Skin Cancer: Diagnosis & Treatment

Skin cancer is the most common type of cancer. It’s a cellular mutation that causes the skin cells to produce rapidly and multiply in areas around the body. These mutations often manifest in tumors or malignant moles, located where the rapid production of skin cells originates. 

Different Types of Skin Cancer 

Skin cancer is generally considered either melanoma or non-melanoma skin cancer. This differentiation is used because melanoma skin cancer is relatively more serious and spreads faster than non-melanoma types of skin cancer. 

There are three main types of skin cancer, including squamous cell carcinoma, basal cell carcinoma, and melanoma. Both squamous cell carcinoma and basal cell carcinoma are characterized as ‘non-melanoma skin cancer’.  

Melanoma

Melanoma is the least common type of skin cancer, but is also considered the most dangerous form of skin cancer as most deaths from skin cancer are caused by melanoma. This type of skin cancer frequently spreads to other parts of the body and destroys the surrounding tissue and organs rapidly if left untreated.

An estimated 1 million Americans are living with melanoma. This skin cancer originates in the melanocytes in the body. (Melanocytes are the cells responsible for pigmentation in the skin.) As these cells start to multiply abnormally, they often give rise to dark spots, moles, or skin growths. 

Squamous Cell Carcinoma

The second most common form of skin cancer, squamous cell carcinoma, is caused by rapid, abnormal growth of the squamous cells. The squamous cells are the thin skin cells located on the surface of the skin, on the lining of various organs in the body, and on the lining of the respiratory and digestive tracts. Squamous cell carcinoma can grow anywhere these cells exist on the body. 

The purpose of squamous cells is to protect the underlying tissue from damage. Unlike melanoma, squamous cell carcinoma is typically not life-threatening. It develops much slower than melanoma, but it can also penetrate deep within the body, injuring vital nerves and blood vessels if left untreated.

Basal Cell Carcinoma

Basal cell carcinoma is the most common type of skin cancer. This skin cancer develops in an estimated 2 million Americans each year. 

Like squamous cell carcinoma, basal cell carcinoma develops slowly and rarely spreads to other organs or tissues in the body. This type of skin cancer is highly treatable when detected early and is typically removed with minimally-invasive Mohs surgery.

If left untreated, basal cell carcinoma can penetrate deep into the bone and, overtime, cause disfiguration and deformity as a result. 

Signs and Symptoms of Skin Cancer

Most skin cancers originate on the surface of the skin, so compared to other cancers, skin cancer is fairly easy to detect. 

Skin cancer can develop anywhere on the skin, including the top of the head, the bottoms of the feet, and under the fingernails. Anywhere the sun can reach, skin cancer can develop. 

The common signs and symptoms of skin cancer include,

• Moles that change colors, shape, texture, size, or elevation
• Elevated growths or tumors on the body
• Scaly patches of skin on the body 
• Sores that don’t heal or perpetually reappear
• Brown or black spots under the fingernails 
• Patches of discolored, itchy skin on the body

Skin cancer can manifest in a number of ways. The most important signs to look out for when completing self examinations are spots that don’t look similar to other spots on your skin, spots that change in any way (size, shape, color), spots that itch, and spots that bleed. 

Examinations to Detect Skin Cancer

The most effective ways to determine potential skin cancer growth are regular examinations. Receive annual skin cancer screenings from your dermatologist, and complete regular self examinations in between your visits.

Because skin cancer often manifests as a mole on the body, self-examinations are important for differentiating between common moles and cancerous moles on your skin. 

To complete a self-exam, assess every mole on your body, following the ABCDE guidelines:

• A: Asymmetry — Abnormal moles are not symmetrical. One side of the mole will not resemble the other side. 
• B: Border — The border of an abnormal mole often blends or bleeds into the rest of the skin, as opposed to common moles that usually have a circular, strong border.
• C: Color — Look out for moles that have more than one color in them. Malignant moles often have darker areas of brown, black, or tan. Moles that are red, blue or green should also be assessed by your dermatologist immediately. 
• D: Diameter — Abnormal moles often have a diameter larger than 6mm.
• E: Evolving — Any evolution in your mole whatsoever, whether it’s the color, size or border, can indicate malignancy.

Once a month, assess all of your moles. If possible, ask a trusted friend or partner to help. Take note of the appearance of each of your moles and contact your Orlando dermatologist right away if you notice any changes in your spots. If Atypical cancerous moles are found, schedule an appointment immediately for an atypical mole removal procedure. 

Risk Factors of Skin Cancer

Skin cancer can develop in anyone, no matter your age, skin color, gender, or level of sun exposure, although there are some risk factors that may increase a person’s chances of developing skin cancer.

Regardless of whether you have any of the following risk factors, it’s still critical to receive annual exams and perform monthly self-examinations:

• Fair skin, or being of a Caucasian race
• A compromised or weakened immune system
• Middle-aged or older
• High number of moles on the body
• A family history of skin cancer
• Daily sun exposure
• Use of tanning beds
• Smoking
• Exposure to harmful chemicals

Treatment of Skin Cancer

Fortunately, most cases of skin cancer are treatable when they’re detected early. Early detection and treatment of skin cancer are essential for preventing the disease from progressing and spreading to other tissues and organs.

Common treatments for skin cancer include excisional surgery, Mohs surgery, curettage and electrodesiccation procedures, radiation therapy, chemotherapy, photodynamic therapy, and biological therapy. 

If skin cancer is suspected, a skin biopsy will be performed to assess the suspicious cells. Depending on the results of the skin biopsy, one treatment method may be more effective than another.

(Furthermore, if basal cell carcinoma or squamous cell carcinoma is detected, a person’s lymph nodes may be removed to determine whether the cancer has spread, and if so, what stage the cancer is in.)

Excisional Surgery

During excisional surgery, the dermatologist will “cut out” the cancerous skin tissue, along with some surrounding healthy skin tissue, to remove the cancerous skin cells. Excisional surgery is generally used to treat basal cell carcinoma and squamous cell carcinoma.  

Mohs Surgery

Mohs surgery is a highly-advanced treatment method performed to remove cancerous skin tissue, while leaving as much healthy tissue intact as possible. This procedure is completed in stages and involves the removal of a thin layer of skin tissue at a time to analyze the tissue and remove only the cancerous areas. Mohs surgery has proven effective for treating both melanoma and non-melanoma skin cancers.

Curettage and Electrodesiccation or Cryotherapy

To treat basal cell carcinoma and squamous cell carcinoma, a curettage and electrodesiccation procedure may be performed. Using a curette (spoon-shaped instrument), the cancerous tissues are scraped out and followed up with a cauterization procedure to minimize bleeding and minimize the chances of the cancer redeveloping. This procedure is most often performed when the cancerous tissue is located on the leg or other areas of the body where the scar won’t be as visible, because it produces a noticeable scar.

Radiation

Radiation therapy may be completed over a number of weeks. It can be used as a follow-up treatment to continue destroying cancerous skin cells, or it may be used as a sole treatment. During this procedure, radiation is applied to the skin to treat cancerous tumors. Radiation can help to manage cancer and prevent it from spreading and developing further.

Chemotherapy

Similar to radiation therapy, chemotherapy is often completed to slow the progression of cancer. Chemotherapy treatment uses different drugs that target rapidly-growing cells. Chemotherapy drugs are usually administered by IV, and may be used alongside radiation therapy or surgical therapy to help manage the symptoms of cancer. 

Photodynamic Therapy

Photodynamic therapy can be used to treat skin cancers and precancers. During this treatment, a substance is applied to the affected skin tissue. (This substance increases the skin’s sensitivity to light.) A laser is then administered to the area to eliminate the cancerous tissue. Photodynamic therapy is commonly performed to treat basal cell carcinoma specifically.

Biological Therapy

Biological therapy triggers the body’s immune system to attack cancerous cells and treat skin cancer itself. This treatment method serves to reprogram the immune system into recognizing cancerous cells as invaders that need to be destroyed. (Cancer cells often go unrecognized by the immune system, which disables the immune system from attacking them.) Certain chemicals may be used to stimulate the immune system’s response, or to target specific cancer cells that are essentially flying under the radar, unnoticed by the immune system. 

Preventing Skin Cancer

Taking actions to prevent the development of skin cancer is the best way to defend the body against this disease. It’s crucial that you stay proactive in protecting your skin from harmful UV exposure to minimize your chances of developing skin cancer. 

• Use sunscreen to protect your skin from UVA and UVB rays. Wear broad-spectrum sunscreen with SPF 30 or more every day. Continue reapplying sunscreen throughout the day if you’re exposed to the sun.
• Wear protective clothing. Wear a protective hat, sunglasses, and a shirt if you plan on basking in the sun.
• Never use tanning beds. Do not expose your skin to the concentrated UVA rays in tanning beds. (More than 419,000 cases of skin cancer in the U.S. are linked to indoor tanning.)
• Don’t skip skin cancer exams. That goes for your annual skin cancer checks with your dermatologist and your monthly self-examinations. Stay aware of new spots and existing spots and be vigilant in assessing them for any changes regularly. 

Preparing for Your Appointment

The sooner we are able to detect skin cancer, the more effective the treatment will be. For patients who require skin cancer treatment, our dermatologist is board-certified with speciality training in Mohs surgery. 

We perform Mohs surgery, because Mohs surgery has a 98% success rate. It’s one of the most effective treatment methods for skin cancer. 

Our leading board-certified dermatologist, is an expert in complex medical dermatology. Our dermatologists are here to help you navigate through any dermatology conditions that may be holding you back from experiencing your greatest quality of life. 

When it’s time for your annual skin cancer exam, we encourage you to schedule an appointment with us. To prepare for your appointment:

• Write down any symptoms you’re experiencing
• Fill out any necessary paperwork
• Write down all medications you’re currently taking

We want to help you choose the best treatment route to suit your lifestyle and alleviate your symptoms. Once your test results are ready, we will give you a call and you’ll be able to view them by logging into our patient portal.