It is one of the most preventable forms of cancer, yet skin cancer is, by far, the most common type of cancer — and its numbers are growing. In fact, “skin cancer” isn’t a single cancer, but several types. While ultraviolet radiation, both from the sun and sources such as tanning beds, is the cause of most all skin cancers, not all of them behave, or even look the same.
And, did you know that as a Colorado resident, you’re even more at risk —even in the winter? Our love for outdoor activities like skiing and snowmobiling, coupled with our high elevation and abundant year round sunshine all contribute to Colorado having a skin cancer rate 30 percent higher than the national average, according to the Colorado Melanoma Foundation.
So, what do you need to know to do it safely? Below, Rocky Mountain Cancer Centers answers some common questions about all types of skin cancer.
Q: What are warning signs of skin cancer?
A: Warning signs include any mole that changes in size, shape, or color; a new growth on the skin, or a sore that doesn’t heal. The American Academy of Dermatology recommends seeing a dermatologist anytime you notice different or unusual spots on your skin, or anything on your skin that is changing, itching or bleeding.
Q: What are the main types of skin cancer?
A: The three main types are: basal cell carcinoma (BCC); squamous cell carcinoma (SCC); and melanoma.
Q: What is basal cell carcinoma?
A: Basal cell carcinoma (BCC) is the most common type of skin cancer. The American Cancer Society estimates that this year, 4.3 million basal cell carcinomas will be diagnosed.
BCC usually develops on skin that gets sun exposure, such as on the head and face, neck, or hands. However, it can appear on any part of the body, including the trunk, legs, and arms.
Basal cell carcinomas tend to grow slowly. It is very rare for them to spread to other parts of the body. However, it left untreated, BCC can invade bone or other tissue beneath the skin.
Q: What is squamous cell carcinoma?
Like basal cell carcinomas, the less-common squamous cell carcinomas usually form on sun-exposed areas such as the face, ears, neck, lips, and hands. They can also develop in scars or chronic skin sores.
Squamous cell cancers are more likely to spread to other parts of the body than basal cell cancers, although this is uncommon.
Q: How are basal cell carcinoma and squamous cell carcinoma treated?
A: Basal cell and squamous cell carcinomas are most often treated with surgery, which may be done in a dermatologist’s office.
The most common types of surgical removal are:
- Excision. In this treatment, the skin is numbed with a local anesthetic, and the tumor is removed with a surgical knife. Some surrounding normal skin may be removed as well.
- Curettage and electrodessication. In this treatment, the doctor removes the cancer by scraping it with a long, thin instrument called a curette. The area is then treated with an electrode to destroy any remaining cancer cells. This process may be repeated during the same office visit.
- Mohs surgery. This procedure, performed by a surgeon, is done when the cancer has a high risk of returning. The surgeon removes a very thin layer of skin (including the tumor) and examines the sample under a microscope. If cancer cells are seen, another layer is removed and examined. This is repeated until the skin samples are free of cancer cells.
- High-dose rate (HDR) brachytherapy. At Rocky Mountain Cancer Centers, HDR is used to treat non-melanoma skin cancers. Tiny, hollow catheters are temporarily inserted directly into the tumor or tumor site. Radioactive pellets are inserted into each catheter. Computer guidance controls where the radiation is delivered, and how long the pellet stays in the catheter to release its radiation dose, which damages the cancer cells to prevent them from growing or spreading.
Q: What is melanoma?
A: Melanoma is cancer that develops in the pigment-making cells of the skin. Melanoma is far less common than either basal cell or squamous cell carcinomas — accounting for just about 1 percent of skin cancers in the U.S. However, melanoma is more likely to spread to other parts of the body when untreated. Colorado’s rate of new melanoma diagnoses is 15 percent higher than the national average.
Q: What are the signs of melanoma?
A: One easy way to help spot melanoma is what’s known as the ABCDE warning signs:
- Asymmetric: Normal moles are often round, but melanomas can look different on each side.
- Border: Melanoma borders are ragged or irregular rather than smooth.
- Color: Melanomas tend not to be one color but several shades, including black, brown, and tan, and even white or blue.
- Diameter: When a mole grows or is larger than a normal mole.
- Evolving: A change in a mole’s appearance can be a sign of malignancy.
Q: How is melanoma treated?
A: As with basal cell and squamous cell carcinomas, melanoma typically is treated by removing the cancerous mole or growth.
However, if melanoma has spread to other parts of the body or to lymph nodes, follow-up treatment may be needed. Immunotherapy drugs, which help the body’s own immune system fight melanoma cells, and targeted therapies, which target common genetic mutations found in melanoma cells are being used separately and in combination to treat metastatic melanoma.
Rocky Mountain Cancer Centers is currently involved in clinical trials evaluating the effectiveness of therapies for advanced melanoma.