Skin Cancer

Skin cancer is the most common form of cancer. More than 9,500 people are diagnosed with skin cancer every day. Yet it’s also one of the most treatable forms of cancer. With early detection and proper care, even melanoma has a five-year survival rate in the high 90 percentiles. Download our Skin Cancer Self-Exam Checklist as a first step if you have concerns about skin cancer.

Considering the importance of early detection, it’s crucial to understand what skin cancer is, what it looks like, and what you need to do if you suspect that you may be at risk.

Skin cancer is characterized by abnormal, excessive growth of skin cells in the outer layer of the skin (epidermis). It occurs most often on areas of skin that are frequently exposed to the sun. However, skin cancer can affect any area of skin on the body.

Each type of skin cancer is named for the type of cells where the cancer begins. There are three major types of skin cancer:

Named for the cells in the bottom layer of the epidermis, basal cell carcinoma is the most common type of skin cancer tumor. It is the least dangerous of the three common types. Because they grow very slowly, it is rare for BCC to spread or metastasize.

Named for the cells that are in the middle layer of your skin, squamous cell carcinoma is less common but more dangerous. If left untreated, squamous cell carcinomas may cause significant disfigurement. Although squamous cell carcinomas may spread to other parts of your body, they are rarely fatal when treated promptly.

Melanoma is named for the melanocyte cells that create the pigment that gives skin its color. This is the rarest of the three main types of skin cancer, but it is the most likely to spread to other parts of your body. Melanoma is the most dangerous type of skin cancer and can be fatal.

While most skin cancers fall into one of the three categories above, there are other, more rare skin cancers. These include:

This rare cancer is named for the cells which give the skin its sense of touch. It is more common in those over 50 with a compromised immune system. It usually occurs on areas like the face and scalp.

This cancer occurs most often in those with a compromised immune system, especially patients with HIV. It is caused by human herpesvirus 8 and may occur as tumors or lesions on the skin. Another type of Kaposi’s sarcoma occurs in older men of Eastern European, Mediterranean, and Middle Eastern descent. Known as classic Kaposi’s sarcoma, this cancer progresses slowly and typically causes few serious problems.

A type of non-Hodgkin lymphoma, this usually occurs in the lymph nodes and may appear as a rash.

These pre-cancerous growths can grow into squamous cell carcinoma if left untreated. They are the result of UV radiation damage.

This very rare cancer is named for the oil glands of the skin in which it occurs. It most often occurs in women over 70 around the eyes.

This is another rare cancer that occurs in the middle layer of the skin. It may appear as a hard bump that does not grow or spread.

KA’s are common, rapidly growing, locally destructive skin tumours.  KAs may regress spontaneously with scarring, but clinically they may be indistinguishable from well-differentiated squamous cell carcinoma (SCC) and the clinical course may be unpredictable. Thus, many clinicians and pathologists prefer the term SCC, KA-type, and recommend surgical excision.

Warning signs of skin cancer can include:

• Translucent or shiny bump
• Itchy, raised patch of skin
• Open sores that do not heal
• Wart-like growth
• Scaly red patches
• Mole larger than 6mm
• Skin that oozes or bleeds easily

To identify skin cancer early, it’s important to regularly check the skin. Look for new or abnormal growths, as well as any changes in the size, shape, or color of moles or skin growths. Skin cancer is most likely to occur in areas exposed to the sun, like the face, neck, arms, legs, and trunk. However, it can occur anywhere, so do not overlook other areas of the skin.

Cancer forms when the DNA in your skin cells becomes damaged. As those cancer cells grow and spread, they can metastasize, or affect other areas of the body.

Skin cancer is the typical result of one of three causes:

• Exposure to harmful substances, such as UV radiation from the sun or tanning beds
• Genetic mutations inherited from your parents
• Random defects in the cell reproduction process

Scientists believe that exposure to ultraviolet (UV) radiation is felt to be the cause of the majority of skin cancer cases. UV radiation is another name for the light and heat created by the sun or indoor tanning lamps.

Exposure to the sun or tanning lamps increases the risk of all types of skin cancer. People who experience prolonged exposure to UV radiation during childhood, particularly if they experience severe sunburns, are thought to be more likely to develop melanomas and basal cell carcinomas later in life.

Some people are more likely to develop skin cancer than others. Doctors have collected and studied data about the genetic characteristics, environmental influences, and lifestyle choices of skin cancer patients over many years. This has allowed them to identify certain factors that are common among people who have developed the disease.

While some of these factors have not been proven to cause skin cancer, each has a correlation with a significant number of people with skin cancer.

• Fair or light skin color
• A family history of skin cancer
• A personal history of skin cancer
• Skin that burns or becomes painful in the sun
• Skin that reddens or becomes freckled in the sun
• Blue or green eyes
• Blond or red hair
• Tendency to develop abnormal moles

• A history of severe sunburns, especially during childhood or adolescence
• Excessive sun exposure, even if the skin does not blister
• Tanning, either indoor or outdoor
• Living at high altitude climates
• Living in warm, sunny climates
• Exposure to certain chemicals, such as coal tar, arsenic, and paraffin
• Exposure to radiation
• A weakened immune system

If you suspect you may have developed skin cancer, you should schedule an appointment with your dermatologist. The sooner you diagnose your skin cancer, the less invasive the treatment will be and the better your prognosis.

Your doctor will first visually examine your skin. Depending on the appearance, texture, and other factors, your doctor will decide if further testing is necessary.

If your doctor suspects you have skin cancer, they will likely perform a biopsy. In a biopsy, your doctor removes the affected skin for testing. Testing will indicate if the skin is cancerous and, if so, what kind of cancer it is.

If the skin is cancerous, the biopsy may be treatment enough. However, with certain cancers, such as Merkel cell carcinoma or melanoma, your doctor may recommend further testing to determine its stage.

Doctors use stages to understand the extent of the cancer. Staging helps your care team to understand where your cancer is and how it has spread, how they should treat it, and the prognosis.

The stages of skin cancer range from zero to four. The more the cancer has spread, the higher the number. Stage zero indicates abnormal cells that may turn into cancer. With stage four cancer, on the other hand, the cancer has spread to other areas of the body.

Skin cancers are rarely assigned stages because they are usually treated before they spread. This is almost always the case with basal cell skin cancer and usually the case with squamous cell skin cancer.

However, there are exceptions. When squamous or basal cell skin cancers are staged, the following scale is used:

Of the three common cancer treatment options, your cancer team may recommend one or more of the following.

Radiation therapy for non-melanoma skin cancer is an effective alternative to surgery. This type of treatment has minimal side effects or scarring and heals quickly.

Surgery is a common skin cancer treatment. Several factors will determine if surgery is the best treatment, including where the cancer is, skin cancer type, and its size.

Chemotherapy may be used to treat advanced stages of melanoma. This type of treatment is usually not the first choice of treatment for this or other types of skin cancer.

Radiation therapy is considered an effective cancer treatment for most non-melanoma skin cancer, including basal cell and squamous cell cancers.

Radiation therapy works by directing forms of radiation, including X-rays or electrons, onto the areas of the skin affected by cancer. This type of radiation is emitted from a machine positioned outside the body. The radiation doesn’t penetrate very deep beneath the skin.

According to the American Cancer Society, radiation is effective enough to be considered a cure for most small basal and squamous cell skin cancers.

It may be recommended as the primary type of cancer treatment in cases in which the skin cancer covers a large area.

It is also recommended when the cancer is in a hard-to-reach area that would be difficult to treat with surgery.

In advanced skin cancer cases, radiation therapy may prevent or slow the growth of tumors.

It may also be used after surgery as an additional (adjuvant) treatment to kill remaining cancer cells.

Radiation therapy is also an option for those who have skin cancer that’s spread to their lymph nodes or other areas of the body.

You should visit a dermatologist annually for a full-body skin cancer screening. This is of particular importance if you identify with any of the risk factors outlined above.

However, you can—and should—screen for skin cancer at home even more regularly. A skin cancer self-exam involves self-examining your skin for any changes, abnormal marks or moles, and other indicators of skin cancer.

If you do notice any changes or abnormal areas of your skin during a screening at home, you should schedule an appointment with your dermatologist.

Regular screenings, both at home and at your dermatologist, are vital for skin health. Doing so allows for effective treatment of any skin cancer that may develop before it spreads.

If you’re interested in radiation therapy as a method for skin cancer treatment, contact the board-certified oncologists in Charlotte at SERO today. With cancer treatment centers in Charlotte, NC and surrounding locations, we are proud to serve individuals from across the Southeast.