Skin Cancer

Skin cancer is the most common form of cancer in the United States. More than 5 million new cases are reported each year — and the incidence is rising faster than any other type of cancer. While skin cancers can be found on any part of the body, about 80% appear on the face, head, or neck, where they can be disfiguring as well as dangerous.

Who gets skin cancer … and why

The primary cause of skin cancer is ultraviolet radiation — most often from the sun, but also from artificial sources like sunlamps and tanning booths. In fact, researchers believe that our quest for the perfect tan, an increase in outdoor activities, and perhaps the thinning of the earth’s protective ozone layer are behind the alarming rise we’re now seeing in skin cancers.

Anyone can get skin cancer — no matter what your skin type, race or age, no matter where you live or what you do. But your risk is greater if …

  • Your skin is fair and freckles easily.elderly man
  • You have light-colored hair and eyes.
  • You have a large number of moles, or moles of unusual size or shape.
  • You have a family history of skin cancer or a personal history of blistering sunburn.
  • You spend a lot of time working or playing outdoors.
  • You live closer to the equator, at a higher altitude, or in any place that gets intense, year-round sunshine.
  • You received therapeutic radiation treatments for adolescent acne.

Types of skin cancer

By far the most common type of skin cancer is basal cell carcinoma comprising 80% of all skin cancers.  Fortunately, it’s also the least dangerous kind — it tends to grow slowly and rarely spreads beyond its original site. Though basal cell carcinoma is seldom life threatening, if left untreated it can become very destructive, growing deep beneath the skin and into the underlying tissue and bone, causing serious damage (particularly if it’s located near the eye).

Squamous cell carcinoma is the next most common kind of skin cancer making up about 15% of all skin cancers.  It most commonly develops  on the lips, face, or ears.  Although in most cases it is slow to spread and is easily treated, It sometimes behaves aggressively with rapid growth and spread to distant sites, including lymph nodes and internal organs. Squamous cell carcinoma can become life threatening if not treated.

A third form of skin cancer, malignant melanoma, is the least common, representing only 4-5% of skin cancers, but is the most deadly and accounts for the majority of deaths due to skin cancer.   If discovered early enough, it can be completely cured. If it’s not treated quickly, however, malignant melanoma may spread throughout the body and is often deadly.

Other skin growths you should know about

Two other common types of skin growths are moles and keratoses.

Moles are clusters of heavily pigmented skin cells, either flat or raised above the skin surface. While most pose no danger, some — particularly large moles present at birth — or those with mottled colors and poorly defined borders — may develop into malignant melanoma. Moles are frequently removed for cosmetic reasons, or because they’re constantly irritated by clothing or jewelry (which can sometimes cause pre-cancerous changes).

Solar or actinic keratoses are rough, red or brown, scaly patches on the skin. They are usually found on areas exposed to the sun, and sometimes develop into squamous cell cancer.

Recognizing skin cancer

Basal and squamous cell carcinomas can vary widely in appearance. The cancer may begin as small, white or pink nodule or bumps; it can be smooth and shiny, waxy, or pitted on the surface. Or it might appear as a red spot that’s rough, dry, or scaly; a firm, red lump that may form a crust; a crusted group of nodules; a sore that bleeds or doesn’t heal after two to four weeks; or a white patch that looks like scar tissue.

Malignant melanoma is usually signaled by a change in the size, shape, or color of an existing mole, or as a new growth on normal skin. Watch for the “ABCD” warning signs of melanoma:

  • Asymmetry — a growth with unmatched halves
  • Border irregularity — ragged or blurred edges
  • Color — a mottled appearance, with shades of tan, brown, and black, sometimes mixed with red, white, or blue
  • Diameter — a growth more than 6 millimeters across (about the size of a pencil eraser), or any unusual increase in size.

If all these variables sound confusing, the most important thing to remember is this: Get to know your skin and examine it regularly, from the top of your head to the soles of your feet. (Don’t forget your back.) If you notice any unusual changes on any part of your body, have a doctor check it out.

Diagnosis and treatment

Skin cancer is diagnosed by performing a biopsy– removing all or part of the growth and examining its cells under a microscope. It can be treated by a number of methods, depending on the type of cancer, its stage of growth, and its location on your body.  Our office specializes in treating all forms of skin cancer and offers the most advanced treatments, including Mohs micrographic surgery.  We will help you select the most appropriate treatment for your particular skin cancer depending on its size, location, and potential for recurrence or spread.  These are the most common treatment options:

  • Curettage-Malignant tissue is scrapped away from healthy tissue with a sharp instrument called a curette.  This method is effective for small, superficial skin cancers that were not previously treated.  The treatment is completed with an electric needle to provide a zone of destruction to lessen recurrence.
  • Surgical Excision-The skin cancer is excised or cut out in an elliptical fashion and closed with stitches.  The specimen is sent to the laboratory to check margins.  This treatment is used for small skin cancers in non-critical areas like the body, arms and legs.
  • Topical chemotherapy and immune response modifiers-In the treatment of non-dangerous superficial skin cancers, topical creams can occasionally be used to either poison the rapidly dividing cells or stimulate the immune system to attack the cancer cells.
  • Mohs micrographic surgery-The most precise method for treating skin cancer.  It provides the highest cure rate while at the same time removing the least amount of tissue, usually resulting in smaller wounds that heal with less potential for scarring.  Dr. Mott has specialized training in Mohs surgery and has performed over 8,000 cases in his career.
  • Wide Excision (melanoma)-Because melanomas have a higher chance of spreading (metastasizing), an additional margin of surrounding skin is removed depending on the depth of invasion (Breslow depth).  These wounds tend to be larger, but are repaired with standard surgical reconstructive techniques.