Skin cancer is the most common form of cancer. Skin cancer happens when abnormal skin cells start to divide uncontrollably in a localized area. When left undetected for long periods, skin cancer can spread to other organs of the body and create significant complications. A good skin care regimen can help you prevent skin cancer before it starts.
There are three major types of skin cancer: basal cell carcinoma (the most common), squamous cell carcinoma (the second most common) and melanoma. Melanoma is the least common of the 3, but is the most dangerous. We will do a brief overview of all 3 of the most common types of skin cancer and review the most common treatments for each.
The Three Most Common Types of Skin Cancer
Basal Cell Carcinoma
Appearance: Pearly, skin colored or pink bump, or is sometimes a pinkish patch of skin
Cause: Usually occurs from unprotected UV exposure, whether from the sun or tanning
Areas on the body: Anywhere on the body commonly exposed to sun, but most commonly on the head, neck, chest, back, legs and arms
Dangers: If left untreated can grow into surrounding nerves, causing nerve damage or disfigurement.
Squamous Cell Carcinoma
Appearance: scaly patch or bump that is pink or red, or a scab/sore that won’t heal or heals and opens again
Cause: Years of unprotected UV exposure due to the sun or tanning
Areas of the body: Usually occurs on the areas of the body that get the most sun exposure, and especially in areas more sensitive to sun exposure. This includes the rim of the ear, nose, face, arms, and hands
Dangers: If left untreated, more aggressive cases can spread to the lymph nodes.
Appearance: can develop in a mole or sun spot or may start in an area of skin that never previously had a lesion.
Cause: Years of unprotected UV exposure from sun or tanning beds, genetics
Areas of the body: Usually chest and back in men and the legs in women, but can occur anywhere on the skin.
Dangers: Melanoma is the most serious type of skin cancer and can lead to death when left undiagnosed or untreated for too long. If you believe you may have melanoma, schedule a skin check with your dermatologist immediately.
All types of skin cancer are most common in people with fair skin, but can happen to people with all skin types and skin colors. This is especially true for those who are not careful about their sun exposure and protection, regardless of skin type or color.
The ABCDEs of Melanoma Warning Prevention to Know if you need a Skin Check:
- A for Asymmetry: One half of a mole or dark spot is not the same as the other half
B for Border: Poorly defined or irregular edge or border
C for Color: Inconsistent coloring. Can have shades of tan, brown or black. Sometimes have more abnormal color such as blue, red or white.
D for Diameter: Usually bigger than 6mm (size of a pencil eraser)
E for Evolving: If it looks different from the other moles on a person’s skin or changes color, size or shape. Itching or bleeding are also signs of melanoma.
Skin Cancer Treatments
There are a number of different skin cancer treatments. The type of treatment that is appropriate for you will depend on what type of skin cancer you have and a number of other factors about your individual case. All skin cancers are diagnosed with a skin biopsy.
To know for sure what treatment is best for you schedule a consultation with your dermatologist.
Treatments for Basal Cell Carcinoma (BCC)
There are a number of different treatments depending on how advanced the skin cancer is and how far it has spread.
Excision: The area is numbed and the dermatologist will cut out the area affected with and some of the good skin around it to ensure that all of the affected skin is removed. It will then be examined under a microscope at a lab to make sure the skin around the edges is cancer free. If it is not, another excision will be required at a later date. An excision can be done in our office in many cases.
Curettage and electrodessication: The BCC tumor is scraped away and electrocautery is used to destroy any cancer cells left behind.
Mohs Surgery: Similar to an excision, but less skin is taken off. The skin is examined while the patient waits. If cancer is found around the edges another layer of skin is taken off only in the necessary area. It is mostly used in areas where it is optimal to have the least amount of skin removed such as the nose and ear.
Radiation: This is only for rare cases where other methods cannot be used to treat the basal cell carcinoma. It generally takes many radiation treatments.
Chemotherapy Creams: These prescription creams are sometimes used with superficial cases of basal cell carcinoma. Apply as directed by your dermatologist.
Pills: In some specialized cases of very advanced BCC, pills may be appropriate, but this is only in very rare instances where other treatments are not appropriate.
Outcomes of Treating Basal Cell Carcinoma
Nearly all basal cell carcinoma can be treated successfully and cured, especially when detected promptly.
Treatments for Squamous Cell Carcinoma (SCC)
Similar to Basal Cell Carcinoma, there are a number of different treatment options depending on the details of your case and how early or advanced it is.
Excision: the dermatologist will cut out the affected area and some of the good skin around the squamous cell carcinoma after numbing the area. The skin will be sent off and analyzed at a laboratory to see if the skin cancer is contained in the area excised or if a further excision is needed at a later date. This procedure can be completed in our office in most cases.
Mohs Surgery: Mohs surgery is the more involved version of an excision, where it is ensured that all of the squamous cell carcinoma is taken out during the first visit. A smaller area is generally taken out than with a regular excision, but the skin sample is examined for skin cancer while the patient waits. If the edges of the sample contain some of the SCC another small section of skin will be removed only from the appropriate area still affected by the SCC. Similarly to BCC, this method is used in areas where there isn’t a lot of extra skin like the nose and ears.
Radiation: This is not a very common option for treating squamous cell carcinoma, but is generally used when cutting out the skin cancer is not a good option. It usually takes 15-30 treatments to get rid of SCC.
The following options are generally for when squamous cell carcinoma is caught relatively early:
Curettage and electrodessication: The area affected with skin cancer is scraped away and then an electric current is used to kill any remaining cells. This process will sometimes need to happen multiple times depending on the size of the area affected with SCC.
Chemotherapy Cream: If caught in the very early stages sometimes a chemotherapy cream can be used to treat squamous cell carcinoma. Use as directed by your dermatologist.
Outcomes of Treating Squamous Cell Carcinoma (SCC)
When the recommended treatment is followed, SCC is generally cured. Early treatment is highly recommended, because if SCC is given a chance to grow it can penetrate deep into the skin and spread to the lymph nodes. Treating squamous cell carcinoma before these problems develop is important for successful treatment.
Treatments for Melanoma
While melanoma is the rarest of the three main forms of skin cancer, it is also the most deadly. It can also be one of the hardest to detect, as sometimes moles or dark spots can go relatively unnoticed for long periods of time. Make sure to check your body for changes monthly to make sure to catch any warning signs of melanoma early.
The type of treatment appropriate for melanoma will vary, depending on how advanced the skin cancer is, whether it has spread to other parts of the body, and the overall health of the patient.
Excision: The vast majority of cases of melanoma will need to be surgically removed. Because melanoma can be so aggressive, often a rather large area of appearingly normal skin must be removed around the cancer. For this reason, often times melanomas are removed by surgeons in an outpatient surgery center under sedation. If the melanoma is very small and caught early, it may be possible for us to remove it in our office or with a Mohs surgeon.
There are a number of other options for treating melanoma in its more advanced stages, but only a board certified dermatologist can evaluate if one of these options is appropriate for your situation.
Other options include: Lymphadenectomy (removing lymph nodes), Immunotherapy (boosting the immune system to help fight cancer), Targeted therapy (drugs used to shrink the cancer), Chemotherapy, and Radiation therapy.
Outcomes of Treating Melanoma
When melanoma is detected early enough that it is only affecting the top layer of skin the cure rate is close to 100%. If it has penetrated below the surface of the skin or spread to other areas it is much harder to treat effectively. In more advanced cases the outcome will vary based on a number of factors, including but not limited to how advanced the melanoma is and the general health of the patient. If you think you might have melanoma schedule a skin check today! It might save your life!
A Quick Note about ‘Natural Treatments’ such as Black Salve
If you look around on the internet you may find a number of ‘natural treatments’ for skin cancer such as black salve. Here at Dermatology Center of Acadiana we strongly encourage you to come in for a skin check if you think you might have skin cancer of any type. While melanoma is usually the only type of skin cancer that can be deadly, they can all have very severe adverse effects when left untreated. Leaving skin cancer untreated (or ineffectively treated) allows the cancer to spread, and cancers can often spread quickly, as the definition of cancer is a ‘disease caused by an uncontrolled division of abnormal cells in a part of the body’.
At Dermatology Center of Acadiana as board certified dermatologists it is important for us to make sure that any treatment we offer is clinically tested and approved, and ‘natural’ solutions like black salve are not. While there may be stories on the internet of people who have supposedly successfully used solutions such as black salve to treat skin cancer, there are also many stories of people who have severely impeded successful treatment by waiting to do a clinically proven treatment. In one case a patient had to remove one nostril of his nose after delaying treatment.
The FDA used to have a list of 187 fake cancer cures, but lately they took the list down and have been taking action against a number of fraudulent companies incorrectly claiming to be providing cancer cures.
Get a Skin Check and do Proper Skin Cancer Prevention
Make sure to wear good quality SPF 30+ every day and limit your exposure to the sun. Being tan may look great now, but it is severely detrimental to your skin and puts you at risk for these 3 types of skin cancer and other less common types. The sun is also the primary factor in aging your skin!
If you keep up a daily skin care regimen including SPF 30+ every day, you will be helping your skin be healthy and significantly reduce the signs of aging!