Skin Changes, How to Spot Skin Cancer
Medical Author: Melissa Stoppler, M.D.
Medical Editor:
William C. Shiel, Jr, MD, FACP, FACR
According to the American Academy of Dermatology, one in
five Americans will develop some form of skin
cancer in their lifetime. Sun
exposure is the leading cause of skin cancer, and people with fair skin and
light eyes whose skin has a tendency to burn easily in the sun are most susceptible to the damaging effects
of the sun's UV rays. Fortunately, most skin cancers can be detected in their
early stages since skin tumors are more visible than tumors of the internal
organs.
Three types of cancers account for virtually 100% of skin cancers. The
nonmelanomatous skin cancers include basal cell carcinoma and squamous
cell carcinoma. Malignant melanoma is the third, and most deadly, type of skin
cancer.
Basal cell carcinoma is by far the most common type of
skin cancer, accounting for 80% of cases. These slow-growing tumors occur most
commonly on areas of the body that are exposed to sun and may take several
forms. A raised, reddish, pearly nodule is the most common appearance of basal cell carcinoma,
but it may also appear as a pink or red scar or area of irritated skin. Basal
cell carcinomas metastasize (spread via the bloodstream or lymphatic
channels) very rarely; instead, they grow invasively into surrounding tissues
and can cause localized tissue destruction when not completely removed.
Squamous cell carcinoma is the
second most common type of skin cancer, representing about 16% of all skin
cancers. As with basal cell carcinoma, squamous cell carcinoma occurs most often
in sun-exposed areas and in elderly people. Its appearance is similar to a
chronic ulcerated area of the skin or a
crusty or scaly skin lesion. Unlike basal cell
carcinomas, squamous cell cancers metastasize to other parts of the body when
they are not detected and removed at an early stage.
The deadliest skin cancer, melanoma, accounts for only 4%
of skin cancers. This type of cancer often spreads to the lymph nodes and
internal organs. While melanomas have a variety of physical appearances, they
are most often pigmented lesions greater than 0.6 mm (about the size of a pencil
eraser) in diameter. They may show a range of colors and generally have an
irregularly-shaped, asymmetrical border. Melanoma can be cured by surgical
removal if detected before spread to other organs has occurred. About 95% of
melanomas can be cured when the cancer is limited to the outermost layer of the
skin, but the prognosis
is poor when melanoma has spread to other parts of the body.
Other, rare types of skin cancer make up less that 1% of
all skin malignancies. Examples of these rare tumors include Paget's disease
of the skin,
Merkel cell carcinoma, and
cutaneous lymphoma.
Early detection is essential for successful treatment of
skin cancers. You should consult your doctor if you have any suspicious skin changes or lesions
including:
- moles that have changed in appearance, bleed, or
become itchy
- new moles or sores
- ulcers that do not heal
- moles that have grown or exhibit unusual changes
Avoidance of sun exposure and use of appropriate sunscreen products are the
best ways to prevent all skin cancers.
Last Editorial Review: 12/26/2006
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