Each year, more than 1.2 million Americans are diagnosed with skin cancer. It is the most common form of human cancers. While skin cancer is not always life-threatening, it can progress if left untreated. Those that have had skin cancer are at a higher risk of developing skin cancer again, which is why routine self-examination is important. Self-exams are important and changes can signal a need for attention. Dermatologists use the ABCDE to describe what to look for in mole changes:
- A = Asymmetry – one half of the mole is unlike the other half
- B = Border – the edge or border of the mole is irregular or blurred
- C = Color – the color is not uniform with shades of black, brown, tan and sometimes red, white and blue
- D = Diameter – the mole is greater than 6 mm (the size of a pencil eraser) although melanomas can be smaller
- E = Evolving – a mole that is changing or evolving or looks different than the others
There are many types of skin cancers, but the majority fall into the following three types: Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma.
Basal Cell Carcinoma
This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body's natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:
- a pearly or waxy raised bump with a pearly edge and small but visible blood vessels
- tan or brown bumps that look like moles with a pearly edge
- a sore that continuously heals and then re-opens
- a flat lesion with a waxy appearance and blurred edges
About 85% of basal cell carcinomas occur on the neck and face – areas most exposed to the sun. Despite how different these may look, they all tend to bleed with little or no cause.
- having fair skin
- sun exposure
- age (>50)
- exposure to ultraviolet radiation (ie. tanning beds) or therapeutic radiation
Diagnosing basal cell carcinoma requires a biopsy. This can be done removing the entire tumor along with some of the surrounding tissue, or removing only a part of the tumor.
Squamous Cell Carcinoma
Squamous cell carcinoma is the second most common type of skin cancer. The cancer first develops in the upper layer of the skin, and then invades the deeper layers. It may metastasize (spread) to other parts of the body. Like basal cell carcinoma, squamous cell carcinoma also requires a biopsy. This can be done removing the entire tumor along with some of the surrounding tissue, or removing only a part of the tumor.
- can develop anywhere although it is most frequently found on the scalp, face, ears, arms and back of hands
- on darker skin squamous cell carcinoma are more likely to develop on areas that are not exposed to the skin
- firm red nodule or a flat lesion with a scaly, crusted surface
- fair skin
- middle-aged and seniors with a history of sun exposure
- having actinic keratosis spots - rough, scaly skin patch caused by the sun (considered pre-cancerous)
Melanoma is the least common type of skin cancer, but the most common form among young adults age 25 to 29. It is also the most serious. Melanocytes are cells in the bottom later of the epidermis that produce melanin, which is responsible for skin pigmentations. Melanomas often present as black or dark brown spots or they can grow inside an existing mole and, if not detected and treated, can spread to internal organs and the lymph system. Melanoma can be hereditary, but most are caused by overexposure to the sun from childhood and on.
Melanoma, like the other skin cancers addressed, is diagnosed with a biopsy. Treatments include surgical removal, radiation therapy or chemotherapy.
- a large brownish spot with darker speckles
- a mole that changes in color, size or feel or that bleeds
- a small lesion with an irregular border and portions that appear red, white, blue or blue-black
- dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus
- equally present in all skin colors
- weakened immune system
- family history
- exposure to ultraviolet light – sunlight or tanning booths
- history of sunburns