Our Providers are Skin Cancer Experts

What is it and how can it be treated...


What is skin cancer?

Skin cancer occurs when DNA damage to skin cells causes cells to mutate.  The mutated skin cells may multiply and develop into malignant tumors.  The DNA damage to skin cells may be caused by one of the following: ultraviolet (UV) radiation (the sun), tanning beds and in some cases by melanoma genetic factors.

Read "Feeling the burn? a dermatologist shares how to recover"... an article quoting one of our physicians, Cynthia Bartus, M.D.

There are three common types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma. Basal cell carcinoma is the most common type and the least serious, but can grow to very large cancerous lesions if not treated. Squamous cell carcinoma is also relatively common and has a higher tendency to metastasize (spread to other areas and organs of the body).  Malignant melanoma is the most serious type of skin cancer. Skin cancer may appear as an enlarging growth, a sore which bleeds or will not heal, or a changing mole. Skin cancers may be flesh-toned, red, brown, black, or blue. They may be smooth, scaly, scabbed, or ulcerated. They can be flat or raised, itchy or asymptomatic. If you have any suspicious lesions, please see your dermatologist.

What are the causes of skin cancer?

Basal cell carcinoma and squamous cell carcinoma may be caused by the cumulative sun exposure over the course of a lifetime.  The risks of melanoma depends on a person's history of sun exposure, the number of moles, skin type and family history.

What are the signs and symptoms?

Basal cell carcinomas can sometimes resemble skin conditions such as psoriasis or eczema. They most commonly present as a non-healing, open sore that bleeds, oozes, or crusts.  Most commonly basal cell carcinomas form on sun-exposed areas such as the face, hands, arms and shoulders/upper back.

Squamous cell carcinomas look like red scaly patches, raised growths with a depression, or open sores that may crust or bleed.  Squamous cell carcinomas can form anywhere on the skin, including on the lips and genitalia.

Melanoma skin cancers often resemble moles, and can be black or brown in color. Melanoma can be skin-colored, pink, red, purple, blue or white.  Melanoma may arise in pre-existing moles or on sun-damaged skin. It can develop on any part of person's skin including locations such as fingernails, toenails and genitalia.

Often referred to as the ABCDE's of Skin Cancer, there are 5 fairly simple warning signs to look for on moles:

A=Asymmetry. If one half of a mole does not match the other half.

B=Border. If there is an irregular, ragged, blurry or notching appearance on a mole.

C=Color. If a mole's color is inconsistent in appearance.  Moles can appear black, brown or tan, but a mole that is more than one color may be suspect.

D=Diameter. Melanomas are generally larger than the size of a typical pencil eraser, or larger than 1/4 of an inch or 6 millimeters.  However, they can be smaller when initially detected.

E=Evolving. Any changes in appearance, be it size, color, shape or growth (such as it appears to be protruding more), or if it bleeds, forms crusts or causes itching.

ABCDE of Melanoma 5

How is skin cancer treated?

Treatment of skin cancer depends on the type of cancer and what your provider determines is the most efficacious course to take.

-  Mohs Micrographic Surgery (Mohs) Skin Cancer Surgery

  • Mohs skin cancer surgery involves removing the visible tumor and then checking all the borders microscopically with frozen sections. If a microscopic tumor is still present, more tissue is removed and tested until the entire tumor has been removed. This highly-advanced technique ensures removal of the most invasive and difficult to treat forms of basal cell carcinoma and squamous cell carcinoma. This surgery is the most tissue-sparing technique with the highest cure rates and minimal scarring.

- Excision

  • Surgical excision and primary closure remains the mainstay of treatment for skin cancer. In this procedure, the tumor is removed with a margin of normal tissue. The wound is closed, and the tissue is submitted to pathology for analysis of the tissue margins. This is the method most commonly used for average basal cell and squamous cell carcinomas as well as malignant melanoma.

- Curettage and electrodessication

  • Curettage and electrodessication or "scraping and burning" can be effective for treating certain kinds of small or superficial skin cancers.  This procedure does not require sutures.

- Superficial Radiation Therapy (SRT)

  • Superficial Radiation Therapy treatment 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. Because the superficial x-rays concentrate the radiation dose on the skin surface, the treatment has several advantages over surgical procedures for certain skin areas. These advantages include:

Virtually painless
Very short procedure time
Heightened safety
No anesthesia requirement
Minimal to no scarring
Virtually no post-surgical infections
Faster healing process
Virtually no need for reconstruction after procedure

All of these treatment options are available here in Advanced Dermatology Associates, LTD's offices.

Resources:

The American Academy of Dermatology

http://www.aad.org/skin-conditions/dermatology-a-to-z
The American Osteopathic College of Dermatology

http://www.aocd.org/skin/dermatologic_diseases/index.html
The Skin Cancer Foundation

http://www.skincancer.org/

 

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