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Skin Cancer
 
Skin Cancer

Skin cancer is the abnormal growth of skin cells, and is the most common and treatable type of cancer that people develop. Though people of all skin colors can get skin cancer, individuals with light skin that sunburns easily are at higher risk. In addition to sun exposure, other risk factors are a family history of skin cancer, certain genetic disorders, exposure to x-rays, scarring from a disease or burn, and exposure to cancer-causing compounds such as arsenic. There are several different types of skin cancers including actinic keratoses (AK), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Each can be identified through unique characteristics.

It is important to understand the warning signs of skin cancer and to protect yourself from the sun as a preventative measure. If detected early and properly treated, the cure rate is high for skin cancer. Dr. Davis can diagnose and treat skin cancer to ensure a good recovery.

What are the different types of skin cancer?

Actinic KeratosesActinic Keratoses (AK)
Actinic keratoses present as dry, scaly red patches or spots on areas of the skin that receive lots of sun exposure (such as the head, neck, hands, and forearms). AKs usually appear in people with fair skin who are over 40 years old, but younger people can also develop them if they live in warm, sunny climates or if they use indoor tanning machines. AKs can transform into another type of skin cancer, squamous cell carcinoma, so early treatment is important.

 

Basal Cell Carcinoma (BCC)
Basal Cell CarcinomaA basal cell carcinoma presents as a skin-colored, pearl-like bump or as a pink patch of skin. It will often crust or bleed, especially if “nicked” during shaving. BCC is the most common type of skin cancer, usually developing in people with fair skin, but it can also occur in people with dark skin. It appears in areas of the skin that receive high sun exposure such as the face, neck, arms, trunk, and lower limbs. It is unlikely that BCC will spread to other parts of the body, but it can grow into the surrounding tissue, nerves, and bones. Therefore, it is important to treat BCCs as soon as possible.

 

Squamous Cell Carcinoma (SCC)
Squamous Cell CarcinomaA squamous cell carcinoma presents as a firm bump, a scaly crusted patch, or an ulcer that heals and then re-opens. SCCs occur more frequently on people with fair complexions, but can also occur in people with dark skin. They appear on skin that is most often exposed to the sun such as the face, neck, arms, trunk, and rim of the ear. SCC needs to be treated early on or it can spread and grow in the surrounding tissue.

 

Melanoma
MelanomaMelanoma is the most serious and deadliest form of skin cancer. It often appears either as a sudden new dark spot or in and around a mole. It is important to recognize the warning signs (ABCDE Warning Signs) and perform periodic self-examinations of your skin. Melanoma can appear anywhere on the skin, but most commonly, it appears in areas exposed to the sun, such as the arms, legs, back, and face. Melanomas can also develop in less exposed areas such as the palms of the hands, soles of the feet, and fingernail beds. These “hidden” melanomas are more common in individuals with darker skin. Melanoma can spread to lymph nodes and travel to distant organs (metastasize). If melanoma is diagnosed and treated early before it spreads, there is a high cure rate.

 

What are the warning signs of skin cancer?

A new mole or changes in existing moles are usually the first sign of melanoma. An easy way to remember the warning signs is by using the ABCDE warning signs.

ABCDE’s of Melanoma Warning signs:

Asymmetrical Mole

Asymmetrical Mole

Border that is irregular or poorly defined

Mole Irregular

Color variation from one part of the mole to another (shades of tan, brown, and black; sometimes white, red, or blue)

Color Mole

Diameter that is larger than 6 mm (about the size of a pencil eraser). However, when diagnosed, they can be smaller

Large Mole
Evolving mole; a mole that looks different from other moles or is changing over time in size, shape, or color.
Changing Mole

How will Dr. Davis diagnose and treat skin cancer?

Dr. Davis will diagnose skin cancer by doing the following:

  • Skin examination where possible skin cancer growths are identified. Dr. Davis can either look at just a suspicious lesion or else perform a full skin examination; so the lesion in question can be compared to other spots on the body and all skin lesions are examined. The latter is preferred.
  • Biopsy of growth if skin cancer is suspected. A biopsy is a quick and safe procedure that can be done during an office visit. A local anesthetic is used to numb the area, and then the growth will be shaved off. If melanoma is suspected, Dr. Davis will cut more deeply with a biopsy punch and use absorbable stitches to close the wound.
  • Dermatopathology lab examination of biopsy sample. The sample will be sent to an outside skin laboratory where it will be examined under a microscope, and a determination of cancer is made.

If skin cancer is diagnosed, the treatment will depend on the location and type of cancer.

Dr. Davis can treat precancerous lesions (actinic or solar keratoses) by:

  • Doing a biopsy. The lesion will be surgically removed and sent for biopsy. This will allow Dr. Davis to determine if it has become cancerous.
  • Performing cryosurgery using liquid nitrogen. This freezes the surface of the skin, which will flake off and be replaced by new skin. Many lesions can be treated in this manner without resulting in scarring.
  • Prescribing topical chemotherapy. A topical cream or lotion (for home use), which targets the lesions, will be applied to the skin of a large area, such as the face or scalp. It will eliminate the lesions while leaving the surrounding healthy tissue unaffected.
  • Performing photodynamic (laser) therapy. This procedure uses light activated chemicals to destroy the keratoses. There may be some discomfort during the procedure and redness after.
  • Performing a chemical peel. A chemical solution is placed on the skin that will cause the skin to peel over a period of days. New skin will then grow to replace the peeling skin. There may be some redness, swelling, and crusting of the skin after treatment. The chemical peel will cause all the skin in the treated area to peel off, removing age spots as well as AKs. This procedure is often classified as cosmetic by insurance companies.

Dr. Davis can treat superficial lesions (basal or squamous cell carcinomas) by:

  • Desiccation and curettage (D&C). This procedure will generally be used on lesions that are softer than the surrounding normal tissue. Under a local anesthetic, a layer of the BCC or SCC will first be scraped off, and then the wound is desiccated (cauterized) with a hyfrecator. This process of scraping and desiccating is repeated more than once. Dr. Davis will determine by feel how deep she needs to go to fully remove the lesion.
  • Excising the lesion. Using a local anesthetic, the cancer will be removed along with some of the healthy tissue around it. After removal, the incision will be closed with stitches. The excised lesion will be sent to an outside laboratory for evaluation to ensure the cancer is fully removed.
  • Recommending Mohs Microsurgery. This treatment is used for lesions on the face. Dr. Davis will refer you to a Mohs Microsurgeon. The procedure is done in a specialized center with both an operating room and a pathology lab on the premises. After removing the lesion, the surgeon will examine the cancerous area with a microscope to ensure the borders are all clear. This technique ensures full removal of the cancer with minimal removal of healthy tissue.

Dr. Davis can treat melanoma by:

  • Excising the lesion with appropriate margins. Using a local anesthetic, the melanoma will be removed along with some of the healthy tissue around it. After removal, the incision will be closed with stitches. The re-excised tissue is again sent to an outside dermatopathology laboratory.
  • Referring you to a plastic surgeon if the lesion is on the face or is large. This will minimize scarring.

How can I protect myself from skin cancer?

Reducing exposure and harm from the sun is the most important factor in preventing the development of skin cancer. You can do this by:

  • Using broad-spectrum water-resistant sunscreen with an SPF of 30 or more on exposed skin. Broad-spectrum sunscreen offers protection against both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Sunscreen should be worn even on cloudy days, and it should be reapplied about every two hours and after swimming or sweating. Also be aware of sun exposure from sun reflection off of water, sand, and snow.
  • Wearing protective clothing such as wide-brimmed hats, sunglasses, long sleeved shirts, and pants.
  • Staying in the shade, especially during the hours of 10am-4pm when the sun’s rays are the strongest.
  • Avoiding tanning beds. Tanning beds are just as harmful as the sun and can cause skin damage and cancer. Use self-tanner with sunscreen instead.
 
 
 

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