Despite increased public awareness, rates of skin cancer in America continue to increase. In addition, the treatment of skin cancer is one of the most significant problems facing the American healthcare system. It remains imperative that physicians and patients alike are aware of the predisposing risk factors associated with the various forms of skin cancer. Both physicians and patients should be knowledgeable in the signs and symptoms associated with early diagnosis of skin cancer. Without a doubt, early detection, diagnosis and treatment of any skin cancer is critical to reducing morbidity and mortality associated with these diseases. Here, we hope to provide some helpful insights on how patients may be more alert and aware of their own skin cancer risk and when they should be seen by a dermatologist for any concerning lesions.
There are three types of skin cancers that make up the vast majority of diagnoses a patient may present with—basal cell carcinoma, squamous cell carcinoma and melanoma.
Basal cell carcinoma (BCC) is the most common cancer in the world. Luckily, with early diagnosis, the morbidity and mortality associated with these cancers are fairly low. Patients at risk for BCC are most often those who’ve had large, cumulative amounts of sun exposure in their lifetime. Again, early diagnosis is key. BCC is most commonly found on the head and neck and has a particular predilection for the nose and other parts of the face. These cancers most often appear as red, pink or faintly blue in color with a smooth, shiny surface. When detected early, they are often very flat and thin, but advanced lesions may be thicker with bleeding, crusting, and ulceration. We recommend that any patients with new lesions that are itching or bleeding, or generally not healing over a few weeks, be seen by their dermatologist for assistance in diagnosis. BCC is most often treated with outpatient (in-office) surgery, however, some non-surgical options may exist.
Squamous cell carcinoma (SCC) is the second most common form of skin cancer encountered in America. These cancers are also associated with large amounts of cumulative sun exposure and are often found on more “sun-exposed” skin such as the face, ears, scalp, neck, chest, hands and arms; however, SCC can be found practically anywhere on the body. These cancers generally appear as thick and scaly red spots on the skin. They may appear harmless when discovered early, often described as a crusty, tender spot that “just won’t heal.” Again, early detection is imperative in reducing the morbidity and mortality of squamous cell carcinoma. These cancers are most often treated with outpatient surgery.
Melanoma continues to be a growing problem in America. Melanoma is particularly troubling because it is often diagnosed in younger patients (20s and 30s), unlike other forms of skin cancer, which often present later in life. Melanoma is also one of the deadliest diseases we encounter as dermatologists, and we encourage all patients, regardless of age, race, gender or family history to be seen as soon as possible for any melanoma concerns. However, patients most at risk for melanoma are those with fair skin, blonde or red hair or numerous moles or freckles. Patients who have used indoor tanning beds or have a history of severe sunburns in the past are also at increased risk for melanoma. Early detection is critical in the diagnosis of melanoma and, frankly, saves lives. Melanoma is most often described by patients as a new or changing mole. These are often dark brown or black and completely flat and not scaly. They are often completely asymptomatic but may be associated with mild itching, bleeding or pain. These dark spots may have irregular shapes or have variations in color. Most importantly, any new or changing mole should be shown to your dermatologist, and regular examinations by your doctor can help increase your chance of catching melanoma early. Again, these cancers are treated with outpatient surgery.
Skin cancer is quite common, but being aware of any changes on your skin and acknowledging your own risk factors can help assist in the diagnosis of these conditions and reduce any problems associated with these diseases in the future.
“Both physicians and patients should be knowledgeable in the signs and symptoms associated with early diagnosis of skin cancer. Without a doubt, early detection, diagnosis and treatment of any skin cancer is critical to reducing morbidity and mortality associated with these diseases.”
Written by Daniel Walker, MD.
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