What is Skin Cancer?
Skin cancer, the most common form of cancer in the United States, is the uncontrolled growth of abnormal skin cells. Skin cancer types include actinic keratosis (or solar keratosis), basal cell carcinoma, squamous cell carcinoma and melanoma.
While only 1% of skin cancers are melanomas, they are the deadliest of all skin cancers due to their ability to spread throughout the body and metastasize. However, melanoma is also one of the most curable cancers due to its visibility to the unaided eye. Other types of skin cancer that are far less common include Merkel cell carcinoma, Kaposi sarcoma, cutaneous lymphoma and skin adnexal tumors. These account for less than 1% of all skin cancer.
- Signs and Symptoms
Warning signs of skin cancer include:
- Changes in the shape, size or color of a mole or other skin lesion
- New growth on the skin
- Sores that do not heal
- Diagnosis of Skin Cancer
Regular screenings by a dermatologist are encouraged if you or a family member has already had melanoma.
- Skin Exam: Dermatologists, or patients themselves, examine the surface of the patient's face, head and body for any new or abnormal changes (large, dark, misshapen or raised spots). Skin exams are quick and non-invasive.
- Skin Biopsy: All or part of any abnormal-looking growth is cut from the skin and viewed under a microscope to check for the presence of cancer.
- Talking With Your Physician
Your dermatologist may refer you to a surgical, medical or radiation oncologist for treatment. However, physician assistants (PAs), nurse practitioners (NPs), nurses, nutrition specialists, social workers and other health and hospital professionals may be a part of your treatment team.
Some question you might consider asking a health care professional include:
- How far has my melanoma spread within or beneath the skin?
- What are the chances of my cancer growing or recurring?
- Should I take special precautions to avoid sun exposure?
- Are my family members at risk for skin cancer?
- Causes and Risk Factors of Skin Cancers
Skin cancer occurs when unrepaired DNA damage to skin cells triggers mutations that lead the cells to multiply rapidly and form malignant tumors.
Some causes of skin cancer are:
- Tanning beds
- Excessive sun light or ultraviolet rays
- Previous skin cancer
- Exposure to certain chemicals and radiation
Several factors that increase your risk of getting skin cancer include:
- Fair skin
- History of sunburns
- Moles and other precancerous skin lesions
- Family history of skin cancer
- Weakened immune system
- Prevention of Skin Cancer
A few ways to reduce your chances of skin cancer include:
- Avoiding intentional tanning
- Seeking shade on sunny days
- Wearing protective clothing and hats
- Applying sunscreen with SPF 30 or higher
- Stages of Skin Cancer
Because basal cell carcinomas rarely spread the staging system may not be used. Squamous cell carcinomas have a slightly higher chance of spreading therefore the staging system may be used. However, melanomas are usually categorized by stage.
- Stage 0: The cancer cells are confined to the epidermis (the top layer of the skin) and have not spread. The cancer is usually cured by surgery.
- Stage I: The cancer cells have grown deeper into the skin. They have not spread to the lymph nodes or beyond.
- Stage II: The cancer cells have grown deeper into the skin or have more high-risk features. They have not spread to the lymph nodes or beyond.
- Stage III: The cancer cells have spread to nearby lymph nodes.
- Stage IV: The cancer cells have spread beyond the skin and regional lymph nodes to distant organs.
- Treatment Option for Skin Cancer
If melanoma is recognized and treated early, it is almost always curable. If left alone, the cancer may advance and spread to other parts of the body, where it becomes hard to treat and can be fatal.
Working and speaking with your doctor can help determine which treatment option is best for you.
Mohs Micrographic Surgery
Physicians trained in Mohs surgery remove the visible tumor and surrounding tissue with a scalpel. The tissue is sectioned, frozen and examined under a microscope.
Physicians remove the entire tumor, along with the surrounding normal skin. The wound is then sutured. The excised tissue is then sent to the lab for examination to verify that all cancer has been removed.
The physician freezes and destroys the cancerous tissue with liquid nitrogen, using a cotton-tipped applicator or spray bottle. There is not cutting or bleeding and no anesthesia is required.
Other methods include:
- Photodynamic Therapy
- Laser Surgery
- Topical Medications
- Prognosis of Skin Cancer
When discussing with patients that have Stage I, II, III or IV melanoma, the five-year survival rate for each is:
- Stage IA: The five-year survival rate is around 97%
- Stage IB: The five-year survival rate is around 92%
- Stage IIA: The five-year survival rate is around 81%
- Stage IIB: The five-year survival rate is around 70%
- Stage IIC: The five-year survival rate is around 53%
- Stage IIIA: The five-year survival rate is around 78%
- Stage IIIB: The five-year survival rate is around 59%
- Stage IIIC: The five-year survival rate is around 40%
- Stage IV: The five-year survival rate is around 15-20%