Skin Cancer: Frequently Asked Questions
- What are the most common skin cancers?
- What are the warning signs of skin cancer?
- What are the treatments for skin cancer?
- Is skin cancer becoming more common? What are some of the risk factors?
- What can we do to protect ourselves from the sun?
A. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma (both are often grouped in non-melanoma skin cancers) and melanoma.
- Basal cell carcinoma (BCC) is usually found on the sun-exposed areas of the skin, such as the face, scalp, ears, arms and torso. It rarely spreads to other parts of the body, but can be locally destructive. BCCs are the most common form of skin cancer, with more than a million new cases diagnosed in this country each year.
- Squamous cell carcinoma (SCC) begins in the uppermost layers of the skin and is most commonly a result of lifelong sun exposure. A small percentage of SCCs have the potential to spread to other areas of the body. SCCs are the second most common skin cancer, with hundreds of thousands of new cases diagnosed in this country each year.
- Melanoma develops in the cells that make pigment in the skin. It is the most serious type of skin cancer. Melanoma can spread quickly through lymph nodes and to the internal organs but when diagnosed and treated early has a high cure rate. Melanoma is the most common form of cancer for adults between 25-29 years old. More than 100,000 new melanoma cases and close to 9,000 related deaths -- were reported in the US in 2011.
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A. Because skin cancers are caused by the uncontrolled growth of skin cells, the first presentation is usually a visible change in a person's skin. Consult a trained physician immediately if you observe any of these warning signs associated with common skin cancers:
- Basal cell carcinoma - shiny nodule or pimple, a sore that won't heal, a scar-like area or rough red patches.
- Squamous cell carcinoma- crusted red nodules (typically on sun-exposed skin but can also occur inside the mouth or the genitalia).
- Melanoma - a growing mole that changes shape, color or size; a mole that bleeds or is painful; a new "mole" that grows rapidly; a dark streak or black discoloration of the fingernail.
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A. Non-melanoma skin cancers are some of the most treatable cancers. When melanoma is caught and treated early (before it spreads to the lymph nodes), it is also highly curable. The goal of treatment for skin cancer is to remove, or excise, all of the cancer. Typically, the first line therapies are surgical. Non-surgical treatments may be an option in some cases.
The type of surgical treatment used depends on the type, size, depth and location of the tumor. In most cases, the procedure is done on an outpatient basis. The most common surgical procedures to remove cancerous areas of the skin are:
- Mohs micrographic surgery - a "stepwise" excision performed by a dermatologist with special training in the procedure. Thin layers of skin are removed in stages and examined under a microscope for the presence of cancer cells. The process is repeated until no cancer cells remain. Mohs is used for certain types of skin cancer on the head, neck, feet and genitalia. It offers the highest cure rates (up to 99 percent for certain skin cancers) and leads to the best possible cosmetic result.
- Standard excision - the skin cancer is excised along with a standard amount of normal appearing skin. This may be used for melanoma and small non-melanoma skin cancers on the torso and extremities.
- Curettage and electrodessication - involves the scraping the cancerous growth with a curette and cauterizing the area to destroy residual tumor and to control bleeding. This may be effective for a subtype of basal cell carcinoma and very early squamous cell carcinoma.
Radiation or chemotherapy may be necessary for advanced cases of skin cancer or when patients are unable to have surgery.
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A. The incidence of skin cancer has been increasing quickly for the past few years. One in two men and one in three women will develop non-melanoma skin cancer in their lifetime. Once a patient has a non-melanoma skin cancer, there is a much higher risk of developing more skin cancers. .
The risks factors for developing non-melanoma skin cancer include: fair skin, indoor tanning bed use, multiple blistering sunburns, heavy UV exposure, prior skin cancer diagnosis, northern European ancestry, history of radiation therapy, immunosuppression, exposure to arsenic, and some forms of the HPV virus. Individuals at higher risk of melanoma include those with: red or blonde hair, blue or green eyes, many atypical moles, a first-degree relative with a history of melanoma, a previous diagnosis of melanoma or non-melanoma skin cancer(s).
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A. Sun exposure can damage your skin during any season, but summer rays are more harmful and can raise the risk of developing skin cancer. University of Chicago Medicine dermatologist Diana Bolotin, MD, PhD, is an expert in Mohs micrographic surgery -- an advanced technique for the removal of common skin cancers. She offers these tips for smart sun care:
- Use sunscreen daily. Look for a "broad spectrum" sunscreen that protects against both UVB light and UVA rays.
- Opt for water resistant products with a Sun Protection Factor (SPF) of at least 30 on an average day, whether bright or cloudy. Choose a higher SPF for outdoor activities, especially swimming and exercise.
- Apply sunscreen liberally and reapply at least every two hours and after swimming or sweating.
- Wear sunglasses, use SPF15-30 lip balm and reapply often.
- Wear sun-protective clothing.
- Minimize sun exposure between 10 a.m. and 4 p.m. Seek shade.
- Avoid tanning bed use.
- See your dermatologist for a yearly skin exam.
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