Skin cancer is the most common form of cancer in the United States. More than 500,000 new cases are reported each year—and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80 percent appear on the face, head, or neck, where they can be disfiguring as well as dangerous.
The primary cause of skin cancer is ultraviolet radiation exposure from the sun and artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities, and the thinning of the earth’s protective ozone layer are behind the alarming rise we’re now seeing in skin cancers.
Anyone can get skin cancer—no matter what your skin type, race or age, no matter where you live or what you do. But your risk increases if:
Your skin is fair and freckles easily.
You have light-colored hair and eyes.
You have many moles or moles of unusual size or shape.
You have a family history of skin cancer or a personal history of blistering sunburn.
You spend a lot of time working or playing outdoors.
You live closer to the equator, at a higher altitude, or in any place that gets intense, year-round sunshine.
You received therapeutic radiation treatments for adolescent acne.
Types of skin cancer
Basal cell carcinoma is the most common type of skin cancer. Fortunately, it’s also the least dangerous as it tends to grow slowly and rarely spreads beyond its original site. Though it is seldom life-threatening, it can grow deep beneath the skin and into the underlying tissue and bone, causing severe damage.
Squamous cell carcinoma is the second most common type of skin cancer and frequently appears on the lips, face, or ears. Sometimes it can spread to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life-threatening if it’s not treated.
Malignant melanoma is the least common form of skin cancer, but its incidence is increasing rapidly, especially in the Sunbelt states. It is also the most dangerous type of skin cancer. If discovered early enough, it can be completely cured. If it’s not treated quickly, however, malignant melanoma can spread throughout the body and may be deadly.
Other Skin Growths to Watch
Two other common types of skin growths are moles and keratoses. Moles are clusters of heavily pigmented skin cells and can be flat or raised above the skin surface. Most pose no danger, but some like large moles present at birth or those with mottled colors and poorly defined borders may develop into malignant melanoma. Moles are frequently removed for cosmetic reasons or because they’re constantly irritated by clothing or jewelry (which can sometimes cause pre-cancerous changes). Solar or actinic keratoses are rough, red, brown, scaly patches on the skin. They are usually found on areas exposed to the sun and sometimes develop into squamous cell cancer.
Recognizing Skin Cancer
Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white, or pink nodule or bumps or it can be smooth and shiny, waxy, or pitted on the surface. It might also look like a red, scaly, rough, dry spot a firm, or a red lump that may form a crust. Sometimes they look like a crusted group of nodules, a sore that bleeds or doesn’t heal after two to four weeks, or a white patch that looks like scar tissue.
Malignant melanoma is usually signaled by a change in the size, shape, or color of an existing mole, or as a new growth on healthy skin. Watch for the “ABCD” warning signs of melanoma:
Asymmetry—a growth with unmatched halves
Border irregularity—ragged or blurred edges
Color—a mottled appearance, with shades of tan, brown, and black, sometimes mixed with red, white, or blue
Diameter—a growth more than 6 millimeters across (about the size of a pencil eraser), or any unusual increase in size.
If all these variables sound confusing, the most important thing to remember is this: Get to know your skin and examine it regularly, from the top of your head to the soles of your feet. (Don’t forget your back.) If you notice any unusual changes on any part of your body, have a doctor check it out.
Diagnosis and Treatment
Skin cancer is diagnosed by removing all or part of the growth and examining its cells under a microscope. It can be treated by many methods, depending on the type of cancer, its stage of growth, and its location on your body. Small skin cancers can often be excised quickly and easily in our office.
Most skin cancers are removed surgically. If the cancer is small, the procedure can be done quickly and easily, in an outpatient facility or the physician’s office, using local anesthesia. The procedure may be a simple excision, which usually leaves a thin, barely visible scar. Or curettage and desiccation may be performed. In this procedure, the cancer is scraped out with an electric current to control bleeding and kill any remaining cancer cells. This leaves a slightly larger, white scar. In either case, the risks accompanying surgery are low.
If the cancer is significant, however, or if it has spread to the lymph glands or elsewhere in the body, major surgery may be required. Other possible treatments for skin cancer include cryosurgery (freezing the cancer cells), radiation therapy (using x-rays), topical chemotherapy (anti-cancer drugs applied to the skin), and Mohs surgery, a special procedure in which the cancer is shaved off one layer at a time. Mohs surgery is performed only by specially trained physicians and often requires a reconstructive procedure as a follow-up.