By Amy Kennard
Cancer of the skin is by far the most common of all cancers. Over the years, dermatologists have gone to great lengths to educate patients and the public about the dangers of melanoma, a skin cancer that affects more than 70,000 Americans a year and causes nearly 10,000 deaths.
The “Other” Skin Cancers
Far more common, however, are basal and squamous cell carcinomas. Basal cell cancer originates in the lower part of the skin, called the basal layer. This cancer usually develops on sun-exposed areas like the head and neck. About eight out of 10 skin cancers are basal cell. According to the American Cancer Society, these can appear as:
- Flat, firm, pale or yellow areas, similar to a scar
- Raised reddish patches that might be itchy
- Small, pink or red, translucent, shiny, pearly bumps, which might have blue, brown, or black areas
- Pink growths with raised edges and a lower area in their center, which might contain abnormal blood vessels
- Open sores (which may have oozing or crusted areas) that don’t heal, or heal and then come back
Squamous cell cancer is more likely to grow into deeper layers of skin and spread to other parts of the body. This type of cancer also appears on sun-exposed areas like the face, ears, neck, lips, and back of the hands. About two out of 10 skin cancers are squamous cell, and appear as:
- Rough or scaly red patches, which might crust or bleed
- Raised growths or lumps, sometimes with a lower area in the center
- Open sores (which may have oozing or crusted areas) that don’t heal, or that heal and then come back
- Wart-like growths
Wounds Run Deep
Unlike melanoma, basal cell carcinomas are rarely fatal. Squamous cell carcinomas are more frequently fatal than basal cell carcinomas, but are less dangerous than melanomas. However, both basal cell and squamous cell carcinomas can be very destructive and are potentially more disfiguring if not caught and treated early, especially since they can invade the skin rather deeply.
Dr. Doug Leone, a board-certified dermatologist at the Dermatology & Mohs Surgery Institute in Bloomington, says that, “Your treatment options will be dependent on how large the cancerous area is and where the cancer is located on your body.” Prior to your diagnosis, a biopsy will be performed in which a sample of the skin and surrounding tissue will be taken. Depending on the type of biopsy done, the wound could require stitches.
The treatments for basal and squamous cell carcinoma are usually simple and straightforward. These include:
Curettage and electrodesiccation
This is a simple procedure developed to treat superficial cancers. It entails scraping the cancerous spot with a long, thin instrument called a curette. The area is then treated with an electrode to destroy any cancer cells. Even though this treatment is confined to the top layer of skin, it will leave a white scar.
Excision
A more common method of removing the cancer, this procedure involves cutting the cancer as well as the margin of surrounding normal tissue. The wound can at times be deep, and some level of scarring is likely.
MOHs surgery
This highly-successful surgery involves removing a very thin layer of the cancerous skin and checking the outer edges under a microscope. If cancer cells are detected, another layer is removed and examined. Though this process can take hours, it leaves more of the normal skin intact, thus resulting in less scarring, less disfigurement, and higher cure rates than standard excision. MOHs surgery allows for the absolute minimal amount of skin to be removed, yet has the highest rate of skin cancer cure. It is the only type of procedure where 100% of the margin or border is checked and the tumor is mapped out, making MOHs much more effective.
“The biggest issue is that people wait too long to seek treatment,” says Dr. Leone. “The more time that goes by, the larger the growth can become and the more invasive the treatment.” Not only that, he adds, but once you are diagnosed with one non-melanoma cancer, your chances are much greater of developing another.
Reduce Your Risk
The dermatology industry goes to great lengths to educate people on skin cancer prevention. “It may seem like common sense,” says Dr. Adrienne Schupbach, also a dermatologist at the Dermatology & Mohs Surgery Institute, “but it always bears repeating. Avoid the sun if you can between 10am and 2pm when the rays are the strongest — even in the winter. Use sunscreen with an SPF of at least 15 in the winter and at least 30 in the summer and apply it daily. Wear protective clothing including a broad-brimmed hat and sunglasses that provide protection from both UVA and UVB rays, and avoid tanning beds at all costs!” Dr. Schupbach also recommends examining your skin on a regular basis and taking note of any changes or appearances of new spots or spots that never heal. She adds, “Scheduling a yearly exam with your dermatologist, especially if you have a family history of skin cancer, will also go a long way towards early detection and prevention.”
For more information or to schedule an appointment, contact the Dermatology and Mohs Surgery Institute at 309-451-DERM(3376) or visit www.dermatologistbloomington.com. Dr. Leone and Dr. Schupbach, both residents of Bloomington, are board certified dermatologists, specializing in medical and cosmetic dermatology, including the treatment of skin cancer, moles, acne, rashes, warts, and all skin disorders. Dr. Leone is one of the few Mohs-trained surgeons in the area. Their practice is located at 3024 E. Empire St., 2nd Floor, in the Advocate BroMenn Outpatient Center.
Photo credit: 35007/iStock, OGphoto/iStock