Skin cancer refers to any cancerous growth occurring on the skin. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma.
Basal cell carcinoma in the most common type of skin cancer. It typically appears on sun exposed areas in people with fair skin and a history of extensive sun exposure. BCCs are most common in the older population but can affect younger patients as well. They initially present as non-healing red or pink bumps or scaly patches. They do not tend to be painful, but they can bleed. Slowly, over time, they enlarge and can invade deeper levels of the skin and can even invade to muscle and bone if left untreated. A tiny percentage of untreated BCCs will metastasize.
Squamous cell carcinoma is the second most common type of skin cancer. The most commonly affected sites include the scalp, ears, face, and hands. It typically affects people with fair skin and a history of extensive sun exposure. Other risk factors for SCC are older age, history of smoking, and immunosuppression. SCCs present as red or pink bumps. In contrast to BCCs they tend to be more painful and grow more quickly. When treated early, they are highly curable. If left untreated, they are more likely to spread beyond the skin.
Melanoma, also called malignant melanoma, is the most serious type of skin cancer. It is a cancer of the cell that produces pigment in the skin, the melanocyte. Melanomas can develop from existing moles or freckles, and they can develop on previously normal skin. Melanoma typically affects fair skinned people on sun exposed areas, but it can occur anywhere on the body, including on the palms and soles, and on mucous membranes. Warning signs for melanoma include the ABCDEs - asymmetry, border irregularity, color variation, diameter > 6mm, evolving size, shape, color. If caught early, melanoma is highly treatable. If left untreated, melanoma in the most likely to spread beyond the skin.
After a biopsy is done to confirm the diagnosis, a treatment plan will be discussed. There are many options for treatment of skin cancer. These options are determined based on the type of skin cancer, size, and location on the body.
Basal and squamous cell carcinomas contained in the top layer of skin (squamous cell carcinoma in situ and superficial basal cell carcinoma) can be treated with a chemotherapeutic cream or a procedure called electrodessication and curettage (“scraping and burning").
Small BCCs and SCCs on the trunk and extremities can be treated by excision. In skin cancer excision, a standard margin of normal skin is taken around the skin cancer and the wound is closed. The skin that was removed is sent to the lab to confirm that the entire skin cancer has been removed.
BCCs and SCCs on the head, neck, and other specific areas of the body are best treated with Mohs micrographic surgery. Learn more about Mohs surgery.
Melanomas are treated with surgical excision. For early stage melanoma, this is the only treatment needed. If the melanoma has invaded deeper layers of skin, your dermatologist may refer you to a doctor who specializes in cancer treatment (an oncologist). The oncologist may recommend further workup to determine if the melanoma has spread beyond the skin.