Skin Cancer Types
Every year more people are diagnosed with skin cancer than all other cancers combined. Skin cancer commonly occurs on sun-exposed skin. Those at highest risk are fair-skinned individuals and those who spend a significant time in the sun for work or outdoor activities. Better prognoses result from early skin cancer diagnosis and treatment.
The most common types of skin cancer
There are two main categories of the most common types of skin cancer: melanoma and nonmelanoma skin cancers (NMSC). There are two types of NMSCs: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Approximately 80% of skin cancers are BCC,16% are SCC, and 4% are melanomas. At least one in five Americans will develop skin cancer by age 70.
What causes skin cancer?
- 90% of nonmelanoma skin cancer, and 86% of melanomas are associated with UV radiation.
- More people develop skin cancer from indoor tanning than lung cancer from smoking.
- Indoor tanning is responsible for about 6200 cases of melanoma.
- 5 or more sunburns double the risk for developing melanoma.
- Just one blistering sunburn in childhood or adolescence more than doubles the lifetime risk of developing melanoma.
Diagnosis of skin cancer
Board certified dermatologists are formally trained to identify skin lesions that are highly suspicious for skin cancer. They are also trained to use various devices to aid in the diagnosis of skin cancer, such as, using an instrument called a dermatoscope. A dermatoscope allows the dermatologist to see features of the skin lesion that are not viewable with the naked eye, such as, blood vessels and various colors. When the dermatologist suspects skin cancer, the physician will take a biopsy. The biopsy is reviewed by a board certified dermatopathologist to determine the type and staging of skin cancer.
Types of skin cancer
The deadliest form of skin cancer is malignant melanoma. It is a result of the overgrowth and mutation of skin cells called melanocytes. Melanocytes produce melanin, which gives color to skin. It is malignant and invades deep into the skin, other vital structures, and spreads to other parts of the body. Because there are melanocytes in all skin and other vital organs, melanoma can be found in the eyes and also under the finger and toenails. 7% of new cancer cases in men, and 5% of new cancer cases in women are melanomas. Men are more likely to develop melanoma on the chest and back, while women are more likely to develop melanoma on the legs. The majority of people who develop melanoma are white men over the age of 55. However, all individuals including skin of color can develop melanoma. Furthermore, only 20-30% of melanomas are found in existing moles. Melanoma most commonly occurs as a new skin spot.
Risk factors for melanoma
- UV radiation from the sun
- A family history of melanoma
- Pale skin and light-colored hair and eyes
- High number of moles
The ABCDE’s of melanoma:
- Asymmetric: normal moles are symmetric, one side looks like the other side, but melanomas do not follow this pattern.
- Borders: melanomas have irregular borders. They can be jagged, notched or blurred. Normal moles have round borders.
- Color: melanomas usually include more than one color including black, brown, tan, white and blue.
- Diameter: melanomas tend to be larger than a pencil eraser or normal mole.
- Evolving: melanoma changes appearance overtime. This is an important red-flag to alert your dermatologist.
When the diagnosis is made the tumor is staged to determine the aggressiveness of the tumor. Stage 0 means it is in the outermost layer of the skin.
- Stage 0 means it is in the most superficial layer of the skin.
- Stage I means it is thicker (up to 2MM), may be ulcerated but has not spread.
- Stage II means the cancer is thicker (greater than 2MM), may be ulcerated but has not spread.
- Stage III means the cancer has spread to the lymph nodes.
- Stage IV means the cancer has spread to other organs or metastasized.
Treatment depends on the stage of the tumor. Complete surgical removal is the goal. Mohs surgery is a technique that removes the lesion and leaves as much normal tissue as possible so as to avoid disfigurement.
Basal cell carcinoma (BCC)
BCC is a slow-growing skin cancer that almost never spreads to other parts of the body. However, BCC continues to grow and invade and destroy local tissue. Those at risk are fair-skinned individuals with significant amounts of sun exposure. BCC most commonly develops on the face, nose, chest, neck and back of the hands. BCC appear as small, shiny bumps that slowly enlarge. They can break open, bleed and form a scab or look like a scar. Early diagnosis and treatment can reduce the risk that BCC can grow deep and destroy tissue and bone. Mohs surgery is often recommended to spare healthy tissues and prevent disfigurement.
Squamous cell carcinoma (SCC)
SCC is also caused by years of sun exposure that most commonly affects light-skinned individuals. It can appear anywhere including the mouth, lips and genitals. SCC most commonly presents on sun-exposed skin. SCC appears as firm, red bumps, scaly patches, or a sore that won’t heal. SCC has potential to spread to other parts of the body and be fatal. When caught early SCC can be cured. Surgery or Mohs surgery is the treatment of choice, but may include topical chemotherapy drugs, and at times radiation therapy may be recommended.
Contact Dr. Rachel White to receive the correct diagnosis and treatment. She is a kind, compassionate expert in skin cancer and skin cancer surgery.