Skin cancer is the most common type of cancer in the U.S., accounting for roughly half of all cancer cases. It often begins as an unusual, uncontrolled growth on the skin.
Skin cancers are named for the type of cell that is affected. Major types include:
Basal cell carcinoma (BCC) is the most common type of skin cancer. It starts in the top layer of the skin called the epidermis. Most of the time, BCC can be removed and treated. But sometimes it can grow back.
Melanoma is a type of cancer that begins in the melanocytes. These are cells that make the pigment melanin. Melanomas often start in moles on the skin.
Squamous cell carcinoma (SCC) is the second most common type of skin cancer behind basal cell carcinoma. As its name suggests, it develops in the flat squamous cells that make up the outer layer of the skin (called the epidermis).
Also called neuroendocrine carcinoma of the skin or trabecular cancer, Merkel cell carcinoma is a very rare type of skin cancer that forms when Merkel cells grow out of control.
Spotlight on Skin Cancer: Advanced SCC and BSSC Skin Cancers
In this episode of our special series Spotlight on Skin Cancer, we take a look at 2 forms of advanced skin cancer: advanced basal and squamous cell skin cancers.
Skin cancer can occur anywhere on the body but is most often found on areas exposed to sunlight, such as the face, neck, hands, and arms.
Skin cancer is almost always curable when it is found early but it can spread to other parts of the body. Cancer cells can invade nearby healthy tissue or break away from the tumor, enter the blood or lymph vessels and spread to other parts of the body. When this happens, it is called metastatic disease. Melanoma is much more likely than other skin cancers to spread to other parts of the body. If your cancer spreads to the bone, visit our bone metastases page.
Anyone can get skin cancer but it is more common among people with light or fair skin color. Other risk factors include:
- Exposure to sunlight or ultraviolet radiation from tanning booths
- Frequent blistering sunburns, especially early in life
- A personal history of skin cancer
- Having more than 50 moles
- Possible genetic factors (i.e., mutations in certain genes or family history)
- History of radiation therapy, certain conditions that suppress the immune system or exposure to high levels of arsenic
Symptoms and Diagnosis
As always, talk with your health care provider if you notice anything unusual on your skin, or if you have a sore or patch of skin that won’t heal. Tell your doctor if you notice changes or anything unusual on your skin. Do monthly skin checks – check all the surfaces of your skin and look closely at your moles so that you can tell if they begin to change in shape, size or color.
The ABCDE’s of Skin Cancer:
- Asymmetry - The shape of one half does not match the other.
- Border - The edges are often ragged, notched, blurred or irregular in outline; the pigment may spread into the surrounding skin.
- Color - The color is uneven. Shades of black, brown and tan may be present. Areas of white, grey, red, pink or blue also may be seen.
- Diameter - There is a change in size, usually an increase.
- Evolving - Changes in size, shape, color or elevation, or any symptoms such bleeding, itching or crusting.
Tests that are commonly used to find skin cancer include:
- Skin exams - A dermatologist will check the skin for bumps or spots that look abnormal in color, size, shape or texture.
- Skin biopsy - If needed, all or part of an abnormal-looking growth is cut from the skin. A pathologist will look at the sample under a microscope to check for signs of cancer. There are different types of biopsies that may be used depending on the cancer and its location.
If the disease is more advanced, other diagnostic tests may be added, including CT or PET scans. However, this is done very infrequently.
Treatment and Side Effects
The treatment for skin cancer will depend on a number of factors, including:
- The stage of the disease (whether it has spread deeper into the skin or to other areas of the body)
- The type of skin cancer
- The size and location of the tumor
- Your preferences
Treatment options may include:
- Surgery to remove the cancer cells. Different surgical techniques may be recommended.
- Topical medications that are applied to the skin (when the skin cancer is a type that is known to be very thin).
- Radiation therapy using high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
- Chemotherapy using a drug or combination of drugs to kill cancer cells. These medications may be taken by mouth or given through a vein.
- Immunotherapy using substances made by the body or in a laboratory to activate or trigger the body’s immune system to recognize and fight cancer cells.
- Targeted therapy using new medications designed to target and kill cancer cells without harming healthy cells. Targeted therapies work in different ways. For example, the target may be a specific protein or abnormal mutation in the cell that is promoting cancer growth.
- Clinical trials or studies that test new ways to use or combine drugs or techniques that are already approved or investigate novel therapies. Clinical trials may be a good option for some people. Ask your doctor if a clinical trial is right for you.
Because skin cancer can come back, be sure to ask your doctor how often to have your skin checked for signs of cancer. Remember to keep any follow-up visits.
Spotlight on Advanced Non-Melanoma Skin Cancer
This book is specifically about advanced non-melanoma skin cancers (NMSCs). While certain chapters relate to NMSCs broadly, most of the content focuses on the ins and outs of life with advanced NMSC. This book aims to serve as a resource and begin to answer some of the questions you may have.
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