Pathologist’s Corner – Dr. Cecilia Rosales on Skin Cancer

Dr. Cecilia Rosales

What is skin cancer? 

Skin cancer is the most common of all cancers. Most skin cancers are slow-growing easy to recognize and relatively easy to treat when detected early. Most skin cancers are caused by too much exposure to ultraviolet (UV) rays, mostly from the sun, but also from tanning beds.

Types of skin cancer

Non-Melanoma: are the most common types of skin cancer and include Basal Cell Carcinoma and Squamous Cell Carcinoma. The tumors can be fast or slow growing, but rarely spread. Commonly found on sun exposed parts of body. They are called non-melanomas because they develop from skin cells other than melanocytes (the cells that make the brown pigment that gives skin its color).

Melanoma: are less common, but more serious. Almost always curable when detected early, but more likely to spread to other parts of body. A melanoma begins in the melanocytes and can occur anywhere on the skin but is more common in the trunk in men and in the legs in women.

What should I know about early detection of skin cancer?

Get a cancer-related checkup by a doctor, including skin examination, every three years between ages 20 and 40 and annually for those 40 and older.

It’s important to check your own skin, preferably once per month and to see a doctor immediately if you notice any warning signs.

What should I look for?

Look for new growths, spots, bumps, patches, or sores that don’t heal after 2 to 3 months.

Basal cell carcinomas often look like flat, firm, pale areas or small, raised, pink or red, translucent, shiny, waxy areas that may bleed after a minor injury. They may have one or more abnormal blood vessels, a lower area in their center, and/or blue, brown, or black areas. Large basal cell carcinomas may have oozing or crusted areas.

Squamous cell carcinomas may look like growing lumps, often with a rough, scaly, or crusted surface. They may also look like flat reddish patches in the skin that grow slowly.

Both of these types of skin cancer may develop as a flat area showing only slight changes from normal skin.

To spot Melanoma use the ABCD Rule:

The “ABCD rule” is an easy guide to the usual signs of melanoma.
A (Asymmetry) one portion of the mole does not match the other

B (Border) edges are irregular, notched, or blurred

C (Color) different shades of black or brown, patchy colors

D (Diameter) spot is 6 millimeters across, or growing large

E (Evolving) change in the size, shape, or color of a mole or the appearance of a new spot.

Some melanomas do not fit the ABCD rule described above, so it is very important to tell your doctor about any changes in skin markings or new spots on your skin. Other warning signs are a sore that does not heal, spread of pigment from the border of a spot to surrounding skin redness or a new swelling beyond the border. Also, change in sensation — itchiness, tenderness, or pain change in the surface of a mole, scaliness, oozing, bleeding, or the appearance of a bump or nodule. A mole that looks very different from your other moles is to be shown to your health care provider. Melanomas can also develop in the nails, genital area and oral cavity.

How to check your skin:

A self-exam is best done once a month in a well-lit room in front of a full-length mirror. A hand-held mirror can be used for areas that are hard to see. Check your face, ears, neck, chest, and belly. Women will need to lift breasts to check the skin underneath. Check your scalp, your mouth and your genital area. The first time you inspect your skin, spend a fair amount of time carefully going over the entire surface of your skin. Learn the pattern of moles, blemishes, freckles, and other marks on your skin so that you’ll notice any changes next time. Any trouble spots should be seen by a doctor.

How is skin cancer diagnosed?

If there is any chance that you suspect you may have skin cancer, you should see a dermatologist. He or she will look at the area closely and determine what steps to take next. The spot may be recorded via photograph or computer image. If the doctor thinks that an area of skin might be cancerous, he or she will take a sample of skin from the suspicious area to look at under a microscope. This is called a skin biopsy.

How is skin cancer treated?

Treatment options include surgery, chemotherapy, radiation therapy, cryosurgery, laser surgery, skin grafting & reconstructive surgery depending of the stage and characteristic of the tumor.

Why is it important to get regular skin cancer screenings?

Most basal and squamous cell cancers can be cured if the cancer is detected and treated early. If detected in its earliest stages and treated properly, melanoma is also highly curable.

Five-year survival rate when melanoma is found at its earliest stage is about 99%

Five-year survival rate when melanoma is found after it has spread is about 18%

If you want to learn more, call 1-800-ACS-2345 or visit www.cancer.org for more information about skin cancer or any other cancer-related topic.

References: American Cancer Society

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