Skin cancer is the most common form of cancer and affects over 2 million Americans annually. There are more cases of skin cancer diagnosed each year than the combined cancers of breast, prostate, lung and colon annually. One in five Americans will develop some form of skin cancer over their lifetime. The majority of skin cancers are completely cured with early detection and treatment. Common risk factors for skin cancer include: previous sun exposure, sunburns, family history of skin cancer, age and skin color. Skin Cancer is a malignant growth of abnormal skin cells. The most common types of skin cancers, in order of frequency, include: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Malignant Melanoma. Read more here
Actinic Keratosis (AK)
Actinic Keratosis (AK) is the most common “precancer” or precursor to Non-melanoma Skin Cancers (NMSC’s) known as Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Approximately 65% of SCC’s and 36% of BCC’s arise in lesions previously diagnosed as Actinic Keratoses (AK’s). AK’s affect more than 58 million Americans each year. AK’s usually appear on sun damaged areas of skin as pink, red, tan, rough, scaly spots that become tender or redden with sun exposure. Read more here
Non-Melanoma Skin Cancer (NMSC): Includes BCC and SCC
Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) are collectively known as Non-melanoma Skin Cancers (NMSC’s) and 90% of NMSC’s are associated with ultraviolet (UV) radiation from the sun. Research shows that 40-50% of Americans who live to age 65 will have at least one BCC or SCC in their lifetime. BCC is the most common and least aggressive type of skin cancer, with an estimated 2.8 million patients diagnosed annually in the US. SCC is the second most common form of skin cancer with an estimated 700,000 cases diagnosed annually in the US. These types of NMSC’s are most commonly seen in persons with fair skin types, but can be seen in anyone. They usually start as a small pink or red, scaly, bump on sun damaged skin that continues to grow, doesn’t heal, itches, or bleeds. NMSC’s (BCC and SCC) are rarely life threatening when diagnosed and treated early. Read more about BBC
Malignant Melanoma (MM)
Melanoma is the least common, but most aggressive, type of all skin cancers. 1 in 50 men and women will be diagnosed with a melanoma in their lifetime. About 86% of melanomas can be attributed to ultraviolet (UV) radiation exposure to the sun. An estimated 76,000 new cases of invasive Melanoma will be diagnosed annually in the US, with an estimated 9,400 deaths from metastatic (spreading) Melanoma. Melanoma accounts for only 5% of all skin cancers, but is associated with the vast majority of skin cancer deaths. A person’s risk for melanoma doubles if they have: 1 or more blistering sunburns in childhood/adolescence, OR, 5 or more sunburns in their lifetime. Regular daily use of SPF 30 or higher sunscreen reduces the risk of developing melanoma by 50%. Melanomas usually appear as a dark brown or black moles on the skin with the following helpful clues, ABCDE
symmetric shapes, irregular B
orders, and multiple C
olors (brown, black, blue, red, tan, or white), with D
iameters usually bigger than 6mm (pencil eraser) and usually E
volving (growing, changing, itching, bleeding, pain, etc). Melanomas can be found anywhere on the body, but are most commonly found on the upper backs and lower legs of both men and women. Survival rates are vastly improved with early detection and surgical treatment. Read more here
Dysplastic Nevus (also known as, an Atypical Mole, or “Pre-Cancerous Mole”)
Dysplastic moles are not cancerous moles, but patients with these types of atypical moles have a higher risk of getting Malignant Melanoma. The risk of developing melanoma is higher in patients with multiple atypical moles, a personal history of melanoma and if they have a 1st degree relative with melanoma (parent, sibling, child). Atypical moles differ from normal appearing moles by having the following: larger size (usually bigger than pencil eraser or 6mm), indistinct borders, multi-colored, asymmetrical shape and they may itch, bleed or increase in size. These moles usually start appearing around puberty and all throughout one’s life. They can be found anywhere on the body and are most common on the back, chest and abdomen. Patients with numerous atypical moles should have skin checks at least every 6 months and atypical lesions should be biopsied. After biopsy, some patients need an excision to prevent recurrence for deep moles or highly atypical nevi. Photography of moles (mole mapping) is done to monitor changes over time in these nevi. Using sunblock daily is important, especially in these patients. Read more here
Diagnosis and Treatment of Skin Cancer
Diagnosis of a skin cancer is confirmed by a skin biopsy done in the office. Biopsies are done on the day of your initial office visit or scheduled soon afterwards for special circumstances. Biopsies are done under local anesthesia with lidocaine, typically taking only a few minutes. Biopsy results usually take less than one week to return to patients.
Treatment of skin cancers depends on the following: location of the skin cancer; type, depth, aggressiveness of skin cancer, recurrence risk and the patient’s age and health. Treatments include: routine wide local excisions, Mohs Micrographic Surgery (see link) (BCC, SCC), SRT (Superficial Radiation Therapy)(see link), Electrodessication and Curettage (ED&C, also known as a scrape and burn technique), topical chemotherapy creams, Laser ablation, and liquid nitrogen cryotherapy. After your evaluation and biopsy, our providers at Collins Advanced Dermatology Institute will assist you in choosing the most appropriate treatment needed for your skin cancer.
Superficial Radiation Therapy
SRT helps bring safe, painless and effective non-melanoma skin cancer treatment to patients, right in the physician’s office. SRT is a low energy radiotherapy that goes no deeper than the thickness of the skin. It is a proven non-invasive procedure that has been used to treat non-melanoma skin cancer for over 50 years and is highly recognized and reimbursable. Because the superficial x-rays concentrate radiation dose on the skin surface, the treatment has several advantages over surgical procedures. Learn more here
Mohs surgery is a highly effective treatment for certain types of skin cancer, mainly Non-Melanoma Skin Cancers (NMSC’s) such as BCC and SCC of the head and neck areas. It is an exacting procedure in which the dermatologist performs both surgical excision of the skin cancer and microscopic examination of the surgical tissue margins to ensure that all of skin cancer cells have been removed. Read more about the Mohs Surgery
for information and statistics on skin cancer.