For every three cancers diagnosed in the U.S. one will be skin cancer, estimated to be over 700,000 cases. Summer present the greatest risk as the the sun more direct, there are more hours of sun and people tend to spend more time outside.
One element of relief in these numbers is that the most common skin cancers are more than 95% curable when detected and treated early. Most skin cancers are preventable by protecting your skin from the sun.
Dr. Blumenstrauch, as a Mohs College Surgeon, has extensive experience in the diagnosis and treatment of all types of skin cancer and precancerous conditions.
Different Types of Skin Cancer
Skin cancer is the most common cancer. Despite it’s fear aspect, there are a couple of pluses with skin cancer:
- It is easy to detect since it is visible.
- There are simple proactive steps you can take to prevent skin cancer.
There are three major kinds of skin cancer:
Basal Cell Carcinoma (BCC)
Basal cell carcinoma is the most common. BCC will usually begin on sun exposed areas and manifest as a small, round, raised, red spot. If detected early the chances of cure are good. If a BCC is left untreated it tends to grow in a very destructive and disfiguring way.
Warning Signs of BCC
Smooth, pink bumps with a shiny appearance that will develop a crust, then ulcerate, and begin to bleed.
Mostly seen on the head, neck and hands.
Who’s at risk for BCC?
Any ethnic background and any age can develop basal cell carcinoma, but the vast majority of people with BCC skin cancer are Caucasian and middle-aged or elderly. More than 99% of people with basal cell carcinoma are white, and over 95% are aged between 40 and 80 years old. Men and women are affected nearly equally. Sun exposure plays an integral role in the development of basal cell carcinoma. People living in sunny climates or who spend time outside with work or sports are more likely to develop basal cell carcinoma.
What are the treatments for Basal Cell Skin Cancer?
In addition to the treatments noted below for SCC, there are other treatments for BCC Skin Cancer. These include:
- Imiquimod: This cream encourages the body’s immune system to attack and eradicate the superficial basal cell carcinoma. It is usually applied several times per week for 6 to 12 weeks.
- Photodynamic therapy: With this technique, a photosensitizing liquid which activates when exposed to a special light is applied to the cancer-affected area. The product (often Levulan by name) is left on to be absorbed selectively by the skin cancer cells. Once the incubation time is complete, the skin is exposed to red or blue light at your doctor’s office. The light activates the chemical which in turn destroys the BCC skin cancer cells. Learn more about Photodynamic therapy
- Laser: For superficial basal cell carcinomas, some physicians are using carbon dioxide (such as the MiXto laser) and other lasers to destroy the skin cancer.
Squamous Cell Carcinoma (SCC)
The second most common skin cancer is Squamous Cell Carcinoma. Mostly found on sun exposed skin, it is a slow-growing cancer which tends to spread. SCC is closely related to actinic keratosis, often referred to as precancer. Early detection improves the rate of cure..
- SCC Photo link 1 – Skinsight
- SCC Photo link 2 – Shadezone
Warning Signs of SCC
Raised, scaly, pink, growths that resemble warts. SCCs ulcerate as they grow.
What types of treatments are used for Squamous Cell Skin Cancer?
Treatments for Squamous Cell Carcinoma
Correct diagnosis is a first step. This is done by biopsy of the lesion. A biopsy is usually a quick and simple procedure:
- The skin is numbed with an injected numbing agent.
- Your doctor will use a flexible razor blade, a scalpel, or a tiny punch tool (called a “punch biopsy”). With punch biopsy, a suture (stitches) may be placed. This stitch will be removed in one to two weeks.
- Having the skin sample examined under the microscope by a specially trained physician
If caught early and treated appropriately, squamous cell carcinomas generally have a good prognosis.
Treatment of squamous cell carcinoma that have been confirmed by biopsy will depend upon many factors: microscopic appearance, size and depth, location, and the patient’s health status. The most common treatments for squamous cell carcinoma:
- Cryosurgery using liquid nitrogen; Super-cooled liquid nitrogen is sprayed on the cancer, freezing and destroying it in the process. For low-risk SCC this is a common and effective treatment.
- Electrodessication and curettage. After numbing, the doctor uses a curette tool to “scrape” the skin cancer cells away, followed by an electric needle that will burn or cauterize the cancer tissue. Electrodessication helps kill the cancer cells and also helps stop any bleeding that might result from the scraping. Frequent choice for low-risk squamous cell carcinomas.
- Excision; The squamous cell carcinoma is removed with a scalpel, with stitches to close the wound. Frequent option for low-risk and some high-risk squamous cell carcinomas.
- Mohs micrographic surgery; The physician removes thin layers of skin from the cancer site until it is completely removed. Usually the treatment of choice for high-risk squamous cell carcinomas and for cancers on the nose, ears, lips, and hands.
- Radiation; X-ray therapy is often useful for patients who are not good surgical candidates because of other health issues. Rarely, squamous cell carcinoma spread internally (metastasize). Squamous cell carcinomas that develop in scars, on the lip, and on the ear have the highest risk of spreading. Lymph nodes may need to be examined for the presence of SCC. If internal spread is suspected, referral to an oncologist (a physician specializing in cancer treatment) for possible chemotherapy or other treatments would be appropriate.
Treatment of squamous cell carcinoma continues in frequent follow-up exams with a trained skin physician. This is to ensure that the SCC has not recurred and that a new skin cancer has not developed.
Mohs Micrographic Surgery
Mohs Surgery can be a potential treatment for patients who are diagnosed with basal cell and squamous cell skin cancers. Mohs surgery is a specialized surgical procedure that strives to preserve as much of the normal tissue as possible to prevent undue scarring and the need for corrective plastic surgery. Because the Mohs Micrographic Surgery process surgery features a systematic microscopic search that traces skin cancer down to its roots, it offers the highest chance for complete removal of the tumor while sparing the normal tissue surrounding it. Patients with a malignant diagnosis are referred to a specialized surgeon. Our trained Mohs surgeons and physicians perform Mohs on basal cell and squamous cell lesions.
Click to View Mohs Surgery Patient Video
Click to View America Society for Mohs Surgery Treatment Brochure
Facts about Mohs surgery:
* Mohs surgery was developed in the 1940′s by Dr. Frederick Mohs, a general surgeon from the University of Wisconsin, as a method to remove skin cancers.
* Mohs surgery is a specialized technique for removing various types of skin cancer.
* Mohs surgery is also known as microscopically controlled surgery. A microscope is not used during surgery, but is used to examine skin tissue immediately after it has been surgically removed.
* Mohs surgery provides the opportunity for the evaluation of all tissues around the surgical margins as compared to a “sampling” of the margins, which occurs with routine evaluation of excised tumor specimens.
Malignant Melanoma (MM)
Malignant melanoma is the most dangerous and life-threatening skin cancer of all, killing nearly 7,000 Americans each year. It has a great potential to spread to other parts of the body. When certain moles change their appearance this can be the indicator of evolution into malignant melanoma. Because of the severity of MM, it is important for survival to detect MM as early as possible.
First Warning Signs of a Malignant Melanoma
Melanoma can look like a mole, bump or growth on the skin. It can appear anywhere – even on areas that are not sun exposed.. In men, melanoma is found most often on the chest, stomach or back, and in women it is found most often on the legs. Beware of any development of a multicolored mole with jagged uneven borders or any other change in size, shape or color. Unlike the other skin cancers, these can occur on any part to the body. Find out more important facts about MM here Malignant Melanoma
Non Cancerous and Precancerous Lesions
Sometimes there are also abnormal skin areas that are not yet skin cancer. They are called precancers since they have the potential to turn into skin cancer. This precancerous condition is called Actinic Keratosis.
Actinic Keratosis (AK)
Actinic keratosis is often associated with SCC. It nearly always occurs on sun exposed areas and looks like a rough scaly skin patch. Because an AK can turn into cancer, it’s a good idea to pay attention to your skin. Do not let an actinic keratosis turn into a skin cancer. Read more about Actinic Keratosis and your treatment options
Who’s at most risk for skin cancer?
It is most commonly seen in elderly, light-skinned people with a large amount of sun exposure. Risk factors for the development of squamous cell carcinoma include:
- Fair skin, light hair, or light eyes
- Age over 50 years
- Chronic exposure to sunlight or other ultraviolet light
- Previous skin cancer
- Exposure to certain chemicals, such as arsenic or tar
- Exposure to radiation, such as X-ray treatment for internal cancers
- Long-term suppression of the immune system, such as organ transplant recipients
- Long-term presence of scars from burns
- Chronic ulcers
- Darker-skinned people are less likely to develop squamous cell carcinoma. It is still possible and in fact is the most common form of skin cancer in people of African and Asian descent.
How can I help avoid getting skin cancer?
- Seek Shade
Shade is not only the best place to go in the heat of the midday sun, but one of the safest places to be for your skin.
- Wear protective gear
If you know you’re going to be spending time in the sun, there are some things you can take along to protect your skin and eyes. UV protective sunglasses, a long sleeve cover and of course, sunscreen or sun block.
- Use sunscreen every day
A little bit of cream, spray, or gel can save your skin to be applied every two to three hours.
- Keep kids out of the sun
Children are in more danger than any other group when in the sun. Therefore they need special protection. Infants need shade and a hat.
- Self Exam
The best way to catch cancer before it catches you, is to discover it early. Take advantage of the fact that your skin is the most visible organ of the body and check it regularly.
- Follow up
If you have had skin cancer or precancerous lesions in the past you need to take special care and visit a dermatologist regularly.
- Basal Cell and Squamous Cell Carcinoma – American Family Physician
- Skin Cancer Foundation Links (http://skincancer.org)
- Self Examination
- Skin Types and At-Risk Groups
- Year Round Sun Protection Tips
- Seal of Recommendation Product List