Basal cell carcinoma is the most common type of skin cancer and accounts for over 75 percent of all skin cancer cases in the United States. This type of cancer rarely spreads and can usually be removed easily, but is still a serious condition that requires prompt treatment. Most cases are caused by long-term exposure to ultraviolet rays but people with fair skin and a personal or family history of skin cancer may be at a greater risk.
Basal cell carcinoma affects the top layer of the skin known as the epidermis. It may appear on the skin as a new growth that bleeds easily or does not heal quickly and may be white, pink, flesh-colored or brown. Removal treatment depends on the size, depth and location of the cancer, but may include excision, cryosurgery, Mohs surgery, laser surgery or electrodesiccation and curettage. Basal cell carcinomas are often a recurring condition, so preventive measures and regular body screenings should be taken advantage of.
Squamous cell carcinoma is a common form of skin cancer that affects over 250,000 people in the United States each year. It is usually caused by excessive, long-term exposure to ultraviolet rays from the sun and most frequently affects people over the age of 50 and with pale skin. Squamous cell carcinoma does not cause pain or any other symptoms, but develops as a growth on the skin, usually in sun-exposed areas. These growths can vary in appearance and may be new or a change to a pre-existing scar.
Squamous cell carcinoma affects the area just below the outer surface of the skin. Most cases can be completely removed through minimally invasive procedures that may include freezing, excision, laser therapy, Mohs surgery or radiation therapy. Skin cancer can usually be treated successfully if detected and removed quickly. It is important to take precautionary measures such as avoiding sun exposure and performing regular skin checks to prevent new cases of squamous cell carcinoma.
Melanoma is a potentially life-threatening skin cancer of the melanocytes, the cells that make melanin (brown pigment). Melanoma has a fatality rate higher than those for basal cell and squamous cell cancers – it accounts for more than 80 percent of all deaths from skin cancer.
The causes are not yet known, although there are many suspected risk factors, including:
- Familial tendency to develop freckles or prominent or atypical (unusual-looking) moles.
- Presence of many freckles, moles, large moles or atypical moles
- Family member with melanoma
- Overexposure to ultraviolet radiation, especially sunbathing
- Overexposure to sunlight before age 18
- Caucasian ancestry, with fair skin (although all races/skin tones are susceptible)
- Sun sensitivity / Poor tanning ability
- Immune system deficiency due to disease or organ transplantation
- Previous presence of melanoma
Treatment for melanoma depends on the tumor’s location, thickness and progression as well as the patient’s age, health, medical history and preferences. A biopsy is often performed to determine the extent of the cancer. Most often, the appropriate treatment is surgery, followed by adjuvant therapy (interferon, vaccines) for patients at great risk of metastasis (spreading of cancer throughout the body). Other common options are chemotherapy, radiation therapy and biologic therapy (interferon, cytokines, monoclonal antibodies, vaccines) to improve the body’s self-defense abilities.
Actinic keratoses (AKs) are lesions on the surface layer of the skin (epidermis) caused by chronic exposure to sunlight, particularly ultraviolet light. AKs occur when the cells that comprise 90 percent of the epidermis, the keratinocytes, change their size, shape and/or organization in a process called cutaneous dysplasia. AKs typically manifest as rough or scaly skin, bumps, mottled patterns and cutaneous horns. They may appear anywhere on the skin surface exposed to sunlight, but common areas include the face (including ears and lips), neck, arms and hands. Lesions range in size from a pinpoint to several centimeters in diameter and may be yellow, brown, red or violet, smooth, wrinkled or furrowed.
Actinic keratoses can signal the onset of skin cancer; they can become squamous cell carcinomas, the second-most common form of epidermal skin cancer. For this reason, during the treatment process, surgical biopsy is frequently performed on AKs to determine whether cancer has developed.
Depending on a number of factors such as the size, location and severity of lesions, as well as the patient’s age, health, medical history, occupation, expectations and preferences, treatment for AKs may take the form of traditional surgical excision, cryosurgery (freezing), curettage (scraping), topical medications, laser treatment, chemical peels, dermabrasion and pulsed light therapy.
People who have had AKs are much more likely to develop them again, so routine examinations every few months and limitation of exposure to direct sunlight are recommended for patients who have been treated for them.
