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General Dermatology

Skin Cancers

Most often caused by overexposure to the sun, skin cancer is an abnormal growth of cells that can occur on any area of the body. Skin cancer, one of the most common forms of cancer, affects more than one million Americans each year. Skin cancer is usually very treatable with high cure rates as long as it is detected early. Once you have skin cancer, your chances for developing it again increase significantly, so self examinations and routine doctor visits are critical components of recovery.

The top layer of your skin, the epidermis, provides a protective layer of skin cells that your body continually sheds. These cells typically develop and slough off in an orderly fashion, a process controlled by DNA. When the DNA sustains damage, often from the sun, changes occur in the process and new cells can grow out of control, forming a mass of cancer cells. UVA and UVB rays produced by the sun cause the most damage to the skin, but other factors, such as heredity and toxic chemicals, can contribute to the development of skin cancer.


Basal Cell Carcinoma

Basal cell carcinoma, a type of nonmelanoma skin cancer, is the most common form of cancer in the United States. Seventy-five percent of all skin cancers are basal cell carcinomas. Basal cell carcinoma starts in the top layer of the skin called the epidermis. A new skin growth that bleeds easily or does not heal well may suggest basal cell carcinoma. Symptoms may include a skin bump or growth that is:
  • Pearly or waxy
  • White or light pink
  • Flesh-colored or brown

Other possible symptoms of basal cell carcinoma include:
  • A skin sore that bleeds easily
  • A sore that does not heal
  • Oozing or crusting spots in a sore Appearance of a scar-like sore without having injured the area
  • Irregular blood vessels in or around the spot
  • A sore with a depressed (sunken) area in the middle

The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation. Basal cell skin cancer progresses slowly and almost never spreads to other areas of the body (metastasize). However, if left untreated, it may grow into surrounding areas and nearby tissues and bone.


Squamous Cell Carcinoma

Squamous cell cancer may occur in normal skin or in skin that has been injured or inflamed. Most skin cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation.

The earliest form of squamous cell skin cancer is called Bowen’s disease (or squamous cell in-situ). This type of squamous cell carcinoma is in the epidermis (top layer of the skin) and has not yet invaded into the dermis (deeper layer of skin). Squamous cell carcinoma is the 2nd most common type of skin cancer. Each year in the United States, over 250,000 cases of invasive squamous cell carcinomas are diagnosed. About 65% of squamous cell carcinomas occur on the head and neck. Currently it is estimated that 1 in every 5 Americans will develop a skin cancer during their lifetime; many of which are squamous cell carcinoma.

Actinic Keratosis is a precancerous skin lesion that may become a squamous cell cancer if left untreated. Approximately 10% of actinic keratosis will develop into a squamous cell carcinoma if not treated.

Risks for squamous cell skin cancer include:
  • Having light-colored skin, blue or green eyes, and blond or red hair
  • Long-term, daily sun exposure (such as in people who work outside)
  • Older age
  • Radiation exposure
  • Chemical exposure
  • Burns or large scars

If your doctor finds cancer, or precancerous cells known as actinic keratoses, therapy will depend on the depth, size, type and location of the lesions. Usually, skin cancer removal requires only a local anesthetic and can be performed as an outpatient procedure. Often removal of the affected area is all that is needed.

Treatment options include:

  • Excisional surgery to cut out the cancerous tissue with a margin of healthy skin
  • Laser therapy to vaporize the growth
  • Mohs surgery to remove larger, recurring or difficult-to-treat skin cancers
  • Radiation therapy for areas where surgery is not advisable
  • Chemotherapy when skin cancer spreads to other areas

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.


The ABCDE's of Melanoma

The American Academy of Dermatology's ABCDEs uses this guide to access whether or not a mole may be becoming cancerous. If you see one or more of these, make an appointment with a dermatologist..
  • 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 one of our dermatologists right away. The doctor may do a biopsy of the mole to determine if it is or isn't cancerous.

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