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Facts and Questions

Diagnosis

Skin cancer is the abnormal growth of skin cells, often developing on skin exposed to the sun. However, it can also occur on areas of the skin not ordinarily exposed to sunlight. Skin cancer occurs when the DNA in skin cells is damaged and the body cannot repair the damage, leading to uncontrolled cell growth and tumor formation.

The three main types of skin cancer include:

  • 1. Basal Cell Carcinoma (BCC)
    Basal Cell Carcinoma is the most common and least dangerous type of skin cancer. Basal Cell Carcinoma develops from the basal cells, which are found in the deepest layer of your skin. It often appears as a translucent bump on the skin, though it can take other forms. Basal Cell Carcinoma grows slowly and rarely spreads to other parts of the body.
  • 2. Squamous Cell Carcinoma (SCC)
    Squamous Cell Carcinoma is the second most common type of skin cancer and develops from the squamous cells, which make up most of the skin’s upper layers. Squamous Cell Carcinoma typically presents as a red, scaly, or crusted lesion. Squamous Cell Carcinoma can grow more quickly than Basal Cell Carcinoma and has a higher likelihood of spreading to other parts of the body if not treated properly.
  • 3. Melanoma
    Melanoma is the most dangerous form of skin cancer, originating in the melanocytes, the cells that produce pigment in the skin. Melanoma can develop in existing moles or appear as a new dark spot on the skin. Melanoma is more likely to spread to other parts of the body and requires early detection and treatment for the best outcomes.

Skin cancer is diagnosed through a combination of physical examinations and medical tests. Here’s a step-by-step overview of the process:

  • 1. Physical Examination
    A dermatologist will visually inspect your skin for any suspicious moles, growth, or lesions. They may use a dermatoscope, a special magnifying lens with a light, to get a closer look at the skin’s surface
  • 2. Skin Biopsy
    If a suspicious area is found, the dermatologist will perform a skin biopsy. This involves removing a small sample of the affected skin, which is then sent to a laboratory for analysis. There are different types of biopsies, including:
    • Biopsy: a thin layer of skin is shaved to the surface
    • Punch Biopsy: a small, circular piece of skin is removed using a punch tool
    • Excisional Biopsy: the entire suspicious area, along with some surrounding tissue, is removed
  • 3. Pathology Examination
    In the laboratory, a pathologist examines the skin sample under a microscope to determine whether cancer cells are present. They will also identify the type of skin cancer and its characteristics.
  • 4. Further Tests (If Needed)
    If the biopsy confirms skin cancer, additional tests may be performed to determine the extent of the cancer. These may include imaging tests (such as CT scans or MRI) or lymph node biopsies to check if the cancer has spread.

Early detection of skin cancer greatly improves the chances of successful treatment. Here are some steps you can take to detect skin cancer early:

  • 1. Perform Regular Self-Examinations
    Check your skin from head to toe once a month. Use a mirror to examine hard-to-see areas like your back and scalp. Look for any new moles, growths, or changes in existing moles.
  • 2. Know the ABCDEs of Melanoma
    Use the ABCDE rule to help identify suspicious moles or skin changes:
    • A – Asymmetry: One half of the mole doesn’t match the other half.
    • B – Border: The edges are irregular, ragged, or blurred.
    • C – Color: The color is not uniform and may include shades of brown, black, pink, red, white, or blue.
    • D – Diameter: The spot is larger than 6mm across (about the size of a pencil eraser), although melanomas can be smaller.
    • E – Evolving: The mole is changing in size, shape, or color over time.
  • 3. Look For Other Warning Signs:
    Be alert to any sore that doesn’t heal, a mole that grows, changes, or bleeds, or any new growth that appears unusual. Other signs include redness or new swelling beyond the border of a mole, changes in sensation (itchiness, tenderness, or pain), and changes in the surface of a mole (scaliness, oozing, bleeding, or the appearance of a bump).
  • 4. Schedule Regular Dermatologist Visits:
    See a dermatologist annually for a professional skin examination. If you have a higher risk of skin cancer, such as a family history of skin cancer or a personal history of excessive sun exposure, your dermatologist may recommend more frequent check-ups.
  • 5. Protect Your Skin
    Protection your skin can help to prevent skin cancer from developing in the first place. Use sunscreen with an SPF of 30 or higher, wear protective clothing (such as rash guards), and avoid tanning beds.

Recognizing the skins and symptoms of skin cancer early can lead to more effective treatment. Here are some common indicators to watch for:

  • 1. New Growths or Sores That Don’t Heal
    Any new spot or growth on your skin, especially one that doesn’t heal within a few weeks, should be examined by a dermatologist.
  • 2. Changes in Existing Moles or Spots
    Pay attention to any changes in size, shape, color, or texture of existing moles or spots. Use the ABCDE rule as a guide:
    Use the ABCDE rule as a guide:
    • A – Asymmetry: One half of the mole doesn’t match the other half.
    • B – Border: The edges are irregular, ragged, or blurred.
    • C – Color: The color is not uniform and may include shades of brown, black, pink, red, white, or blue.
    • D – Diameter: The spot is larger than 6mm across (about the size of a pencil eraser), although melanomas can be smaller.
    • E – Evolving: The mole is changing in size, shape, or color over time.
  • 3. Redness or Swelling
    Look for redness or new swelling beyond the border of a mole or spot.
  • 4. Changes in Sensation
    Be aware of any changes in sensation, such as itching, tenderness, or pain in a mole or spot.
  • 5. Changes in Surface Texture
    Notice any changes in the surface of the mole, including scaliness, oozing, bleeding, or the appearance of a lump or bump.
  • 6. Changes in Surface Texture
    Notice any changes in the surface of the mole, including scaliness, oozing, bleeding, or the appearance of a lump or bump.
  • 7. Unusual Spots
    Look out for any unusual spots that are different from the others on your skin. These can be new growths or spots that stand out due to their appearance.
  • 8. Firm, Red Nodules
    Squamous cell carcinoma often appears as firm, red nodules or flat lesions with a scaly, crusted surface.
  • 9. Shiny or Pearly Bumps
    Basal cell carcinoma commonly manifests as shiny, pearly bumps that can be pink, red, or white. They may also appear as brown or black like a mole.
  • 10. Flat, Scaly Patches
    Some skin cancers, particularly squamous cell carcinoma, can appear as flat, scaly patches that may bleed or crust over.

Regular self-examinations and dermatological check-ups are crucial for early detection. If you notice any of these signs or symptoms, schedule an appointment with a dermatologist as soon as possible.


Treatment

The treatment for skin cancer depends on the type, location, and stage of the cancer, as well as the patient’s overall health. Common treatments include:

The three main types of skin cancer include:

  • Surgical Removal
    • Excisional Surgery: The cancerous tissue and a margin of healthy skin around it is surgically removed.
    • Mohs Surgery: A precise surgical technique where thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. It is often used for larger, recurring, or difficult-to-treat skin cancers.
  • Radiation Therapy
    High-energy rays are used to target and kill cancer cells. It is often used when surgery is not an option or for cancers that have spread.
  • Chemotherapy
    Topical chemotherapy involves applying a cream or lotion containing anti-cancer drugs directly to the skin. Systemic chemotherapy, which involves taking medication by mouth or injection, may be used for more advanced skin cancers.
  • Immunotherapy
    This treatment boosts the body’s immune system to help fight the cancer. It can be applied topically or given as an injection.
  • Targeted Therapy
    This involves drugs that specifically target the genetic mutations or proteins that contribute to cancer growth. It is mainly used for advanced melanomas.

Several factors can influence the choice of treatment for skin cancer, including:

  • Type and Stage of Skin Cancer
    The specific type (e.g., basal cell carcinoma, squamous cell carcinoma, melanoma) and stage (extent of spread) of the cancer will determine the most appropriate treatment.
  • Location and Size of the Tumor
    Tumors in areas that are difficult to treat surgically or that affect critical functions may require different treatment approaches.
  • Patient’s Age and Overall Health
    The patient’s general health, age, and ability to tolerate certain treatments are important considerations.
  • Previous Treatments
    Any prior treatments for skin cancer and their outcomes can influence the current treatment plan.
  • Risk of Recurrence
    Tumors with a high risk of recurrence may require more aggressive treatment.
  • Patient Preferences
    Patient Preferences and lifestyle considerations, such as recovery time and potential side effects, play a role in deciding the treatment approach.
  • Genetic Factors
    • Genetic mutations and biomarkers identified through testing can guide the use of targeted therapies.

Discussing these factors with your healthcare provider will help determine the most effective and appropriate treatment plan for your specific situation. Early detection and personalized treatment strategies are key to managing skin cancer effectively



Post Treatment

The likelihood of skin cancer coming back depends on several factors, including the type of skin cancer, its initial treatment, and individual risk factors.

  • Type of Skin Cancer
    Basal Cell Carcinoma has a high cure rate, but recurrence is possible, especially in other areas of the body. Squamous Cell Carcinoma has a high cure rate with treatment, but there is the chance that new Squamous Cell Carcinomas develop. Melanoma has a higher risk of recurrence, especially in more advanced stages.
  • Initial Treatment
    Effective initial treatment reduces the likelihood of recurrence. Treatments like surgical removal can help ensure all cancerous cells are removed.
  • Risk Factors
    Factors such as excessive sun exposure, fair skin, weakened immune system, or family history can increase recurrence risk.
  • Follow-Up Care
    Regular dermatologist visits and skin checks are crucial for early detection of any recurrence.
  • Preventative Measures
    Using sunscreen, wearing protective clothing, and avoiding tanning beds can help reduce the risk of new skin cancers.

While skin cancer can recur, vigilant skin checks, preventative measures, and regular follow-up visits can help manage and reduce this risk. Discuss any concerns with your healthcare provider for personalized advice.



Risk Factors

Several factors can increase your risk of developing skin cancer, including:

  • Excessive Sun Exposure
    Prolonged exposure to ultraviolet (UV) radiation from the sun, especially without protection, is a major risk factor.
  • Tanning Beds
    Use of indoor tanning beds significantly increases the risk of all types of skin cancer.
  • Fair Skin
    People with fair skin, light-colored eyes, and red or blonde hair have less melanin and are more susceptible to UV damage.
  • History of Sunburns
    A history of severe sunburns, particularly in childhood, increases the risk.
  • Moles
    Having many moles or atypical moles increases the risk of melanoma.
  • Family History
    A family history of skin cancer, especially melanoma, can increase your risk.
  • Personal History
    If you have had skin cancer before, you are at a higher risk of developing it again.
  • Weakened Immune System
    Conditions or medications that weaken the immune system can increase the risk of skin cancer.
  • Exposure to Certain Substances
    Exposure to certain chemicals, such as arsenic, can increase the risk.
  • Age
    The risk of developing skin cancer increases with age.
  • Geographic Location:
    Living in sunny or high-altitude climates increases exposure to UV radiation, raising the risk.

By being aware of these risk factors and taking preventive measures, such as using sunscreen and avoiding tanning beds, you can reduce your chances of developing skin cancer. Regular skin checks and dermatologist visits are important for early detection.

To reduce your risk of developing skin cancer, follow these preventative measures:

  • Use Sunscreen
    Apply a broad-spectrum sunscreen with SPF of 30 or higher, even on cloudy days. Reapply every two hours, or after swimming or sweating.
  • Seek Shade
    Limit direct sun exposure, especially between 10 a.m. and 4 p.m. when the sun’s rays are strongest.
  • Wear Protective Clothing
    Cover exposed skin with clothing, such as long-sleeved shirts, pants, and wide-brimmed hats.
  • Avoid Tanning Beds
    Avoid using indoor tanning beds and booths, as they emit harmful UV radiation.
  • Perform Regular Skin Checks
    Examine your skin head-to-toe every month to detect any changes or new growths early.
  • Know Your Skin
    Be aware of your moles, freckles, and other skin marks. Monitor them for any changes in size, shape, color, or texture.
  • Stay Informed
    Learn about your personal risk factors and discuss any concerns with a healthcare professional.

By adopting these habits and staying vigilant about your skin health, you can help prevent skin cancer and promote overall skin wellness.