments for squamous cell carcinoma and squamous cell carcinoma in-situ include:

  • Cryosurgery — Some in-situ Squamous cell carcinomas respond to cryosurgery, where liquid nitrogen is used to freeze off the tumor.
  • Curettage and Desiccation — A common method of treatment for SCC in-situ. This treatment involves using a small metal instrument (called a curette) to scrape out the tumor along with an application of an electric current into the tissue to kill off any remaining cancer cells.
  • Mohs Micrographic Surgery — The preferred method for facial tumors, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor, and the best cure rates are obtained.
  • Prescription Medicated Creams — These creams can be applied at home. They stimulate the body's natural immune system over the course of weeks. Creams are only used for SCC in-situ.
  • Radiation Therapy — Not an ideal treatment. Radiation therapy is used for difficult-to-treat tumors, either because of their location, severity or persistence.
  • Surgical Excision — In this treatment the tumor is surgically removed and sutured. A very common treatment.

In some cases, squamous cell carcinoma evolves from actinic keratoses. These spots are considered the earliest stage in the development of skin cancer and are usually seen on fair skinned people who have had sun exposure, typically after age 40. Actinic keratoses are dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery.  Because Actinic keratoses increase the risk of getting squamous cell carcinoma, actinic keratoses are usually treated. Proper sun protection can help prevent actinic keratoses.

Melanoma

While melanoma is the least common type of skin cancer, it is by far the most deadly. It is the most common form of cancer among young adults age 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for skin pigmentation. That's why melanomas often present as dark brown or black spots on the skin. Melanomas spread rapidly to internal organs and the lymph system, making them quite dangerous. Early detection is critical for curing this skin cancer.

Melanomas look like moles and often do grow inside existing moles. That's why it is important for people to conduct regular self-examinations of their skin in order to detect any potential skin cancer early, when it is treatable. Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.

Melanoma is diagnosed via a biopsy. Treatments include surgical removal, radiation therapy, sometimes lymph node staging, immunotherapy, chemotherapy and study trials.

What to Look For

The key to detecting melanoma is to notice changes in your skin. Look for:

  • Large brown spots with darker speckles located anywhere on the body.
  • Dark lesions, anywhere, including on the palms of the hands and soles of the feet, fingertips toes, mouth, nose or genitalia.
  • Existing moles that begin to grow, change color, itch or bleed.
  • Brown or black streaks under the nails.

The American Academy of Dermatology has developed the following ABCDE guide for assessing whether or not a mole or other lesion may be becoming cancerous:

Asymmetry: Half the mole does not match the other half in size, shape or color.

Border: The edges of moles are irregular, scalloped, or poorly defined.

Color: The mole is not the same color throughout.

Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller.

Evolving: A mole or skin lesion that is different from the rest, or changes in size, shape, or color.

If any of these conditions occur, please make an appointment to see a dermatologist right away. The doctor may do a biopsy of the mole to determine if it is or isn't cancerous.

For more information, contact us or call 618.288.9450 today.

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