Skin Cancer

Basal cell carcinoma is the most common skin cancer and appears frequently on head, neck, and hands. Basal cell carcinomas are frequently found in fair-skinned people. It is fairly slow growing. Untreated the cancer often will begin to bleed, crust over, heal, and repeat the cycle. This type of cancer very rarely spreads to other parts of the body, but it can invade and destroy surrounding skin tissue.

Basal cell skin cancer usually appears on sun exposed areas, most commonly the face and neck, but also on the trunk, arms and legs.

Some early warning signs would include a firm, skin coloured or slightly reddish bump, often with a pearly border; a sore or pimple-like growth that bleeds, crusts over and then reappears, or a small, red scaling patch, which tends to spread out most often on the trunk or limbs.

The cause of basal cell carcinoma is from ultraviolet radiation from the sun. Frequent severe sunburns and intense sun exposure in childhood increase the risk of basal cell skin cancer in adulthood. Cumulative long term sun exposure over your lifetime and intense exposure combine to cause damage that can lead to BCC.

Fair skinned people with blonde or red hair and skin that usually burns when out in the sun are most at risk, but it can occur in any skin type. BCC typically arises in people over the age of 50 but is now being seen in teenagers and people in their early twenties. People who have already had basal cell skin cancer will have higher risk of developing another.

Treatment options depend on the size of the tumor, the location, and the patient’s own health status.

These tumors are usually removed surgically or with radiation therapy, and newer therapies such as photodynamic therapy and immune modulating creams can be used for some forms of this type of skin cancer. For more complicated tumors, such as large tumors, recurrent tumors and tumors located on structures such as the face, Mohs surgery is indicated. This is a specialized form of surgery which has the highest cure rate, removing just the tumor and sparing the normal skin. This form of surgery is performed by dermatologists specially trained in this technique. During Mohs surgery, thin layers of cancer-containing skin are removed and examined microscopically until only cancer free tissue remains.

Excision: This involves numbing the area that is going to be treated and cutting out any remaining tumor plus some healthy skin around the tumor. The removed skin is sent to a pathologist to determine the type of lesion.

Radiation: Radiation is a treatment that is used when the cancer cannot be cut out. Due to its inherent long-term risks, radiation is usually performed on elderly patients.

Squamous cell skin cancers appear as thickened, red, scaly bumps or wart like growths. They may also look like an open sore or crusted sore patches of skin. This type of skin cancer may grow quickly over a period of time. It appears on chronically sun exposed areas such as the head and neck, arm, back of hands, and legs.

Squamous Cell Carcinoma (SCC) is the second most common form of skin cancer. This cancer may appear as a bump. Or as a red, scaly patch. Unlike basal cell carcinoma this form of cancer can rarely spread to other parts of the body. Therefore, it is important to get treatment.

SCC usually develops on skin that has been exposed to sun for many years. It is frequently seen on the head, neck, and back of the hands, as these are the most sun exposed areas.

Anyone with a history of sun exposure can develop SCC. People have a higher risk if they have fair skin, blond, or red hair. These most often affect older people, but lately the average age of patients has steadily decreased. The disease is rarely seen in children, but sometimes teenagers can be affected.

People who use tanning beds have much higher risk of getting SCC.

Workers in occupations that require long hours outdoors and people who spend their leisure time in the sun are expected to develop SCC.

The treatment for this skin cancer can be discussed with your dermatologist. It consists mainly of surgical excision, radiation therapy or Mohs surgery.

Excision: This involves numbing the area that is going to be treated and cutting out any remaining tumor plus some healthy skin around the tumor. The removed skin is sent to a pathologist to determine the type of lesion.

Mohs Surgery: Mohs Surgery has the highest cure rate for SCC. During the surgery the surgeon will cut out the tumor and a very small amount of healthy skin that is surrounding the tumor. The surgeon will then look at the tissue removed under a microscope to make sure all cancer cells were removed. If there are still cancer cells remaining the surgeon can go back and remove more tissue. This process will be repeated until all cancer cells are removed.

Radiation: Radiation is a treatment that is used when the cancer cannot be cut out. Due to its inherent long-term risks, radiation is usually performed on elderly patients.

Melanoma is a less common but far more dangerous form of skin cancer. Most melanomas are found in the early stages. If melanoma is left untreated, it will start to invade into the skin. Melanomas are often brown and black in colour but can show other shades. Melanoma can develop in weeks or months. It can appear as a new mole or freckle-like spot on the skin or develop in an existing mole. Melanoma is now the 8th most common cancer in Canada.

Some people have a higher chance at getting melanoma compared to others. These are people with fair, sun sensitive skin that burns rather than tans. People who have freckles, red, or blonde hair will also have a higher chance of getting melanoma as do those who have moles that are large or unusual in shape and colour. You also have a higher risk of getting melanoma if there is a close family history of melanoma. If you’ve had lots of exposure to UV from sun or sunbeds.

Melanoma typically develops on skin that has been exposed to UV from sun or sunbeds. They do not, however, only appear on sun exposed skin.

Most melanomas are associated with severe UV exposure and blistering sunburns.

The best way to protect yourself would be to keep yourself away from the sun from spring to fall, to always wear sunscreen, and to avoid sunbeds. You should also learn what the early stages of melanoma look like and find out how you should be checking your skin every month.

Unlike many other cancers, melanoma is clearly visible on the outer surface of the skin. In the early stages, the tumor is thin, has not spread to the lymph nodes, and is highly curable by surgical removal.

Melanoma can appear as a mole or freckle-like spot on the skin, or it can develop in an existing mole. Melanomas are typically dark in colour.

The most common location for melanomas in men is on the back, and in women, the leg. It can also appear on the arm, scalp, or face. While less common in darker skinned people, melanoma can appear on the soles of the feet, underneath the toenails particularly from beneath the cuticle and palms of the hands.

If a biopsy comes back and confirms that it is melanoma, surgery will be needed to remove the cancer and some surrounding healthy skin. Further treatment depends on the depth of the melanoma.

1. Once the sun comes up no matter if it’s a cloudy day or cold, it has an effect.
2. Sun damage is cumulative so a brief “run out to the car” is adding fertilizer to the grass.
3. Sunscreen needs to be reapplied every three hours, and sometimes even more depending on sweat/swimming or brightness of the sun.
4. All chemical sunscreens need to be applied fifteen to twenty minutes prior to it working. Mineral sunblocks such as zinc or titanium oxides work immediately.
5. SPF should be a minimum of 30 and preferably SPF 60. “SPF” only gives us UVB protection, one must look for UVA protection (Broad Spectrum) on the label.