Skin Cancer

Symptoms

Cancerous and precancerous skin lesions can vary widely in appearance. Some skin cancers may look like:

• Scar-like lesion that is brown or skin-colored
• Pearly or waxy bump
• Crusted, flat lesion
• Firm, red nodule
• Large brown spot with darker speckles
• Moles that change shape or color
• Shiny, firm bumps

This list does not include all possible appearances of skin cancer. All new, changing, and suspicious skin lesions should be examined by a doctor to rule out the possibility of cancer.

Types

Actinic Keratosis (AK): Precancerous skin lesion caused by long-term exposure to UV rays. They usually appear as rough, scaly patches ranging in size from a pinpoint to several inches. AKs are commonly found on the face, scalp, neck, ears, hands, and forearms. Without treatment, they can develop into skin cancer.

Basal Cell Carcinoma (BCC): The most common form of skin cancer. BCCs arise from abnormal growth of basal skin cells, which may occur due to DNA damage from UV exposure. They may look like open sores, shiny bumps, pink growths, red patches, scars, or growths with elevated or rolled edges and a central indentation. BCCs may also occasionally ooze, crust, bleed, or itch, and they often arise in sun-exposed areas of skin. Most are curable when caught and treated early, but if allowed to grow, BCCs can be disfiguring and dangerous and may destroy skin, tissue, and bone. Some types of BCC can be life threatening.

Squamous Cell Carcinoma (SCC): The second most common form of skin cancer. SCCs arise from abnormal growth of squamous cells, which may occur due to DNA damage from UV exposure or other damaging agents. They may look like open sores, scaly red patches, rough and thick or wart-like skin, or raised growths with a central indentation. SCCs may also occasionally crust, bleed, or itch, and they usually arise in sun-exposed areas of skin. Most are curable when caught and treated early, but if allowed to grow, SCCs can be disfiguring, dangerous, or fatal.

Melanoma: A serious form of skin cancer that is less common than BCC or SCC, but can rapidly spread to other organs if not treated early. Melanomas arise from DNA damage that causes mutations in melanocytes, leading to uncontrolled cellular growth. 70-80 percent of melanomas arise on normal-looking skin, and they may appear in many different shapes, sizes, and colors. Some examples include flat or raised and discolored asymmetrical patches, blotchy patches with uneven borders, and bumps. Melanomas can be shades of tan, brown, black, pink, red, blue, white, or skin-toned. While dangerous, with early detection, the five-year survival rate is 98 percent. Early detection is critical as melanoma can spread quickly and become deadly.

Merkel Cell Carcinoma (MCC): A rare, aggressive skin cancer with high risk of recurrence and metastasizing. MCCs often (but not always) appear on sun-exposed areas and are not as distinctive in appearance as other skin cancers. They may appear as pearly, pimple-like bumps that can be red, bluish red, or purple, and they typically grow at a rapid rate. MCC is three times as deadly as melanoma, but successful treatment is possible with early detection.

Risk Factors

You are at greater risk of developing skin cancer if you meet any of the following criteria:

• Risk of melanoma doubles if you’ve had just one blistering sunburn in childhood or adolescence
• Risk of melanoma doubles if you’ve had 5 or more sunburns
• You have actinic keratosis (precancer)
• You expose yourself to ultraviolet radiation from the sun without protection
• You are an organ transplant patient (100 times more likely to develop SCC)
• You are male and over age 50
• You have light skin
• You have used an indoor tanning bed (67% increase in risk of SCC and 29% increase in risk of BCC)
• You have a genetic or family history of skin cancer
• You have atypical moles
• You have red hair
• You have a weakened immune system

Prevention

Skin cancer prevention begins with the following:

• Use sunscreen daily (SPF 15 or higher)
• Minimize sun exposure
• Examine your own skin monthly
• Get an annual skin exam
• Have any suspicious lesions examined by your dermatologist
• Avoid getting sunburned
• Avoid tanning (indoor tanning or sun tanning)
• Wear sun protective clothing, UV-blocking sunglasses, and wide-brimmed hats
• Place a protective window film on your car and home windows
• Eat a healthy diet

Treatments

Treatment for skin cancer may include:

• Mohs surgery: Layers of skin growths are progressively removed little by little until no abnormal cells remain
• Excision: The lesion and some surrounding tissue is surgically cut out of the skin
• Laser treatment: The tissue is heated to destroy cancerous growths
• Chemotherapy: Drugs (including creams or lotions) may be used to destroy the cancer

Most skin cancer treatment is successful, but new tumors can still form. Having a history of skin cancer makes you significantly more likely to develop new skin cancers, so it is important to practice preventive measures and see a dermatologist on a regular basis.