Skin Cancer Screening

There are three different types of skin cancer that most patients present: basal cell carcinoma, squamous cell carcinoma and malignant melanoma.

Basal cell is by far the most common type of skin cancer and accounts for more than 90% of the diagnosed skin cancers in the United States. Thankfully, it is the also the least serious form of skin cancer, thanks in part to the fact that it very rarely spreads from one area of the body to another.

Squamous cell carcinoma is less common and can be more serious, as this form of cancer spreads to a patient’s vital organs in approximately 3% of patients.

Malignant melanoma is relatively rare but can often be quite serious and can spread to a patient’s lymph nodes or internal organs if left untreated and undetected.

Anyone can get skin cancer. Even people who have skin of color get this cancer. Bob Marley, a musician from Jamaica, developed melanoma on his foot. Most people who get skin cancer, however, have lighter skin.

Sun and indoor tanning are the leading causes of skin cancer.

People who are more likely to get skin cancer:

• Spend a lot of time in the sun.
• Fair skin, especially when the person also has blond or red hair and blue, green, or gray eyes.
• Had bad sunburns, especially blistering sunburns.
• Skin that burns or freckles rather than tans.
• 50-plus moles.
• Moles called “atypical nevi” or “dysplastic nevi.”
• Family: When a close blood relative has (or had) skin cancer, a person’s risk of getting skin cancer rises. A close blood relative is a parent, brother, sister, or child.
• History of multiple burns
• Previous history of skin cancer or precancer
• Organ trasplant
• Use tanning beds or sun lamps.
• Live (or once lived) in an area that gets intense sunlight, such as Florida, the Caribbean, or northern Australia.

To diagnose skin cancer, we will examine your skin for growths, moles and irregular dry patches. If we find something that looks like skin cancer, we will remove part of it. The removed skin will be sent to a lab. This is called a biopsy. Skin cancer cannot be diagnosed without a biopsy.

A biopsy is quick, safe, and easy for a dermatologist to perform. A biopsy should not cause anxiety. The discomfort and risks are minimal. The whole procedure takes less than a minute.

There are many treatments for skin cancer. A dermatologist selects treatment after considering the following:

• Type of skin cancer
• Where the skin cancer appears on the body
• Whether the skin cancer is aggressive
• Stage of the cancer (how deeply the skin cancer has grown and whether it has spread)
• Patient’s health
• After considering the above, your dermatologist will choose 1 or more of the following treatments for skin cancer.

Surgical treatment:When treating skin cancer, the goal is to remove all of the cancer. When the cancer has not spread, this is often possible. To remove skin cancer, the following surgical treatment may be used:

1. Excision: To perform an excision, your dermatologist will numb the skin and then surgically remove the skin cancer and a small amount of normal-looking skin. This normal-looking skin is called a margin. Normal margin needs to be removed to make sure that the skin cancer is sufficiently gone.There are different types of excision. Most excisions can be performed in a dermatologist’s office.
2. Mohs Surgery: If your skin cancer is on your nose, ear, eyelid or lip you will be sent to a Mohs surgeon. Mohs surgery begins with the surgeon removing the visible part of the skin cancer. Because cancer cells are not visible to the naked eye, the surgeon also removes some skin that looks normal but may contain cancer cells. This part of the surgery is performed one layer at a time. After removing a layer of skin, it is prepared so that the surgeon can examine it under a microscope and look for cancer cells. The cure rate for skin cancer is high when Mohs surgery is used.
3. Curettage and electrodesiccation: This surgical procedure may be used to treat small basal cell and squamous cell skin cancers. It involves scraping the tumor with a curette (a surgical instrument shaped like a long spoon) and then using an electric needle to gently cauterize (burn) the remaining cancer cells and some normal-looking tissue. This scraping and cauterizing process is typically repeated 3 times. The wound tends to heal without stitches.

Other treatments for skin cancer are:

Immunotherapy: This treatment uses the patient’s own immune system to fight the cancer. The patient applies a cream (generic name is imiquimod) to the skin as directed by the dermatologist.

Cryosurgery: The dermatologist freezes the skin cancer. Freezing destroys the treated area, causing the skin and cancer cells to slough off.

Chemotherapy applied to the skin: The generic name for the medicine used in this treatment is 5-fluorouracil or 5-FU. The patient applies 5-FU to the skin cancer. It destroys the damaged skin cells. When the skin heals, new skin appears.

Photodynamic therapy: This treatment consists of 2 phases. First, a chemical is applied to the skin cancer. This chemical sits on the skin cancer for several hours. During the second phase, the skin cancer is exposed to a special light. This light destroys the cancer cells.

If it is caught early and properly treated, skin cancer can be cured. Even melanoma, which can be deadly, has a cure rate of almost 100% when treated early.

Even if you get a clean bill of health, you need to continue to see your dermatologist. Once a person gets skin cancer, the risk of getting another skin cancer is significantly higher. Sometimes skin cancer returns. Your dermatologist will tell you how often you should return for checkups. After you have a skin cancer you will return in 3 months for a recheck.

Without early treatment, the outcome is not as favorable. Skin cancer can grow deeply.