The five year survival rate for people whose melanoma is detected and treated before it spreads is almost 100 percent. Learn how to self-examine for signs of skin cancer
Skin cancer types
BASAL CELL CARCINOMA (BCC)
BCC is the most common cancer, developing in more than one million people each year in the United States. Most skin cancers are BCC, which develops in the basal cells - the cells that make up the lowest layer of the skin. BCC may appear as a shiny translucent or pearly nodule, a sore that does not heal, a pink slightly elevated growth, reddish irritated patches of skin, or a waxy scar. It is most common on skin that has been exposed to the sun, like the face, ears, scalp, and upper trunk. While these tumors very rarely spread to other parts of the body, early diagnosis and treatment is necessary to prevent extensive damage to surrounding tissue.
SQUAMOUS CELL CARCINOMA (SCC)
SCC begins in the squamous cells, which are found in the upper layer of the skin. It is less common that BCC, with about 200,000 cases reported each year in the United States. It may appear as a crusted or scaly area of skin with a red inflamed base that resembles a growing tumor, non-healing ulcer or crusted-over patch of skin. While it usually appears on areas of the body that are exposed to the sun, it can develop anywhere, including the inside of the mouth and the genitalia. SCC requires early treatment to prevent it from spreading to other areas of the body.
MELANOMA
Melanoma begins in the melanocytes, the cells that give skin its color. Melanoma is the deadliest form of skin cancer because it can rapidly spread to the lymphatic system and internal organs. Approximately one person dies from melanoma every hour. With early detection and proper treatment, the cure rate for melanoma is almost 100 percent. Once it spreads, the cure rate drops.
Skin cancer treatment
Common skin cancer procedures and techniques:
Curettage and electrodesiccation may be used to treat small basal cell and squamous cell tumors by scraping the tumor with a curette (a surgical instrument shaped like a long spoon) and then using an electric needle to gently burn or “cauterize” the remaining cancer cells and a margin of normal-looking tissue.
Cryosurgery may be used to treat some small primary basal cell and squamous cell tumors as well as a few recurrent lesions. Cryosurgery involves freezing the tumor. The frozen cancer cells are destroyed by the freezing and slough off, allowing the underlying normal skin to heal.
Excision may be used to treat both primary and recurrent tumors by surgically removing the tumor and an area of healthy looking skin (margin) around the tumor. In some cases, the wound does not require treatment and is allowed to heal on its own. When closure is necessary, the wound may be closed with stitches, skin from another area of the body (skin graft), or healthy skin moved from a nearby area (skin flap). After surgery, the excised tissue is examined under a microscope to see if any cancer cells were present in the skin that appeared cancer free.
Laser surgery may be used in certain cases to vaporize superficial and multiple basal cell carcinomas and to excise or destroy squamous cell carcinoma. Laser surgery does not destroy cancer cells found deeper in the skin so close follow-up with a dermatologist is important.
Mohs micrographic surgery involves first removing the visible tumor and then successive layers of skin one at a time until no more cancer cells are shown on microscopic examination. Once skin cancer is no longer visible, the surgical wound is treated as needed. Methods include allowing the wound to heal naturally, closing the wound with stitches, covering the surgical site with skin from another area of the body (skin graft), and moving healthy skin from a nearby area to cover the surgical wound (skin flap). See Mohs patient stories on RealSelf.com
Skin cancer facts
More than one million skin cancers are diagnosed in the United States every
year. An equal opportunity cancer, skin cancer can affect people of any race, sex or
age. In fact, melanoma, the deadliest form of skin cancer, is the second most common cancer in women aged 20 to 29.
- Both basal cell carcinoma and squamous cell carcinoma have a better than 95 percent five-year survival rate if detected and treated early.
- One American dies of melanoma almost every hour.
- The five-year survival rate for melanoma detected at all stages increased from 82 percent between 1975 and 1977 to 92 percent between 1996 and 2002.
- More than 75 percent of skin cancer deaths are from melanoma.
How to self-examine for signs of skin cancer
Examining your skin consists of standing in front of a full-length mirror to visually examine your body for signs of skin cancer and using a handheld mirror to view areas that cannot be seen without a second mirror.
It is important to visually inspect your entire body as skin cancer can occur anywhere, not only on areas frequently exposed to the sun.
Be sure to check your back, scalp, underarms, genitalia, palms, soles, and areas between the toes and fingers.
When examining your scalp,it may help to systematically part the hair to check the entire scalp.
What to look for during your self-examination for skin cancer
You should become familiar with your birthmarks, blemishes, and moles so you know what they look like and can spot changes.
As you examine your skin, look for changes in the size, color, shape, or texture of a mark on your skin.
Signs of skin cancer
- Sore that never fully heals
- Translucent growth with rolled edges
- Brown or black streak underneath a nail
- Cluster of slow-growing,shiny pink or red lesions
- Waxy-feeling scar
- Flat or slightly depressed lesion that feels hard to the touchPay special attention to moles, especially one that has recently changed, bleeds, or itches.
Going on a Mole patrol
When examining your moles, keep in mind the ABCDEs of Melanoma detection:
Asymmetry – Does one half of a mole look different from the other?
Border Irregularity – Is the edge (border) of the mole ragged,
notched or blurred?
Color – Does the mole have variety of hues and colors within
the same lesion?
Diameter - What is the size of the mole? While melanomas are
usually greater than 6 millimeters (about the size of a pencil eraser) in diameter when diagnosed,they can be smaller.
Evolving – Change in size, shape, color, elevation, or another trait,
or any new symptom such as bleeding, itching or crusting points to danger. If you notice a mole different from others, or which changes, itches, or bleeds even if it is smaller than 6 millimeters, you should see a Board-certified dermatologist.