Skin Cancer

Overview 

Skin cancer is cancer that begins in the cells of the skin. Most often, skin cancer develops in areas of the body that have been exposed to ultraviolet (UV) rays. Some types of skin cancer include:

• Basal cell carcinoma - this type of skin cancer begins in the skin cells that produce new skin cells – most often beginning on the head or neck.
• Melanoma - melanoma is a type of skin cancer that begins in the cells of the skin that produce melanin, the pigment that gives skin its color.
• Sebaceous carcinoma - sebaceous carcinoma is a rare type of skin cancer that begins in an oil gland in your skin.
• Squamous cell carcinoma - this type of skin cancer begins in the cells in the middle and outer layers of skin known as the squamous cells.

Because it can metastasize (spread) to other areas of the body, it is important that those with skin cancer receive a prompt, accurate diagnosis and treatment.

Skin cancer causes 

Skin cancer is caused by a mutation (change) in the DNA of the cells of the skin.

Skin cancer risk factors

The following factors may increase your risk for developing skin cancer:

• Excessive ultraviolet (UV) light exposure from sunlight or tanning beds
• Having a family history of melanoma
• Having a history of sunburn
• Having a weakened immune system due to a health condition or situation like an organ transplant
• Having fair skin, especially those with blond or red hair
• Having more than 50 ordinary moles on your body
• Living closer to the equator or living at a higher elevation

Skin cancer symptoms

Signs and symptoms of skin cancer vary by type and may include:

• A firm, red nodule
• A flat, flesh-colored, or brown lesion
• A flat lesion with a crusty surface
• A painless lump or thickening of the skin on your eyelid
• A lump that bleeds or oozes (especially in later stages)
• A mole that changes color or shape, especially when it has irregular borders
• A painful lesion that burns or itches
• A pearly or waxy bump on your skin
• A yellowish lump
• Bleeding area or scab that won’t heal

Skin cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam - your doctor will perform a complete physical exam, including asking questions about your health history, symptoms and related risk factors. Your doctor will perform a skin exam and eye exam as part of the physical exam.
• Biopsy - in this test, your doctor removes a biopsy (small tissue sample) from the suspicious area of skin. This sample is sent to the laboratory, where a specialist closely checks the biopsy for abnormalities.
• Computerized tomography (CT) scan - your doctor may order a CT scan to help determine if the cancer has spread beyond your skin. This specialized imaging test uses a series of X-ray images to create detailed pictures of the inside of your body. 
• Positron emission tomography (PET) scan - your doctor may use this type of imaging test to help determine if the cancer has spread. A PET scan uses a radioactive substance to provide information about the activity of potentially cancerous cells.

Skin cancer treatment

Depending on your personal health history, the extent of your skin cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery - your doctor will likely recommend a surgical procedure to remove the cancerous area, along with a margin of healthy tissue. One type of procedure – known as Mohs surgery – involves removing thin layers of tissue and then examining them under a microscope until no cancerous cells remain in the sample.
• Freezing - this treatment uses liquid nitrogen to freeze and destroy early skin cancers. This procedure is performed in your doctor’s office.
• Chemotherapy - this treatment involves the use of medications to destroy cancer cells. Chemotherapy drugs can be delivered orally (a pill taken by mouth) or an intravenous, or IV, liquid (injected into a vein). You may need to undergo chemotherapy after surgery so that your doctor can destroy any cancerous cells that couldn’t be removed surgically or if the cancer has spread beyond the original area.
• Radiation therapy - this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically or if the cancer has spread beyond the original area.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.