Skin Cancer

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) - Most skin cancers are BCC, which develops in the basal cells - the cells that make up the lowest layer of the skin.
  • Squamous Cell Carcinoma (SCC) - begins in the squamous cells, which are found in the upper layer of the skin.
  • Melanoma - Melanoma begins in the melanocytes, the cells that give skin its color.

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.

  1. Both basal cell carcinoma and squamous cell carcinoma have a better than 95 percent five-year survival rate if detected and treated early.
  2. One American dies of melanoma almost every hour.
  3. 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.
  4. 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.

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.

Information on this page courtesy of the American Society for Dermatologic Surgery.