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Skin Cancer
Skin cancer occurs when skin cells start growing abnormally, causing cancerous growths.
Most skin cancers develop on the visible outer layer of the skin (the epidermis), particularly in sun-exposed areas (face, head, hands, arms, and legs). They are usually easy to detect by examining the skin, which increases the chances of early treatment and survival.
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What Types of Skin Cancer Are There?
There are different types of skin cancer, each named for the type of skin cell from which they originated. The majority of skin cancers fall into one of the following categories:
Basal cell carcinoma (also called BCC) comes from the basal cells in lowest part of the epidermis. 80-85% percent of skin cancers are BCCs.
Squamous cell carcinoma (also called SCC) comes from the skin cells (keratinocytes) that make up the top layers of the skin. About 10% of skin cancers are SCC.
Melanoma comes from skin cells called melanocytes, which create pigment called melanin that gives skin its color. 5% of all skin cancers are melanoma. Although less common, it is a very dangerous type of skin cancer and is the leading cause of death from skin disease.
Basal cell and squamous cell carcinoma are sometimes referred to as "non-melanoma skin cancer" to distinguish them from melanoma
Skin cancer is considered low risk when the affected cells remain clustered in a single group. It is considered high risk when the cells have invaded surrounding tissues. High risk forms of cancer require more aggressive treatments.
Almost all skin cancers start as a small, low-risk lesions, but can grow and become high-risk lesions if left untreated. Melanoma is the most alarming type because it has a higher risk of invading surrounding tissues or spreading to other parts of the body (metastasis) before being detected. Squamous cell and basal cell skin cancer are more likely to be detected and treated effectively before they become malignant.
If skin cancer is detected before it has spread to surrounding tissues, chances of a complete cure are excellent.
What Are Pre-Cancers?
Skin cancer may often be preceded by lesions called pre-cancers. The most well-known of these are actinic keratoses (AKs). AKs are considered an early form of squamous cell carcinoma.
AKs, a new or changing mole (nevi), and other unusual lesions on your skin should be carefully monitored and brought to the attention of your doctor.
How Is Skin Cancer Treated?
Diagnosing cancer usually requires a biopsy. A small piece of skin is removed for examination under a microscope and evaluated with other tests.
A treatment plan will be recommended based on several factors:
The type of cancer
The size of the cancer—treatments that may be effective for small cancers may not be optimal for larger cancers
The extent of the cancer (localized to one area vs. spreading to surrounding tissues)
The location of the cancer (face vs. arm)
The number of lesions
Your past history and family history of skin cancers
In general, the treatment plan is based on the risk of the cancer spreading to another location or growing again (recurring) in the same location. Cancers that are likely to spread or recur are treated more aggressively.
Treatment options include:
Medications
Aldara (imiquimod)
5-fluorouracil (Efudex, Carac)
Procedures
Cryosurgery—A small amount of liquid nitrogen is used to "freeze" away the lesion.
Curettage-electrodessication—The tumor is scraped off using a sharp-edged device called a curette. The surrounding skin is then cauterized (heated) to prevent bleeding and further remove the tumor.
Excision—The tumor is surgically removed along with a small portion of surrounding skin. This usually requires stitches to control bleeding and close the wound.
Mohs surgery—A specialized surgery that removes the tumor in stages. Each portion of removed tissue is examined under a microscope to make sure that cancerous cells have been removed while sparing as much normal skin as possible.
Moles
Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups.
Most moles appear in early childhood and during the first 20 years of a person's life. Some moles may not appear until later in life. It is normal to have between 10-40 moles by adulthood.
As the years pass, moles usually change slowly, becoming raised and/or changing color. Often, hairs develop on the mole. Some moles may not change at all, while others may slowly disappear over time.
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