Skin Cancer

There are three types of skin cancer that are most common among the population:

Basal Cell Carcinoma

Basal cell carcinoma is a common type of skin cancer. In fact, every year more people get diagnosed with basal cell carcinoma than any other type of cancer. Every day you shed tens of thousands of dead skin cells. Once they flake off, they’re replaced by new healthy cells. This process couldn’t take place without basal cells. However, if cancer invades your basal cells, the cancerous cells multiply instead of dying and flaking off. They can then grow into a solid tumor on your skin.

When caught early, basal cell carcinoma is highly treatable and rarely fatal. But if left untreated, it can cause serious complications. It may grow deep into the skin, killing nearby tissue and bone. And in rare cases, it can spread to other parts of the body.

Squamous Cell Carcinoma

Squamous cell skin cancer is a common type of skin cancer that can grow quite large, making it hard to remove without scarring. And in rare cases, it can spread to other parts of the body.

Squamous cells are found throughout the body and make up the outer part of your skin. They also line the insides of many organs, including your lungs, bladder and kidneys. If these cancerous cells multiply instead of dying off, they may grow into a solid tumor on your skin. 

• When cancer starts in squamous cells, it may be referred to as squamous cell carcinoma.
  
• Squamous cancer may also be named for the part of the body where the cancerous cells are located.
• If the squamous cells in your skin are cancerous, you have squamous cell carcinoma of the skin, also called squamous cell skin cancer.

Malignant Melanoma

Malignant melanoma is less common than other skin cancers but is more dangerous because it’s more likely to spread to other organs. Your skin gets its unique color from “melanocytes” (cells that produce a pigment called melanin). Melanocytes also make extra pigment in response to sunlight. That’s why your skin may darken after spending time in the sun.

Because melanoma is a serious condition, doctors recommend you make a plan to have routine skin exams. Your primary care doctor or a dermatologist can check your skin during routine medical visits. They can check hard-to-reach areas that you might not be able to see, like your scalp and back.

It’s possible for anyone to develop skin cancer. But certain risk factors may increase the likelihood of getting it within certain individuals. These risk factors include:

• A lighter skin pigment
• A family or personal history of skin cancer
• Having blue or green eyes
• Having blond or red hair
• Having skin that’s susceptible to sunburn, freckling or reddening
• Having a large number of moles on your body
• Having atypical moles
• Old age

Skin Type & UV Exposure

Even if you don’t have any obvious risk factors, you can still get cancer by being exposed to UV (ultraviolet) rays. People of any ethnic background can potentially develop skin cancer from UV exposure. That’s why it’s important to limit your time in the sun and use protective sunscreen while outdoors for extended periods of time.

There are six different skin types that range from very light to very dark. Knowing your specific skin type will help you determine your overall level of risk for contracting skin cancer. Your Mercy doctor can help you if you’re unsure.

Moles

Atypical moles, also known as dysplastic nevi, can increase your risk of developing melanoma. Moles can appear anywhere on the body and their appearance can vary. If you notice any new growths on your body, it’s best to get in touch with your primary care provider or a dermatologist to get a second opinion.

Chemical Exposure

A high amount of chemical exposure to certain chemicals can also increase a person’s likelihood of developing skin cancer. Harmful chemicals such as arsenic, coal, tar, paraffin and oil can cause non-melanoma skin cancers to develop in certain individuals. If possible, limiting your exposure to these substances can decrease your risk of developing skin cancer.

Family History

If you have a grandparent, parent, sibling or child who was diagnosed with any type of skin cancer, it increases your risk of developing skin cancer. As a general rule, the closer the relative, the higher your personal risk becomes

When it comes to knowing your family’s medical history of cancers, the more information you know the better. If you do discover skin cancer runs in your family, it’s recommended that you set up a full skin examination as soon as possible

Inherited Disorders

Inherited conditions may make you more susceptible to skin cancer. One of the most common disorders is known as xeroderma pigmentosum (XP), a condition where a person suffers from acute sensitivity to ultraviolet rays of sunlight.

In certain instances, some people with XP may also develop neurological disorders as a result of this condition. It’s important to talk to your Mercy doctor if you have any rare skin disorders that run in your family.

Signs and symptoms can vary depending on the type of skin cancer. The signs and symptoms of the 3 types of predominant skin cancers include:

Basal Cell Carcinoma Symptoms

Basal cell carcinoma usually occurs on the skin around the face or neck as a result of excessive sun exposure. But it can occur anywhere on the body. Not all basal cell carcinomas look the same. Signs and symptoms of BCC include:

• A bump that is somewhat translucent (see-through) skin-colored or pearly white, sometimes you’ll be able to see tiny blood vessels inside
• A flat, reddish patch with raised edges
• Pale white or yellow growths that feel waxy to the touch or resemble a scar
• New bumps that are brown, black, blue or spotted
• A sore that won’t heal, but may repeatedly ooze, bleed or crust over

Squamous Cell Carcinoma Symptoms

Squamous cell carcinoma usually occurs on skin with lots of sun exposure, usually around the face, lips, ears and neck. But it can occur anywhere on the body. This includes hidden places like the inside of your mouth or on your genitals. Not all squamous cell skin cancers look the same. Signs of SCC may include:

• A firm, red bump that has raised edges with a lower center
• A flat patch of scaly skin
• Growths that resemble warts
• A sore on your lip or inside of your mouth
• A sore that won’t heal, but may repeatedly ooze, bleed or crust over

Melanoma Symptoms

Melanoma usually occurs on parts of the skin with significant sun exposure. But it can occur anywhere on the body, even in hidden areas. These include on the bottom of your foot, under a fingernail, between your toes or inside of your mouth. Not all malignant melanoma cell skin cancers look the same. Signs of melanoma may include:

• A new mole, spot, lump or blemish
• An existing spot that has changed size, shape or color, turns painful or begins to ooze and bleed
• A sore that won’t heal, but may repeatedly ooze, bleed or crust over

If you have a family history of skin cancer, it’s recommended that you schedule a preventive screening with your primary care provider or Mercy dermatologist. Your Mercy doctor might recommend a screening even if you’re not showing any outward signs or symptoms of skin cancer. If your preventive screening returns abnormal results, additional tests may be needed to determine if you have skin cancer.

Benefits of Early Detection

The main benefit of getting screened for skin cancer before you’re showing any outward symptoms is that if cancer is found, there’s a much better chance of treating it successfully. Early detection will give your Mercy doctor plenty of treatment options when it comes to removing a cancerous mass. If untreated for too long, your cancer will spread to other parts of your body, making it more difficult to treat in the long run.

The ABCD's of Spotting Melanoma 

Catching melanoma at an early stage is crucial to successfully removing cancer. If you’re unsure of whether a mole or part of your skin may be cancerous, remember this mnemonic device:

• A is for Asymmetry:  to confirm if a lesion or mole is asymmetrical, draw a line down the middle of it to see if the two sides roughly match. If they don’t, it may be a sign of melanoma.
• B is for Border:  if the borders of a mole are uneven or rough around the edges, it may be a sign of melanoma.
• C is for Color:  a normal mole will usually be brown. If you notice different hues of black, tan, brown, red, white or blue, it may be a warning sign.
• D is for Diameter:  if a lesion expands to the size of a pencil eraser (approximately ¼ inch in diameter), you’ll want to get it checked out by a dermatologist.
• E is for Evolution:  any physical changes to a lesion should be taken seriously. If new itching or bleeding occurs around the site, it may also be a warning sign. 

See a Mercy expert immediately if you notice any new or suspicious-looking moles or bumps. Your primary care doctor or a Mercy dermatologist can check your skin during routine medical visits. They can also check areas that are hard for you to see, like your scalp and back.

Your Mercy doctor might be unable to tell if you have skin cancer based on a simple examination of your skin. In many instances, a skin biopsy may be needed to determine whether you have skin cancer. If your doctor discovers you do have skin cancer, more tests might be needed in order to diagnose your stage properly. These may include a variety of biopsies, dermatoscopy and imaging tests.

Biopsy

A biopsy removes suspicious-looking skin for further testing in a lab. The different types of biopsies include skin biopsy, shave (tangential) biopsy, punch biopsy, incisional or excisional biopsy, fine-needle aspiration (FHA) lymph node biopsy and lymph node biopsy.

Dermatoscopy

Also known as a dermoscopy, a dermatoscopy is a medical examination of abnormal skin lesions with a dermatoscope, a tool that allows doctors to better see superficial skin and deeper skin structures.

Imaging tests

Imaging tests may be done to determine if the skin cancer has spread to other parts of the body. Diagnostic imaging tests are generally more familiar with thicker melanoma and unusual skin cancer categories. Imaging tests can include:

• MRIs
• PET scans
• CT scans

If you have skin cancer, your treatment strategy will depend on several factors. These include the type of skin cancer you have and whether it has spread to other areas of your body. Your Mercy doctor may recommend one or more types of skin cancer treatment.

Medication

More aggressive forms of skin cancer may require more extensive treatments such as chemotherapy, targeted therapy and immunotherapy.

Topical Treatments

When skin cancer is found but isn’t as aggressive, topical treatments may be used to treat early-stage cancers. These treatments can include photodynamic therapy and topical chemotherapy.

Radiation Therapy 

Following skin cancer surgery, radiation therapy may be used to remove any cancer cells that may remain. Your doctor may also use it to alleviate your symptoms if your cancer returns in the future. Types of radiation therapy include:

• External beam radiation therapy (EBRT)
• Intensity-modulated radiation therapy (IMRT)
• TomoTherapy

Cryotherapy

Liquid nitrogen is used in cryotherapy to destroy skin cancer cells. This may be a good option for benign lesions and non-melanoma skin cancers.

Surgery

Surgery is very common when it comes to treating various skin cancers, and there are many different options to choose from. Techniques can vary depending on the type of skin cancer, how big the cancer itself is and where it’s located on the body. Surgical oncology techniques include:

• Excision surgery
• Mohs micrographic surgery
• Skin grafting
• Reconstructive surgery
  

Mercy will do more than treat your skin cancer. We’ll also take care of you. Once you complete your treatment, we’ll give you all the tools you need to maintain a lifetime of positive skin health and reduce the chances of your skin cancer returning.