Skin Cancer
At Reid Cancer Center, our multidisciplinary care team combines personalized care with advanced diagnosis and treatment methods for skin cancer.
What is skin cancer?
Skin cancer occurs when damaged or abnormal skin cells grow uncontrollably. For most types of skin cancer, ultraviolet radiation from the sun or tanning beds causes this cell growth.
Skin cancer can develop anywhere that gets repeated ultraviolet (UV) exposure: the scalp, tops of the ears, face, neck, shoulders, arms, back, hands, legs, and feet. Skin cancer is the most common form of cancer in the United States. It affects men and women of all ages.
There are three common types of skin cancer:
- Basal cell carcinoma (BCC): The most common type of skin cancer, BCC often develops in sun-exposed areas like the face and neck. It tends to grow slowly and rarely spreads to other parts of the body.
- Squamous cell carcinoma (SCC): The second most common type of skin cancer, SCC may develop in sun-exposed areas or places affected by chronic damage, like scars or skin sores. It is more aggressive than BCC.
- Melanoma: The third most common type of skin cancer, melanoma, spreads easily to other parts of the body, including the vital organs, and is responsible for most skin cancer deaths.
When only the best will do
Reid Health’s primary care providers (PCPs) and plastic surgeons work seamlessly with the oncology team at Reid Cancer Center to ensure people in East Central Indiana and West Central Ohio get skin cancer screenings and treatments. This collaborative care helps you avoid long-lasting consequences of melanoma and other forms of skin cancer.
Signs and symptoms of skin cancer and melanoma
Checking your skin regularly can help you identify suspicious spots. Don’t neglect easy-to-miss areas, such as between toes, under nails, and behind the knees.
Keep these ABCDE warning signs in mind:
- A — Asymmetrical: Look for moles with an irregular shape. Healthy moles are oval or round, and if you could fold them in half, the sides would match.
- B — Border: Healthy moles have clear, defined borders. Moles with jagged or irregular edges should raise red flags.
- C — Color: Healthy moles have a uniform color that doesn’t change over time. Watch for moles with multiple colors or colors that have darkened or faded.
- D — Diameter: Moles are typically small (less than ¼-inch across). If a mole grows larger, have a provider check it out.
- E — Evolving: Any mole or spot that has changed in the ways mentioned above or looks different from other moles should be investigated.
Because of its many forms, skin cancer can appear differently. The main sign of melanoma and other forms of skin cancer is a mole, growth, bump, or patch of skin that changes or is new. Other warning signs include wounds, cuts, or sores that don’t heal and moles that itch or bleed.
Skin cancer can appear anywhere on the body — not only in areas with frequent sun exposure. Check your skin for changes regularly.
Skin cancer risk factors
UV exposure increases the risk of all forms of skin cancer, so proper sun protection can help prevent the disease. However, having certain physical characteristics can further increase your risk. Those characteristics include:
- Blonde or red hair
- Blue or green eyes
- Lighter skin tone
- Skin that burns, freckles, or reddens easily, or becomes painful in the sun
In addition, you might have a higher risk if you:
- Are age 50 or older
- Have more than 50 moles
- Have irregular or large moles,
- Have a family history of skin cancer
Skin cancer diagnosis
Checking your skin regularly helps you spot changes or other suspicious areas early. When you do, talk to your primary care provider. Your provider can recommend help from a plastic surgeon or order a skin biopsy.
During a skin biopsy, a provider will first numb your skin and then remove all or part of the suspicious spot. Your provider will send the sample to a lab, where it’ll be tested for cancer.
If you have other symptoms or if your provider suspects cancer has spread, they might perform a lymph node biopsy. Like a skin biopsy, your provider will collect a sample, this time of lymph fluid, and send it to a lab to see if it has cancerous cells.
Melanoma can spread quickly and can reach the lymph nodes and organs while the spot on your skin is still small. These tumors are sometimes found with imaging tests before melanoma on the skin is discovered.
Occasionally, melanoma can spread to other areas of the body before you see a spot on the skin. In these cases, it can be hard to determine where the cancer started.
Stages of nonmelanoma skin cancer
Your cancer’s stage helps your provider come up with a treatment plan. Staging is based on a tumor’s size and location and whether it has spread.
Basal and squamous cell carcinomas are generally staged in levels from 0 to 4:
- Stage 0: Cancer is limited to the epidermis, the outer layer of skin.
- Stage 1: Cancer exists, but the tumor is still very small.
- Stage 2: The tumor is small and, if found on the eyelid, may might have reached tissue below the skin.
- Stage 3: The tumor has grown larger and begun to spread, or the tumor is still small and has spread to one lymph node on the same side of the body where the cancer formed.
- Stage 4: Tumors have grown to any size and have spread extensively.
Stages of melanoma
Melanoma is a more severe form of skin cancer. Stages are often broken down further, for example, 1A and 1B, but in general:
- Stage 0: The cancer exists only on the top layer of skin and hasn’t spread to other parts of the body.
- Stage 1: The tumor is no thicker than 2 millimeters (mm) but hasn’t spread. The skin might have begun to break down, or “ulcerate.”
- Stage 2: The tumor might have grown as thick as 4 mm but hasn’t spread beyond the skin. Smaller tumors have begun to ulcerate, whereas larger tumors haven’t.
- Stage 3: The tumors have grown and, in most stage 3 tumors, have ulcerated. Cancer has also been detected in lymph nodes or spread to very deep layers of skin.
- Stage 4: Cancer has spread to other areas of the skin, lymph nodes, and organs.
Skin cancer treatments
Your provider will use the type, stage, and location of your skin cancer when recommending treatments.
If your provider was able to remove your entire tumor during the biopsy, you might not need treatment. Sometimes, a biopsy is enough to cure basal or squamous cell carcinomas.
Surgery
Most people with skin cancer have surgery. You might work with a Reid Health general surgeon or plastic surgeon, depending on where your skin cancer is.
During many skin cancer surgeries, the tumor and surrounding skin are removed.
Mohs micrographic surgery involves removing the tumor layer by layer, preserving healthy skin as much as possible. Mohs is frequently used on basal cell carcinoma, squamous cell carcinoma, and melanoma.
Cryotherapy involves liquid nitrogen to freeze and destroy skin cancers. Surgeons usually use cryotherapy for basal and squamous cell carcinomas. You might need surgery on lymph nodes and other organs if you have melanoma that has spread.
Radiation and/or chemotherapy
Some people with skin cancer might need only surgery, but people with advanced cancers often need follow-up care with radiation, chemotherapy, or another treatment.
Immunotherapy
Immunotherapy treatments involve medications that teach your immune system to fight cancer. Some immunotherapies target a protein on the skin that prevents the immune system from attacking cancer cells. They’re generally delivered via injection or as topical creams. For melanomas that have spread to the lymph nodes, immunotherapies that affect the lymphatic system might be used.
Photodynamic therapy
In this treatment, a combination of medications and light therapy kills cancer cells on the skin. Your provider will continue to monitor you after treatment to make sure your cancer is gone and doesn’t return.
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