Skin Cancer

The 3 most common skin cancers in the United States are basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Together they have an incidence of near 1 million cases per year. What is also concerning is that the incidence for each of these cancers has been going up every year.

Basal cell carcinoma (BCC)

Basal cell carcinoma (BCC) is the most common cancer in the United States. It rarely spreads or metastasizes to internal organs. However, since it is a cancer, it will continue to grow, destroy tissue and invade locally until it is treated. BCC's usually present classically as pearly appearing new bumps that grow slowly. Many patients report that the area "just doesn't heal" or "keeps bleeding".

Squamous cell carcinoma (SCC)

Squamous cell carcinoma (SCC) is the second most common skin cancer with an incidence around 250,000 per year. These often appear as red or pink bumps. The distribution is similar to BCC's and most commonly found in sun exposed areas such as the face, neck, scalp, arms and hands. But, like any skin cancer, it can be found on any part of the body.

Most BCC's and SCC's are easily treated with a variety of surgical techniques. These include wide excision or destructive therapies, such as electrodessication and curettage. For difficult tumors, however, Mohs micrographic surgery is the standard of care. This allows for the highest cure rate while preserving as much healthy tissue as possible. Difficult tumors include those that are histologically aggressive, large, recurrent, incompletely excised, have ill defined borders or are located in areas such as the nose, lip, ear, eyelid, hands, feet or temple.

Malignant melanoma

Malignant melanoma is the third most common skin cancer and is the most lethal of the three. This is a cancer of the melanocytes or cells that are responsible for pigmentation of the skin. If these are found early, it is most often curable with a wide excision around the cancer. Unfortunately, advanced disease is difficult to treat.

Melanoma most often appears as an irregularly colored growth. The back and the legs are the most common locations, but it can be found anywhere including inside the mouth or even the eye. A general guideline to differentiate a melanoma from a healthy mole is known as the ABCD's of melanoma.

A stands for Asymmetry. If you draw an imaginary line down the middle of the lesion, one side will not match the other in a melanoma.

B stands for Border Irregularity. Most healthy moles have distinct or well circumscribed borders. A melanoma can have ill defined or scalloped margins.

C stands for Color variegation. Healthy moles are often uniform in color. Melanomas can have multiple colors within the same lesion. Some may even have red, white and blue areas.

D stands for Diameter. Any pigmented growth larger than 6 mm in diameter should be further evaluated.

Even with these guidelines, a melanoma may be difficult to differentiate from a mole. Have a dermatologist evaluate any new, changing, painful, bleeding, itchy or suspicious lesions. (AAD Phamphlet)