Skin Cancer

See Melanoma for more information

What does skin cancer look like?

I am going to describe the more common skin cancers: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and Melanoma. These cancers tend to start out subtly. Don’t let yourself get fooled, rather recognize the signs and symptoms and get checked.

BCC, the most common form of skin cancer, is often found on the face, especially the nose, cheeks and forehead. They tend to range from ¼ inch to a number of inches in diameter. You can often notice a pearlescent, raised up outer edge with a depressed scabbed center, much like an ulceration. BCC often makes quite a deep hole, more than you might expect. If you have an abnormality on your skin, get it checked, be sure. Generally, if caught early, SCC and BCC can be easily cured. Some people wait and then wind up requiring large surgical procedures to remove an advanced cancer. BCCs are the least likely to spread, but that doesn’t mean they won’t and they certainly can make for a very deep skin problem. Don’t be a waiter.

SCC, the second most common form of skin cancer, usually starts as a small patch of pink skin, which may be a little scaly. It may be small such as ¼ inch or it may be inches in size. Areas most often affected are those that see the sun such as the face, neck, back chest, arms and legs. Often people find that there may be a scaly surface, which they mistake for a scrape. This scale may fall off and for a little while one might imagine that the area is better. However, the pink area doesn’t go away. The edges are usually irregular. I am not going to give you all kinds of additional details, but rather say that if you have a suspicious area, you should be seen by a physician who is familiar with the diagnosis and treatment of skin cancer. Squamous Cell Carcinomas can metastasize and thousands of people die from this cancer every year. The good news is that caught early, it is usually easily treated.

What causes skin cancer?

Frequent or excessive sun exposure results in the skin receiving levels of UV radiation that it cannot protect against. These UV rays damage DNA in the nucleus of the skin cells and transform normal cells into cancerous cells. For example, it has been found that sun induced mutations are present in over 90% of all BCCs.

Fortunately, the skin has a repair mechanism that is constantly trying to repair the DNA, however, occasionally the damage cannot be repaired or a mistake is made during the repair process and the result is a mutation which can be cancer. Additionally, UV radiation also suppresses the immune systems ability to fight skin cancer.

Sun exposure is dangerous. Tanning salon exposure is also dangerous. That means that exposure is putting you at an increased risk of skin cancer. People with fair skin (e.g. blue eyes, blond or red hair) have especially sensitive skin. We have seen many people who remember getting one significant burn at the beach 30 or 40 years ago. And now they have lots of skin cancers.

How can you avoid getting skin cancers?

Prevention of skin cancers depends on preventing the genetic mutations that lead to the cancer. We know that sun exposure leads to DNA breakage and increases the chance of mutations. Therefore, avoid sun exposure, especially during the brightest part of the day. You don’t even have to see reddened skin in order to be sustaining damage from the suns rays. Cover exposed areas of the skin when you are outside and use skin care products with high levels of SPF (such as 30 and up). Do not use tanning salons. This is good advice for everyone and crucial for those with fair skin or a family history of skin cancer. Another important key to the prevention of skin cancer is screening. This should be a combination of careful self-examination and getting your skin checked for precancerous or suspicious areas by a physician. In this way, if something requiring attention is discovered, you can receive early, simple treatment, thereby avoiding cancer.

Treatment

The treatment for skin cancers needs to be individualized and treatments for BCC and SCC may include: surgical excision, shave excision with curettage and desiccation, Mohs Surgery, cryosurgery, radiation, intralesional injections (interferon, 5-fluorouracil), chemotherapy, electrochemotherapy with Bleomycin, Phytodynamic therapy.