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Recognizing Major Types of Skin Cancers

Skin cancer is one of the most frequent forms of cancer in the world. In the United States, it is the most common cancer with nearly five million people being treated for skin cancer each year. It also happens to be the most easily diagnosed type of cancer. Usually, an examination of a small sample of the affected area of skin under a microscope can confirm the suspicion.

In general, the sooner cancer is diagnosed and treated, the better a patient’s chance for a complete recovery. Therefore, examine your entire body regularly in a mirror. Skin cancers are often identified by somebody else, a spouse or a doctor, so ask a family member for help when checking your back. Look everywhere, as skin cancers can develop in the unlikeliest places, even in areas which have never been exposed to the sun.

You should also know that there are skin growths that resemble skin cancer and may or may not increase your chances of developing skin carcinoma. They can be divided into harmless and precancerous skin growths. A common sign of ageing skin are noncancerous growths. Some are hard to distinguish from cancers unless you are a physician. The most common types of benign and precancerous skin growths include:

Noncancerous Skin Growths

Seborrheic keratoses are brown or black raised areas that resemble warts, appearing mostly on the face, shoulders, chest or back. The growths can occasionally itch. Seborrheic keratosis can appear as a single growth but multiple growths seem to be more common. The growths typically start after age 30 and can get several inches across. They resemble skin cancer but do not become cancerous.

Cherry angiomas also known as ruby spots or senile angiomas are small, red bumps caused by dilated and broken blood vessels. Their size can range from a pinpoint to one-quarter of an inch across. Cherry angiomas can grow on most areas of your body but they are most often found on the back and chest. They also commonly appear on the arms, legs, scalp and face. At least 85% of people aged 30 or older develop these growths. They are harmless and do not require any treatment.

Precancerous Skin Growths

Moles are small brown or black growths on the skin. They are usually slightly raised. Moles are very common, especially in people with light-colored skin. They are harmless unless they change in shape or color, as melanoma, a type of skin cancer, can develop in or near the mole. Watch them carefully for any such changes. Individuals with more than 100 moles on their body are at increased risk of developing melanomas than those with fewer moles.

Actinic keratoses are scaly, crusty spots, usually appearing on sun-damaged skin. They typically develop after age 50 on the face, ears, bald scalp, lips, the back of the hands, neck or forearms. They may be flat and smooth or be raised and have an uneven surface. Their color may range from pink and red to reddish-brown. Actinic keratosis is not cancer but the growths should be removed because they have up to a 10% chance of developing into squamous cell carcinoma. If diagnosed early, actinic keratoses can be removed with a cream or a gel, topical chemotherapy, freezing, scraping or dermabrasion. Removal at a later stage may require cosmetic surgery.

Skin Cancers

An abnormal growth on the skin or change in an existing skin condition or coloration can be alarming as it may signal skin cancer. The three major types of skin cancer include basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal Cell Carcinoma

A basal cell carcinoma is the most common form of skin cancer, accounting for two thirds of all cases of skin cancer. This type of cancer can take a range of different forms: smooth, small, pearl-colored, semi-translucent bumps; crusty growths; hard, flat plaques; or growths that look like psoriasis or a skin irritation. A basal cell carcinoma usually begins as a small, shiny bump that grows slowly. A few months later, it develops a slightly raised, pearly border with a dip in the middle. It may crust or bleed occasionally as it continues to grow further. Basal cell carcinomas almost never metastasize and are rarely fatal.

Basal cell carcinomas typically develop on the parts of the body most frequently exposed to the sun, such as the face (mostly the nose), forehead, bald spots on the head and ears. These cancers will not spread to other parts of the body, but they can become serious and even fatal, if left in place so that they can invade a vital tissue under the skin such as the cartilage, bone or the eye. Basal cell carcinomas should be removed promptly by a dermatologist. Topical treatments, such as imiquimod (Aldara) and fluorouracil (Carac, Efudex, Fluoroplex), are only used for basal cell carcinomas that are superficial and do not extend very deep into the skin. Various kinds of minor surgery, such as electrodesiccation, curettage, cryosurgery, excision or Mohs surgery, can be performed often right in the doctor’s office. Sometimes, radiation therapy may be also given.

Squamous Cell Carcinoma

Squamous cell carcinoma happens to be the second most frequent form of skin cancer. This type of cancer begins in the thin, flat squamous cells in the outer layer of the skin. Squamous cell carcinoma takes two forms: shallow, red dip in the skin with hard, raised borders or red, scaly patches with irregular borders, sometimes crusting or bleeding at the surface. This cancer can occur on any part of the body, but it most often appears on the face, neck, bald scalp, ears and lower lip. Squamous cell carcinoma sometimes develops in burn scars. Cancerous growth is probably caused by damage to the DNA in skin cells resulting from too much sun exposure or exposure to toxic chemicals. Surgery (the same techniques as those used to remove basal cell carcinoma mentioned above), photodynamic therapy or radiation therapy is commonly used to remove these cancers. Topical anti-cancer medications can only be used to treat very superficial carcinomas.

Melanoma

Melanoma is a type of dangerous skin cancer, which starts in the pigment-producing melanocytes in the basal layer of the epidermis. It can spread throughout the body, making treatment increasingly difficult as it progresses. This makes it the most serious type of skin cancer. Melanoma accounts for 75% of deaths related to skin carcinoma. Yet when it is identified early enough, it can usually be removed without causing further complications. Because melanomas always arise in a pigmented area, resembling a mole, and can become fatal within a span of several months, it is necessary to have any suspicious mole examined without delay by a skilled dermatologist.

In melanoma, some pigment-producing cells, called melanocytes, become transformed into cancer cells, most likely under the influence of ultraviolet radiation from the sun. Heredity and immunosuppression also seem to play their role. Light-skinned people are at greatest risk for melanoma. Paradoxically, dark-skinned people usually develop the so-called hidden melanoma on the palms of their hands or the soles of their feet.

Mole or Melanoma?

It is not too difficult to identify the warning signs of melanoma. Watch out for a change in the color, shape, size or height of an existing mole or for a new, dark mole with an irregular outline. If any mole grows to more than one-quarter of an inch in diameter, it should be examined by a dermatologist. The mole may develop irregular borders and the skin around the mole may become red, spotty or swollen. Its consistency may change, becoming softer, harder or inclined to crumble. The surface of a melanoma may become crusty or scaly and it may also start to itch and ooze or bleed and feel painful. However, by that time, the cancer may have already spread. Also keep in mind that melanoma is asymmetrical. Thus, drawing a line down the middle would produce two parts with quite different shapes. Moreover, its color may vary from one part to another, while ordinary moles tend to be the same color all over.

Melanoma Treatment

Melanoma is staged I through IV. The exact type of treatment depends on which of four stages of melanoma has been identified, but in most cases the tumor must be removed surgically and quickly. Additional treatments may include chemotherapy, immunotherapy, radiation therapy, biological therapy and targeted therapy with medications, such as dabrafenib (Tafinlar) and vemurafenib (Zelboraf), for advanced stages of melanoma. A stage I melanoma can be surgically removed without any additional treatment needed and success rate is typically very high. But the higher the stage, the lower the chances of a full recovery. Once the cancer has spread into the body, the odds of a cure drop dramatically.

Where to Get More Information: Skin Cancer Foundation