Skin cancer is the most common form of cancer, affecting millions of people in the United States each year. The predominant types of skin cancer are basal carcinoma, squamous carcinoma, and melanoma, although rarer types of skin cancer also exist.

3.3 million people, approximately, are diagnosed with basal and/or squamous carcinoma - the two most common types of skin cancer - in the U.S. annually. Each year, 5.4 million basal and/or squamous cell carcinomas are diagnosed. Every year, about 2000 Americans, most of them elderly, die from these types of skin cancer.

Melanoma represents only about 1% of skin cancer cases in the U.S., with approximately 100,350 diagnoses occurring yearly. Approximately 6,850 people die from melanoma every year in the United States, while about 4,630 Americans die from less common forms of skin cancer.

The majority of skin cancers are preventable and treatable. Recognizing telltale signs and symptoms can help more people recognize skin cancer in its earlier stages so they can get the necessary treatment.

There are a number of types of skin cancer, and each one can be indicated by a range of symptoms. To monitor your health and keep an eye peeled for warning posts, it can be helpful to recognize some of the signs and symptoms of different skin cancers.

Basal cell skin cancer

Basal cell cancer can occur anywhere on the body, but it typically develops on areas regularly exposed to the sun.

This type of cancer may appear on your face, neck, or other body parts in the form of:

• A recurring sore that may bleed or scab, and never fully heals
• Itchy, red patches on the skin
• A flat, brown/yellow or flesh-colored lesion that looks like a scar
• Small, shiny, waxy, or pearly-feeling bumps on the skin
• Pink, donut-shaped skin growths with abnormal blood vessel patterns

Squamous cell skin cancer

Like basal cell cancer, squamous cell cancer tends to appear on sun-exposed body parts. Squamous cell cancer most frequently occurs on the hands, neck, head, and face, but can also develop on genital skin or other parts of the body.

Squamous carcinoma can show up as:

• A firm, red lump or nodule on the skin, which may be raised on the edges with a lower spot in the center
• A scaly, red patch or lesion, which might bleed, scab, or crust over
• A recurring sore that won’t heal
• Growths that look like warts

Melanoma

No skin on your body is immune to melanoma, including body parts that haven’t had any sun exposure. In women, melanoma is most common on the lower legs. In men, melanoma most commonly develops on the face and the torso.

Melanoma appears as a new spot on the skin, or as a spot that begins to grow and change. Warning signs of melanoma include:

• An asymmetrical, abnormally shaped mole
• A mole that changes in color, size, shape, or texture, and which may bleed
• A mole/spot with jagged-looking or blurred edges
• A skin spot that is larger than ¼ inch wide
• A multicolored mole or spot, which may have patches that are spotted, black, brown, red, pink, or white
• Redness around the edges of a mole
• An itching, burning, or bleeding lesion in the skin

Merkel cell skin cancer

Merkel cell cancer is a rare form of carcinoma that usually occurs on sun-exposed areas of skin.

This type of cancer can appear on the head, neck, arms, legs, or other body parts as:

• A firm, shiny bump just beneath the surface of the skin
• One or multiple lumps that are red, pink, or purple in color, which may occur on the skin and in hair follicles
• A bleeding lump where the tumor splits open

Kaposi Sarcoma

Kaposi sarcoma (KS) is a rare type of skin cancer that develops in the blood vessels of the skin. It is found most commonly in patients with compromised immune systems.

KS can show up on the skin’s surface in the form of:

• Flat patches of spots, or lesions, which may be red, purple, or brown in color
• Slightly raised, brown or reddish lesions (called plaques)
• Fully raised, bumpy lesions (called nodules) with a red or brown color

If you think you may be experiencing any of the symptoms of different skin cancers described above, you should call a doctor to discuss your symptoms. You may find that you simply have a large, non-cancerous mole, and can have your concerns put to rest by a professional. On the other hand, your doctor may be able to diagnose your condition and recommend treatment sooner rather than later. Either way, it is best to be on the side of caution and speak with your doctor about what you’ve noticed.

Different forms of skin cancer develop when there are mutations in the DNA of skin cells. Skin cancer begins with a mutation in the epidermis, which is the top layer of the skin. Cells begin to multiply and grow out of control, eventually forming a cancerous mass.

While various risk factors have been identified, it is not always apparent what factor actually causes skin cell DNA to mutate.

One cause of skin cancer that is clear is exposure to sunlight (both real and artificial). The ultraviolet (UV) rays in sunlight and tanning beds can cause extensive damage to the DNA in skin cells. In turn, these damaged cells may someday become cancerous. Harmful UV radiation can occur relatively soon before the appearance of skin cancer, but it can also pre-date a cancer diagnosis by many years. (For example, someone may have a habit of visiting tanning beds in their early teens, and could subsequently develop skin cancer a decade or even two decades later.)

However, UV radiation can’t explain skin cancers that occur on body parts that aren’t exposed to the sun. This suggests that different causes exist for certain cases of skin cancer. Among these causes, for instance, may be a drastic or repeated exposure to toxic substances.

In some cases, a person may inherit genes that lead to melanoma. Certain gene changes received from a parent could cause a failure in the body to control unruly cell growth, eventually resulting in melanoma. These inherited, or familial, melanomas are relatively rare.

While the exact causes of skin cancer are sometimes unknown, there are a number of known risk factors that correlate with higher chances of developing skin cancer.

These risk factors include:

• Being fair-skinned. Having less melanin in your skin means that you have less protection from harmful UV rays. For this reason, people with lighter skin are at a higher risk of developing skin cancer than people with darker skin. With that being said, anyone can develop skin cancer, regardless of the shade of their skin.


• Living in a sunny climate. People who live in warm, sunny climates - especially those at high altitudes - can face long, intense exposure to the sun’s UV rays. As a result, skin cancer is more likely to occur in people living in these climates than in people who live in colder, darker climates.


• Having a history of sunburns. Suffering through serious sunburns in childhood, adolescence, or adulthood increases a person’s risk of skin cancer.


• Exposure to UV radiation. Having your skin exposed to UV radiation for long and/or repeated periods of time is the most well-known risk factor for different types of skin cancer. UV radiation may come from the sun itself or a human-made source, such as a tanning bed.


• Exposure to other radiation. Besides UV rays, other forms of radiation can also heighten a person’s risk of skin cancer later in life. People who undergo radiation treatment for other conditions, including different forms of cancer or acne or eczema, face a higher risk of skin cancer in the area that received radiation.


• Being of an advanced age. Melanoma, basal cell skin cancer, and squamous cell skin cancer are all more likely to occur in older people than in younger people. This may be because, over the course of their life, middle-aged and elderly people have had a significant build-up of exposure to the sun. Nonetheless, skin cancers are also becoming more common in younger patients.


• Exposure to toxic chemicals. Exposure to arsenic and other toxic substances can increase a person’s risk of skin cancer. Being exposed to large amounts of paraffin, petroleum products, and coal tar may also increase the risk of skin cancer.


• Having a weakened immune system. A body with a weakened immune system may struggle to fight off potentially cancerous cells, and is therefore at a heightened risk of developing skin cancer. People have weakened immune systems for various reasons, including having autoimmune diseases, using immunosuppressant drugs, or being infected with HIV.


• Having a family or personal history of skin cancer. People who have had skin cancer in the past are at an increased risk of developing it again, whether it is the same or a different type of skin cancer than the initial occurrence. Furthermore, if your parent or sibling has had some form of skin cancer, you may have a higher chance of developing skin cancer yourself.

Although some risk factors for skin cancer can’t be helped, many cases of skin cancer are preventable.

Here are some steps you can take to protect yourself and minimize your chances of developing skin cancer:

• Limit your sun exposure. Do your best to avoid prolonged, intense periods of UV exposure outside. Seek shade when possible, and limit the time that you spend in the sunshine between 10 a.m. and 4 p.m., when the sun’s rays are strongest.


• Wear sunscreen consistently. To protect yourself from some of the harshest UV rays, apply sunscreen to your face, neck, arms, and other exposed body parts before spending time in the sun. Since UV radiation penetrates through clouds and exists year-round, wearing sunscreen is an important habit to practice all year long - even in the winter and on overcast days. For the best possible protection against UV radiation, make sure to use a sunscreen with an SPF of at least 30.


• Cover your skin. In addition to sunscreen, which doesn’t stop all UV rays, protective clothing guards against damaging UV radiation. When you are able, cover your arms, legs, and torso with tightly woven clothing before spending time in the sun. You can also protect yourself by wearing a hat that keeps your face shaded, and UV-blocking sunglasses that protect the sensitive skin around your eyes.


• Do not use tanning beds. Tanning beds emit dangerous UV radiation that can increase your chances of developing skin cancer. As a preventative measure, avoid using tanning beds and sun lamps.


• Use medications carefully. Some prescription and over-the-counter medications may increase your skin’s sensitivity to UV radiation, possibly increasing the risk of skin cancer. Moreover, some medications have the effect of weakening your immune system. Always speak to your doctor or pharmacist about drugs you are taking to make sure you understand the effects they may have.


• Check your skin. Simple familiarity with your own skin is an important step in catching skin cancer as early as possible. Use mirrors to check different areas of your skin regularly, on all parts of your body. Keep a special eye on moles and spots that you have, particularly large or abnormally shaped ones. If you notice mole growth/change or another abnormal skin condition, contact a doctor to take a closer look.

Again, the best way to screen for skin cancer is knowing your own skin. If you are familiar with the freckles, moles, and other blemishes on your body, you are more likely to notice quickly if something seems unusual

To help spot potentially dangerous abnormalities, doctors recommend doing regular self-exams of your skin at home. Ideally, these self-exams should happen once a month, and should involve an examination of all parts of your body. Use a hand-held mirror and ask friends or family for help so as to check your back, scalp, and other hard-to-see areas of skin. If you or someone else notices a change on your skin, set up a doctor’s appointment to get a professional opinion.

If you contact your health-care provider with concerns about your skin, your doctor will conduct an examination to determine whether the skin abnormality is cancerous.

To diagnose your condition, your primary care doctor or dermatologist may:

• Closely examine your skin using visuals and touch
• Take a sample piece or biopsy of the affected skin for lab testing

Based on the examination and biopsy, your doctor will most likely be able to diagnose whether you have skin cancer and (if you do) what type of cancer it is.

Determining If the Cancer Has Spread

As part of your diagnosis, your doctor will also determine what stage the cancer is in. The different “stages” refer to whether and how far the cancer has spread in your body, on a Roman numeral scale of I to IV. A stage I cancer is small and contained to the body part where it originated, whereas a stage IV cancer has spread aggressively to other parts of the body.

Depending on the type of skin cancer that a person has, it may be more or less likely that it has spread through the body. For instance, basal cell skin cancer rarely spreads beyond the skin where it starts. However, melanomas and large squamous cell carcinomas are more likely to spread into other regions of the body. Cases of melanoma, in particular, may call for further tests to determine the specific stage they’re in.

Your doctor may evaluate multiple factors in order to “stage” the cancer. Using biopsies and imaging tests, your doctor may take a look at:

• The size and thickness of the tumor, and whether it has grown into surrounding tissues
• Nearby lymph nodes, to check for signs of cancer spread

If you are diagnosed with skin cancer, you may have multiple options for treatment. Based on the specifics of your case, your doctor will recommend your best course of action.

The suggested methods for fighting the cancer may include:

• Cryotherapy. In cryotherapy, a doctor freezes and kills precancerous or cancerous skin cells using liquid nitrogen. This technique is most often used to treat minor basal or squamous carcinomas or precancerous skin conditions.


• Surgery. Different types of skin cancer may be removed by surgery. Surgery can be excisional - simply cutting out a cancerous area and the skin surrounding it - or may involve meticulous removal of layers of skin.


• Radiation therapy. In radiation therapy, energy beams are used to kill cancerous cells. Radiation therapy may help finish off a cancer that was not fully removed by surgery, and can also be instrumental in cases that don’t allow for surgery.


• Chemotherapy. This type of therapy uses drugs to kill cancer cells. To treat some cases of skin cancer, chemotherapy may be applied locally through topical creams or lotions. It may also be administered by IV to target multiple body parts at once.


• Immunotherapy. Immunotherapy, also called biological therapy, involves boosting the immune system to fight cancer cells. With the help of strengthening medicines, the immune system may be better prepared to kill cancerous cells.

If you have any concerns about the health of your skin, it is important to share them with your doctor. After making an appointment, there are steps you can take to prepare yourself and make the most of your time with your doctor.

Here are some things to consider and be prepared to discuss before visiting the clinic or hospital:

• What symptoms are you experiencing (including symptoms that are seemingly unrelated to the skin condition)?


• When did you first notice your symptoms?


• Have there been any major changes or stressors in your life recently?


• What medications and/or vitamins are you taking?


• What questions do you have for your doctor?

After receiving a skin cancer diagnosis, you may feel pressure to make an immediate decision about your treatment plan. However, if you’re able, it is important to take the time to consider your needs and priorities as you face this process.

Each case of skin cancer is unique, and so is every patient’s treatment strategy.

Some important points for you to consider as you move forward include:

• The type and stage of your cancer
• Your age and health
• Side effects that different treatments may have
• How likely different forms of treatment are to cure your cancer

As you consider these factors, you may want to seek a second opinion from another doctor. You may also choose to consult with friends and family members who know you well on a personal level. All of these people can help you make the decision that works best for you.

Contact Us

At South Texas Oncology and Hematology for Cancer Care, we have more than 35 years of experience providing advanced treatment for prostate cancer patients. Our dedicated staff will assist you in choosing the best options and give you hope for the future. We know cancer is scary. You can depend on us to educate you on the process, provide compassionate support, and work hard to meet your expectations. To find out more about the services we offer, call us at (210) 593-5700 or fill out our online form.