What is Skin Cancer?
Skin cancer is a malignant condition that begins with the uncontrolled growth of abnormal cells. Though the skin is our first line of defense from the outside environment, its location on the surface of our body makes it susceptible to damage from the sun's radiation. Like other types of cancer, skin cancer often starts with DNA damage. Ultraviolet (UV) radiation from the sun causes the most damage. The damage is usually repaired by the body's built-in repair mechanisms but long-term sun exposure can lead to severe DNA damage that may not be repaired. If the damage occurs in genes that are responsible for controlling the division of skin cells, these cells may begin to divide uncontrollably, which can result in skin cancer.
Skin Cancers and Pre-Cancers
The three most common skin cancers are Melanoma, Basal Cell Carcinoma (BCC), and Squamous Cell Carcinoma (SCC). There are also pre-cancers, known as Actinic Keratoses (AK) that can turn into SCC if left untreated.
- Melanoma is the most deadly of all skin cancers (Melanoma causes more than 75% of skin cancer deaths), but when CAUGHT EARLY is almost always curable. In 2012, there will be approximately 44,250 new cases of melanoma and 6,050 deaths among men, versus 32,000 new cases and 3120 deaths in women.
- Basal Cell Carcinoma (BCC) is the most frequently occurring skin cancer, with an estimated 2.8 million cases diagnosed every year in the US. Though they are generally easily treated, BCCs tend to keep growing if untreated, and in rare cases can start to spread.
- Squamous Cell Carcinoma (SCC) is the second most frequently occurring skin cancer. Every year, about 700,000 SCC are diagnosed in the US and an estimated 65% of them arise in lesions previously diagnosed as AKs. Most are easily treated, but if not removed, some can metastasize, spreading to nearby lymph nodes, which drain the area where the cancer is located: from the lymph nodes, the cancerous cells can spread to distant tissues and organs, becoming life threatening.
- Actinic Keratoses (AK), pre-cancers, are often an early stage in development of skin cancer. They affected 58 million Americans in 2012. AK is an abnormal growth of keratinocytes, the skin cells that make up the top layer of the skin (epidermis).
Signs and Symptoms
Each type of skin cancer has particular individual signs and symptoms:
- An actinic keratosis is a small (usually grow from 1/8"-1/4") crusty or scaly patch, often red, or a combination of colors. It sometimes itches, is inflamed and occasionally bleeds.
- A basal cell carcinoma tends to be pearly looking, sometimes with rolled borders. The signs to look for are also an open sore, a shiny bump, a reddish or irritated patch or a white, yellow or waxy scar-like area.
- A squamous cell carcinoma is often pink and scaly, a wart-like growth/open sore with irregular borders, that crusts and occasionally bleeds, persisting for weeks.
- A melanoma is typically a dark mole. Check for changes in the number, size, shape and color of pigmented areas.
The patient does not generally feel any symptoms of skin cancer but may notice a new or changing spot or a sore that will not heal. However, advanced stages of melanoma or squamous cell carcinoma that has spread into the bloodstream may cause associated symptoms, such as pain in an area close to the spot.
Skin Cancer Diagnosis and Treatment
Skin cancers are diagnosed by a combination of clinical examination and biopsy of the lesion. Once the results are back, removal of the cancer depends on the type.
- Actinic Keratoses Treatments - Pre-cancers can be treated within one of fifteen convenient locations with liquid nitrogen, chemicals, levulonic acid and/or photodynamic therapy. In addition to our in-office procedures, multiple effective prescription topical creams can be also used at home under the direction of yourhealth care provider.
- Mohs Micrographic Surgery - our dermatology practice has gained its reputation while specializing Mohs Micrographic Surgery, a highly specialized treatment for the removal of skin cancer that requires detailed knowledge of skin anatomy, skin cancer, pathology as well as advanced surgical skills.
Mohs consists of removing thin layers of cancer-bearing skin and microscopically examining the area until it is tumor-free, your Mohs surgeon - Dr. Steppie and/or his surgery team - can pinpoint areas involved with cancer that are otherwise invisible to the naked eye, therefore, even the smallest microscopic roots of cancer can be removed. It offers skin cancer patients the most minimal recurrence rate, in addition to optimal preservation of uninvolved tissue and, therefore, minimal scarring. In fact, Mohs surgery has been shown to have a 99 percent, or better, cure rate for basal cell carcinoma, the most common type of skin cancer.
This procedure does not require general anesthesia, which permits its use on many patients who are poor candidates for conventional surgery. For more details, read our Mohs Page.
- Low-Energy Radiation Therapy - Patients that meet certain criteria can now also be treated with a breakthrough non-surgical technique called Superficial Radiation Therapy, we are the first dermatology practice in the Central Florida area to offer SRT 100™ from Sensus Healthcare. Click to learn more about the SRT 100™.
Follow up and Outcomes
Cure rates are high, and recurrence rates are low for cancers that are caught and treated early. Early detection of skin cancer is key - Call us today for a skin exam.
Read Dr. Steppie's article in The Skin Cancer Foundation Journal published in May 2012. Skin Cancer and the Gender Gap: Why More Men Die from Skin Cancer.
You can also follow Dr. Steppie's tips and resources on WebMD®.
*Facts provided by the Skin Cancer Foundation and American Academy of Dermatology.
DISCLAIMER: The information provided by this site is intended solely for educational purposes. This information is not to be used for medical diagnostic purposes and is not intended to serve as a recommendation for treatment and/or management of any medical/surgical condition. Most of all, this information should not be used in place of a physician or other qualified health provider. If you believe you have a medical condition, please contact your physician immediately.
My mother and I come every 6 weeks to have chemical peels for sun damage and to prevent further skin cancer. Our esthetician is Jenny Paul and she is wonderful. We drive an hour to come to her location because she takes such amazing care of us. She is kind, thoughtful, informative and a joy to be around. Thank you to Associates in Dermatology for hiring such a wonderful person to take care of us!
— Vicki P