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Common Types
Of Skin Cancer
There
are many different kinds of skin cancer, but three types are common:
basal cell carcinoma, squamous
cell carcinoma, and malignant melanoma.
Each of these types of skin cancer gets its name from the type of
cell in the skin that gives rise to that cancer. Actinic keratoses
are pre-malignant keratoses that can turn into skin cancer if left
untreated. The following pages will review these common types of
skin cancers and pre-malignant actinic keratoses:
Actinic Keratosis
An actinic keratosis is a pre-cancerous skin lesion. Actinic keratoses
are small scaly or rough spots on the face, scalp, and back of the
hands and arms. They are more prevalent in individuals who have
significant sun exposure. If left untreated actinic keratoses can
become skin cancer, requiring more extensive treatment. This is
estimated to occur in about 2-3% of cases. If diagnosed early actinic
keratoses can be treated by cryotherapy (freezing), laser resurfacing, or by applying a topical form of chemotherapy.
Actinic cheilitis is best treated with a Carbon
Dioxide (CO2) laser.
Actinic
Cheilitis
Actinic cheilitis is a pre-cancerous condition involving the lip.
This condition develops due to chronic sun-damage to the skin of
the lip. It presents as scaling, cracked, and fissured areas of
the lower lip, which have a tendency to bleed. Actinic cheilitis
is frequently painful and is a chronic condition. The treatment
of choice for actinic is resurfacing of the lip with a CO2
laser.
Basal Cell Carcinoma
Basal
cell carcinoma (BCC) is the most common type of skin cancer in the
United States. Approximately 800,000 cases of BCC occur yearly.
About 79% of all skin cancer cases are BCC, the slowest growing
and least dangerous of the three common types of skin cancer. BCC
rarely metastasizes to distant sites in the body. BCC develops from
the cells in the epidermis (surface layer of the skin) known as
the basal cell layer. This type of skin cancer occurs predominately
in sun-exposed areas, such as the head, neck, and forearms.
Basal cell carcinoma may have many different appearances. It most
commonly appears as a small pearly skin-colored bump or nodule.
Basal cell carcinoma can also appear as a flat growth, a scar, or
a scaling area. Untreated, basal cell carcinomas will begin to bleed,
crust over, and then repeat the cycle.
Squamous Cell Carcinoma
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Squamous cell carcinoma (SCC) is the second most common
type of skin cancer in the United States. Approximately 200,000
cases occur yearly. This cancer develops from cells in the epidermis
known as squamous cells. Squamous cell carcinomas are more dangerous
than BCC because they have a greater tendency to recur after surgery
and to metastasize (spread) to other organs in the body. Although
the cure rate for SCC is almost 95% when properly treated, approximately
2,000 deaths occur each year from this form of skin cancer.
SCC,
like BCC, occurs predominately in sun-exposed areas and is responsible
for 15 percent of all skin cancer cases in the United States. It
may appear as a red nodule or a rough scaling patch. Bowen's disease
(SCC in situ) is a form of SCC that has not yet invaded into the
second layer of the skin (dermis).
Malignant Melanoma
Malignant melanoma (MM) is a life-threatening skin cancer
that develops from the pigment-forming cells in the skin (melanocytes);
hence, it tends to be a black or brown skin cancer. MM is the least
common of these three types of skin cancer, but it is the most dangerous
because it has a strong tendency to metastasize to distant organs.
The lifetime risk for developing melanoma is projected to rise to 1 in 50 Americans by the year 2010. Every year an estimated 7,770 Americans die from melanoma. Melanoma
represents 2% of all cancers and 1% of all cancer deaths in the
United States. Fortunately, early detection and surgical excision
of MM can result in a high cure rate.
Melanoma Risk Factors
Sun Exposure: Excessive exposure to the sun is accepted as
a cause of melanoma. Severe sunburns in childhood or adolescence,
and recent severe sunburns have been associated with an elevated
risk of melanoma.
Skin Type: A fair complexion and inability to tan are a risk
factor for melanoma. Tanning is a protective mechanism in the skin
after it has been injured from the sun. Individuals, who burn easily
and rarely tan, have less protection from the sun and ultraviolet
radiation.
Family History: A family history of melanoma increases the
risk of developing melanoma. Some families also have many atypical
moles and have an even higher risk for melanoma.
Atypical Moles: Moles are clusters of pigment forming cells
in the skin. Atypical moles have a variation in their symmetry,
border, or color (see ABCD's). The more atypical
moles that you have the higher your risk for melanoma.
Signs and Symptoms of Melanoma
Melanoma usually appears as a black or brown skin cancer. It may
suddenly appear without warning or develop in or near a mole or
other dark spot in the skin. Any change in the appearance of a mole
on your body should be a warning sign to this deadly cancer. This
will usually be an increase in size or change in color. Other warning
signs include: changes in the surface of a mole; scaliness or oozing,
bleeding, development of a new bump or nodule; spread of pigment
from the border into surrounding skin; and change in sensation including
itching, pain, or tenderness. Development of a new growth, bleeding,
or itching are other symptoms.
The ABCD's of Melanoma:
Treatment of Melanoma
There are many different treatments for melanoma depending
on how deep the tumor is in the skin and if the cancer has spread
to other parts of the body. The Breslow depth measures the depth
of the melanoma in millimeters. Once you have been diagnosed with
melanoma it will be necessary to perform additional surgery (re-excision).
The Breslow depth determines the margins for this re-excision.
Additional
therapies include interferon, chemotherapy, sentinel node mapping,
and immunotherapy. Your doctor will help you determine if any of
these therapies are necessary. At this time, Mohs micrographic surgery is not the preferred method of treatment for melanoma.
Melanoma Prevention
Sun
protection from regular use of sunscreens
and protective clothing should become part of your daily routine.
We recommend daily use of a sunscreen with SPF 30 or higher. Periodic
self-examinations
are also important. You need to become familiar with your skin.
If you have any risk factors for melanoma you should have periodic
complete examinations by a dermatologist. You may also attend one
of our free skin
cancer screening clinics.
Melanoma Hyperlinks on the Internet
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