According to the American Academy of Dermatology, skin cancer is the most common form of cancer in the United States. Given the fact that 1 in 5 people will be diagnosed with skin cancer during their lifetime, and there are many different types of skin cancer, it’s imperative that everyone is screened regularly for this disease which can be deadly. Early detection often leads to a higher success rate with treatment.
Basal Cell Carcinoma
Basal cell carcinomas (BCC) are the most common and mildest form of skin cancer. There are some invasive or more aggressive types of basal cells too, but usually basal cell carcinomas just sit on the surface of the skin and grow there. They do not tend to spread to other organs like lymph nodes or the brain. In general, they are usually easy to treat and cure, especially if they are found early.
Signs and symptoms to be aware of:
Risk factors:
Treatment options:
Squamous Cell Carcinoma
Squamous cell carcinomas (SCC) are the second most common form of skin cancer. They can be superficial (SCC in-situ) or invasive. Unlike basal cell carcinomas, more invasive SCCs can metastasize or spread to other organs.
Signs and symptoms to be aware of:
Risk factors:
Treatment options:
Melanoma
Melanoma is the most serious type of skin cancer. Most of the time melanomas are very dark in color, but occasionally they are pink and look more like BCCs.
Signs and symptoms to be aware of:
Risk factors:
Treatment options:
We prefer to catch them when they are smaller, but the depth of the lesion is more important than the diameter. A special type of biopsy is performed when we suspect melanoma to get under the entire spot instead of just testing a small piece. We usually do what is called an “excisional biopsy” which will require stitches. If the results come back positive for melanoma, depending on how deep the mole was according to the dermatopathologist who analyzes it under the microscope, you will either simply need another larger excision or you will need to have lymph nodes removed to see if the cancer has started to spread to other areas. Sometimes additional blood testing or scans such as MRIs, CTs and PET scans are needed.
Very important to monitor:
Skin cancers can recur even after they have been removed properly. After one skin cancer, the risk of having another significantly increases. It is important to follow up with your dermatology provider every 6 to 12 months to make sure the site is still healed and also to check for new spots. It is also important to take proper sun avoidance precautions to protect yourself from further sun damage that could cause more skin cancers.
What is an Atypical Mole?
Dermatologists will often biopsy a mole because it looks “atypical.” It often has at least one or two of the ABCDEs of Melanoma. There is a spectrum of atypical moles:
Mildly atypical: Does not need further treatment as these do not seem to have much of an increased risk for turning into melanoma. It is important to keep an eye on the rest of your moles and if new ones pop up or old moles change, we will probably be more likely to biopsy them.
Moderately atypical: Usually recommended to remove entirely. Also do not have a huge risk of turning into cancer but if the mole grows back partially it will appear misleadingly more suspicious down the road.
Severely atypical: Must be completely removed as these do have a higher chance of turning into melanoma. May be treated like a melanoma.
Pre-melanoma or Melanoma: Large excision is warranted to guarantee the entire cancer is removed including any adjacent invasion. Lymph nodes may also need to be removed and tested depending on the depth.
When in doubt, get it checked out! If you have any spots that sound like the above descriptions, or any spots that have changed and look different from how they looked a few months or years ago, then schedule an appointment for a total body skin examination to get those spots and all of your other spots evaluated to see if they need a biopsy.