Skin Cancer

Board-certified dermatologists are trained to identify subtle skin lesions that may indicate skin cancer. Tools like dermatoscopy, which magnify and illuminate the skin, help dermatologists examine and assess suspicious lesions. If a lesion is suspected to be cancerous, a biopsy may be performed. The biopsy is sent to a board-certified dermatopathologist for detailed microscopic evaluation to confirm whether it is cancerous.

Skin cancer falls into two main categories: non-melanoma skin cancers (NMSCs) and melanoma. The most common NMSCs are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Over 5 million of these are diagnosed yearly, and about 200,000 melanomas are projected to be diagnosed in 2024. Early detection is critical to ensuring a good prognosis for most skin cancers.

BCC is the most prevalent type of skin cancer. Individuals with fair skin have about a 30% lifetime risk of developing BCC. This cancer is slow-growing and rarely spreads to other parts of the body. However, if left untreated, BCC can grow deep into the skin, potentially destroying nearby tissues, such as cartilage and bone. While BCC most commonly affects people with light skin, it can develop in individuals with any skin type.

BCC is typically found on areas frequently exposed to the sun, such as the face, ears, neck, shoulders, chest, and forearms/back of the hands. It often presents as a pink or flesh-colored, shiny bump or pink, scaly patch.

SCC is the second most common form of skin cancer. It develops due to prolonged exposure to the sun or tanning beds. Unlike BCC, SCC has the potential to spread to other areas of the body and can cause disfigurement if untreated. The risk of SCC is much higher in individuals with weakened immune systems. SCC commonly affects the face, ears, neck, chest, and hands. It can also appear in less common areas, such as the genitals, or in regions previously exposed to burns, scars, or chemicals. Indoor tanning significantly increases the risk of SCC.

SCC lesions may appear as firm, red bumps, scaly patches, or sores that don’t heal. They can also present as wart-like growths.

Risk Factors for SCC Include:

• A prior history of BCC or SCC
• Family history of skin cancer
• Advanced age
• Long-term, intense UV exposure

Minimally invasive surgical procedures, like Mohs surgery, are often used to treat SCC, especially in cosmetically sensitive areas like the face. This technique spares healthy tissue, reduces the risk of recurrence, and ensures good cosmetic outcomes.

Melanoma has much more potential than BCC or SCC to cause morbidity and mortality. It can develop as a new pigmented lesion or from an existing mole. While melanoma can appear anywhere on the skin, it can also form in unusual locations such as the palms, soles, under the nails, and even in the mouth or eyes. People with a family history of melanoma are at a significantly higher risk of developing this cancer.

Other Risk Factors for Melanoma Include:

• Having even one blistering sunburn during childhood
• Living in sunny climates year-round
• Using tanning beds
• Having fair skin, light eyes, or blond/red hair
• Having a large number of moles

Approximately one in 28 men and one in 41 women will develop melanoma in their lifetime. When detected and treated early, melanoma has a five-year survival rate of nearly 99%. However, if the cancer spreads to the lymph nodes, the rate drops to 64%, and if it spreads to distant organs, the rate falls to 23%. Prompt treatment is crucial to improving survival chances.