Skin cancer

Skin cancer is an abnormal growth of cells in the skin. One of most common types of cancer, most skin cancers are caused by UV radiation from sun exposure, which causes the skin cells to become abnormal and attack the surrounding tissues. While there are several types of skin cancer, it is typically categorized as either nonmelanoma or melanoma.

Nonmelanoma skin cancer

There are two types of nonmelanoma skin cancer:

• Basal cell carcinoma — Most nonmelanoma cancers are this type. It can damage deeper tissues, such as muscles and bones, and almost never spreads to other parts of the body.
• Squamous cell carcinoma — This is less common, often developing from a small, rough spot that grows in sun-damaged skin. It can sometimes spread to other parts of the body.

Melanoma

While melanoma is typically less common than nonmelanoma skin cancer, it remains the most serious. Melanoma looks like a flat mole with uneven edges, with a shape that is not the same on both sides. Most melanomas show up as a new spot or skin growth, but they can form in an existing mole or other mark on the skin. While it can only start in the skin, it can spread to other parts of the body.

Skin cancer usually appears as a growth that changes in color, shape or size. It can be a sore that does not heal or a change in a mole or skin growth. These changes most often happen in areas that get the most sun, such as your head, neck, back, chest, shoulders or nose. The signs and symptoms of skin cancer depend on the type, which can show up in different ways.

Basal cell carcinoma

Knowing the specific symptoms can help you identify skin cancer early. Basal cell carcinoma shows up with these symptoms:

• Bump that itches, bleeds, crusts over and then repeats the cycle and has not healed in a few weeks
• Firm, round bump with tiny blood vessels that look spidery
• Patch of the skin that looks like a scar and is firm to the touch
• Red, tender flat spot that bleeds easily
• Small, fleshy bump with a smooth, pearly appearance, often with a depressed center
• Smooth, shiny bump that may look like a mole or cyst

Squamous cell carcinoma

Though it is a rarer type of skin cancer, squamous cell carcinoma has specific symptoms that you can look for, including:

• Persistent, firm, red bump on sun-exposed skin
• Patch of skin that feels scaly, is bleeding or develops a crust–it may get bigger over a period
• Skin growth that looks like a wart
• Sore that does not heal

Melanoma

The most important warning sign for melanoma is any change in size, shape or color of a mole. These changes can occur over a period of weeks to a month. The ABCDE system tells you what changes to look for:

• Asymmetry – When one half of the mole or skin growth doesn’t match the other half.
• Border irregularity – Where the edges are ragged, notched or blurred.
• Color – When the color is not the same throughout the entire mole.
• Diameter – When the mole or skin growth is larger than the size of a pencil eraser.
• Evolution – When there is a change in the size, shape, symptoms or surface of a mole.

The single greatest risk for skin cancer is from ultraviolet radiation. While it is usually caused by too much sun exposure, it can also be caused by tanning beds or sunlamps.

Other risk factors include:

• Age, if you are over 40
• Exposure to strong X-rays, chemicals or radioactive substances such as radium
• Family history of skin cancer
• Gender, if you are male
• Having light skin that sunburns easily

When you come to us with a skin anomaly, the first step is a medical evaluation. This will include a physical, as well as a review of your symptoms, medical history and family history, to see if additional tests are needed. We will also do a biopsy, where your doctor will remove a small skin sample.

If you are diagnosed with skin cancer, a multidisciplinary group of surgeons, medical oncologists and radiation oncologists will form your care team. Working in collaboration with you, they determine the appropriate order and combination of necessary therapies.

Skin cancer treatments continue to evolve more rapidly than ever, emphasizing the need for a commitment to a forward-thinking, science-minded approach. Whether you need single-therapy, dual-therapy or a combination of several therapies, we regularly begin cancer treatment using nonsurgical approaches, such as:

• Chemotherapy
• Immunotherapy
• Radiation therapy
• Targeted therapy

Skin cancer surgery

Depending on how far your cancer has progressed, surgery may be recommended. Our healthcare system is home to some of the most skilled surgeons in the region, whose expertise extends to a wide range of skin cancer surgical procedures, including:

• Excision — This is a procedure in which the surgeon removes the skin cancer, along with a margin of healthy tissue around it to reduce the chance of recurrence. This may be used for both melanoma and nonmelanoma cancers.
• Lymph node dissection — This surgery either removes lymph nodes to see if they have cancer cells or removes lymph nodes when it is already known that they are cancerous.
• Mohs micrographic surgery — This procedure involves removing skin cancer one layer at a time, checking each layer for cancer cells after it is removed. It is typically used for nonmelanoma cancers.
• Sentinel lymph node biopsy — This procedure removes the first lymph node from the tumor where cancer may have spread. If this lymph node does not have any cancer cells, you may not need to have other lymph nodes removed.

Other types of surgery for nonmelanoma skin cancer may include:

• Cryosurgery
• Curettage and electrosurgery
• Dermabrasion
• Laser surgery

Your doctor will carefully discuss your options with you and choose the best procedure that fits your body type and level of health and wellness.

We understand that a cancer diagnosis can be overwhelming. Your care team is available to answer questions and address any issues related to diagnosis and treatment, as well as helping with your emotional concerns. As such, we place great importance on supplying comprehensive support services to meet any and all educational, nutritional and psychological needs you may have during this difficult time.