Skin Cancer

Skin cancer is the abnormal uncontrolled growth of skin cells. Skin cancer treatment usually involves surgery to remove the cancer cells. There are three major types of skin cancer. The less aggressive two non-melanoma skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The third more aggressive skin cancer is melanoma that spreads to other parts of the body and may be fatal if left untreated.

Types of Skin Cancers

Skin cancer is characterized by an abnormal growth of cells that develops on the skin. While most skin cancer presents in areas that are exposed to the sun, such as the limbs, face, chest, and neck, it can also form in regions that rarely or never experience sun exposure. Therefore, checking the entirety of your skin regularly for any suspicious changes is an important tool for detecting skin cancer early, when it is easiest to treat successfully.

Some common types of skin cancer treated at Colleyville Dermatology include:

• Basal cell carcinoma
• Squamous cell carcinoma
• Melanoma
• Sebaceous carcinoma

Basal Cell Carcinoma (BCC)

Basal cell carcinoma is a form of skin cancer which typically appears on skin that is frequently exposed to the sun (ultraviolet radiation), although it can present in other areas including the genitals. Originating from the basal cells (which produce new skin cells to replace those that naturally die), these skin cancers often appear as an almost translucent bump on the skin’s surface.

Characteristics of basal cell carcinoma can include:

• Pearly, pink, or skin-colored bump: The growth is usually somewhat translucent, and blood vessels may be able to be seen within it. For darker skin tones, the area can still be transparent in nature under a darker-colored bump. These lesions can occasionally rupture and bleed, then scab over.
• A flat, reddish, scaly patch of skin: These carcinomas usually have a raised edge and can grow large over time. They frequently occur on the back or chest.
• Black, brown, or blueish growth: Darker basal cell growths typically have a translucent, raised border surrounding them.
• Waxy, white growth (morpheaform basal cell carcinoma): These scar-like lesions are less common and do not have defined borders.

Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma is a skin cancer that affects the squamous cells that are in the middle and outer layers of skin. Squamous cell carcinoma is typically caused by UV radiation from the sun or tanning beds/lamps and can present anywhere squamous cells are located. While sun-exposed skin is most susceptible, squamous cell carcinoma can present on other areas, such as inside the mouth, on the genitals, and the soles of the feet. The lesions occur when the squamous cells develop mutations in DNA which causes them to grow rather than die as they normally would over time.

Squamous cell carcinoma can appear in various forms such as:

• Dome-shaped bump
• Red, scaly patch of skin
• Flat, scaly, crusted sore
• Firm, red nodule
• New lesion in an old scar
• Rough, red sore in the mouth
• Wart-like or raised, red patch of skin on the anus or genitals

Squamous cell carcinoma can spread to other parts of the body if left untreated. When diagnosed early, it is highly treatable and not life-threatening.

Malignant Melanoma

Melanoma is the most serious form of skin cancer and develops in the melanocytes, the cells that produce melanin which gives pigmentation (color) to the skin. Melanoma occurs when the DNA in the skin cells that produce melanin becomes damaged. While exposure to UV radiation is thought to be a leading risk factor for developing melanoma, a definitive cause is not completely known, as it can present anywhere on the body. Melanoma often first appears as a change in an existing mole but can also begin as an unusual growth or pigmentation on the skin.

Is My Mole Normal?

Most people have moles somewhere on their bodies. A normal mole is typically one color (usually black, brown, or tan) and has a border surrounding it that visually separates it from the adjacent skin. Generally, non-cancerous moles are smaller than a quarter inch in diameter (approximately pencil eraser sized) and are round or oval-shaped.

Most new moles may appear starting in childhood through age 40 and can change in appearance or disappear completely over time. It is not unusual for an adult to have 10 to 40 moles.

What Does a Cancerous Mole Look Like?

A good method to identify concerning moles is by thinking of the letters A through E.

These symptoms do not necessarily mean that your mole is a melanoma, however moles that exhibit one or more of these attributes should be evaluated by a dermatologist.

Melanomas can develop in hidden areas as well, such as in the mucous membranes, under a fingernail or toenail, or in the eye. Any skin changes that seem unusual should be checked by your doctor.

Sebaceous Carcinoma (SC)

Sebaceous carcinomas (SC) are also referred to as sebaceous gland carcinoma, sebaceous gland adenocarcinoma, or meibomian gland carcinoma.

Sebaceous carcinoma is a less common skin cancer that originates in an oil gland in the skin. Typically appearing as a lump or thickening of the skin, sebaceous carcinoma often presents on the eyelid (similar to a chalazion). Sebaceous carcinoma can occur in other parts of the body, usually as a yellowish lump. In any case, the lump may ooze or bleed as it grows. Treatment for sebaceous carcinoma is most often surgical removal of the growth.

Am I at Risk for Skin Cancer?

Anyone can develop skin cancer at any age however, certain factors can put you at higher risk. People who spend large amounts of time outside are exposed to the sun’s UV rays frequently, and therefore have a greater risk of getting skin cancer.

Other contributors which can increase skin cancer risk include:

• Light skin, hair, and/or eyes: People who burn or freckle easily, who have red or blonde hair, or blue or green eyes are at higher risk statistically. Those who had frequent/chronic sunburns in the past also have increased risk.
• Personal or family history: People who have previously experienced skin cancer or who have skin cancer in their family history have a greater chance of developing skin cancer.
• Radiation exposure: Patients treated with radiation therapy can get skin cancer more easily.
• Weak immune system: Certain medical conditions or treatments involving immunosuppressant drugs may increase skin cancer risk.
• An excessive number of moles: While most moles are harmless, having an abundance of moles increases the chances of one being cancerous.

Diagnosing and Treating Skin Cancer

If you have a suspicious mole, growth, or bump, your dermatologist will do a thorough examination of the area. A tissue sample may be taken by numbing the area in question and removing a small piece of skin (skin biopsy) which is then sent to a lab for evaluation. If the results show the lesion to be cancerous, your dermatologist will proceed with treatment to remove the cancer while minimizing scarring.

Skin cancer treatment may include:

• Excision: Using a local anesthetic, the tumor is cut out with some of the healthy skin around it.  The healthy skin is called a margin. An elliptical excision is the most common way to excise a tumor. An elliptical (football) shape around the margin is removed, and stitches are used to close the incision in a linear fashion.
• Curettage and desiccation: During this procedure, your doctor scrapes off the tumor with a small spoon-shaped instrument called a curette, then uses an electronic needle to kill any remaining cancer cells.
• Cryosurgery: Some tumors can be frozen off with liquid nitrogen.
• Prescription medicine: Topical chemotherapy creams (such as fluorouracil and imiquimod) can be prescribed to treat some skin cancers. Pills (such as sonidegib and vismodegib) may be utilized if basal cell cancer has spread to other areas of the body.
• Radiation: X-ray therapy over several weeks can be an effective treatment to destroy cancer cells. Radiation treatment does carry with it a higher risk of recurrence, and thus, only recommended when surgical treatments are not a viable option.
• Mohs surgery: Part of the tumor is excised and studied in the lab during the surgical procedure. The surgeon removes and tests additional layers of tissue one at a time until no cancer is found.

Your doctor will determine which treatment is most appropriate for your condition based on the type and extent of skin cancer involved, as well as your preference and tolerance for specific therapies.

Patients who have previously been diagnosed with skin cancer are at greater risk for recurrence, so taking preventative measures is extremely important.

Skin Cancer Prevention

While there is no absolute method that guarantees skin cancer will not develop, taking certain preventative measures can greatly reduce your risk.

Preventative steps include:

• Avoid prolonged exposure to the sun, especially between 10 a.m. and 2 p.m. when UV rays are strongest.
• Wear a broad-spectrum sunscreen (protection factor of 30 or higher) every day. Apply to any area of the body exposed to sunlight. Reapply every 60-80 minutes when outside for an extended period.
• Wear clothing that protects/covers the skin when possible (including sunglasses that block both UVA and UVB rays).
• Avoid tanning beds and lamps.
• Check your skin for growths or changes on a regular basis.
• Visit your dermatologist regularly for skin cancer screenings.

The key to successful skin cancer treatment is early detection. If you are concerned about a growth, mole, lump, or patch on your skin, please contact our team of experts at Colleyville Dermatology for a skin cancer screening.