Skin cancer is the most common of all cancers and results primarily from prolonged exposure to the sun (as well as sun lamps and tanning beds). Despite increased use of sunscreens, skin cancer is on the rise.

The good news is that nearly all skin cancers can be successfully treated and cured when caught early. The Cancer Center at El Camino Hospital is here to help you know the signs and symptoms of skin cancer, examine your skin to catch any cancerous or pre-cancerous spots, and to provide the most advanced treatments available if you become a skin cancer patient.

Types of Skin Cancer

Skin cancers fall into three categories. The majority of skin cancer diagnoses are for basal cell carcinoma and squamous cell carcinoma, both considered non-melanoma cancers.

Basal Cell Carcinoma

Look for:

• A pearly or waxy bump on your face, scalp, ears, trunk, or extremities that bleeds easily
• A scar-like lesion anywhere on your skin which grows larger over time

Squamous Cell Carcinoma

Look for:

• A firm, pink, red, or flesh-colored nodule on your face, lips, ears, neck, hands or arms
• A flat lesion with a scaly, crusted surface on your face, ears, neck, hands, or arms Although they tend not to spread to distant parts of the body (metastasize), these nonmelanoma cancers should be treated promptly to avoid invasion of tissues below the skin. Unless the cancer is very advanced or the individual’s immune system is suppressed, these cancers are easily cured and rarely result in death.

Melanoma

Melanoma is far less common than non-melanoma cancer, but it is far more serious. It accounts for only 3% of skin cancer cases, but it is the cause of the vast majority of skin cancer deaths. Melanoma can be treated successfully when caught early.

Look for:

• Any mole which is asymmetrical in shape and is changing over time
• Any mole that has an irregular border and is changing over time
• Any mole with irregularity in color – more than one color in the same growth
• A mole that has the above features and is greater than 6mm (1/4 inch) in diameter or bleeds.
• Dark lesions on your palms, soles, fingertips and toes, or on mucous membranes lining your mouth, nose, or genital areas that change over time.

Fair-skinned people are more likely to develop melanoma; however dark-skinned people are not immune. It can appear anywhere on the body, but it is most likely to occur on the upper back or face of both men and women and the lower legs of women.

Early diagnosis and treatment are critical. Your doctor will closely examine the suspected area, as well as the rest of your body, paying attention to the size, shape, color, texture, and if there is bleeding or scaling.

Diagnosis

Biopsies
The type your doctor chooses will depend on the site and size of the affected area.

• Excisional biopsy: The entire tumor is removed with stitches to close the skin. Incisional biopsy: Only part of the tumor is removed with stitches to close the skin.
• Fine needle aspiration (FNA): A thin needle is used to remove very small pieces of the skin lesion for growth located below the skin surface.
• Punch biopsies: A "cookie cutter" device is used to punch a 3 to 5mm cylinder in the lesion with stitches to close the skin.
• Shave biopsies: A scalpel is used to shave the lesion off of the skin. No stitches are needed.

Treatment

Your doctor will talk to you about the skin cancer treatment that is right for you based on a number of factors:

• The type and extent of the skin cancer - and the expected course of the disease
• Your age, overall health, and medical history
• Your tolerance for specific medications, procedures, or therapies

Surgery

• Electrodesiccation and curettage: using a circular scalpel to scape the lesion followed by an electric current to remove the lesion.
• Simple excision: cutting the cancer from the skin along with some of the healthy tissue around it.
• Mohs Micrographic Surgery: El Camino Hospital is one of the only hospitals in the area with a fellowship-trained Mohs Surgeon (www.mohscollege.org ). This technique offers the highest cure rate and smallest sacrifice of normal skin. It is used most commonly for facial skin cancers.

Radiation Therapy

This therapy shrinks tumors by directly and precisely targeting cancer cells with high levels of radiation.

Chemotherapy

This typically works by interfering with the cancer cell's ability to grow or reproduce. Your treatment may include either topical (superficial skin cancers), systemic or electrochemotherapy (more advanced skin cancers).

Biological Therapy

Fights cancer by using materials made by your own body or in a laboratory to boost, direct, or restore your body’s natural defenses against the disease

Photodynamic Therapy

A type of laser treatment that involves injecting photosensitizing chemicals into the bloodstream and directing a laser light at the tumor to cause a chemical reaction and destroy the cancer cells.

Preventing Skin Cancer

Skin cancer can be prevented, but many of us are not taking the necessary steps to avoid this disease - about percent of American adults do not use sun-protection measures. At the El Camino Hospital Cancer Center, we strongly urge you to follow the preventive steps recommended by the American Academy of Dermatology (AAD) and Skin Cancer Foundation:

• Wear protective clothing, including a hat with a four-inch brim. Avoid the midday sun from 10 am to 3 pm
• Regularly use a broad-spectrum sunscreen with an SPF of 15 or higher, even on cloudy days.
• Reapply sunscreen every two hours - even on cloudy days - and also after swimming or perspiring.
• Avoid UV radiation from sun lamps and tanning beds.

Don’t forget to protect your children. Most skin cancers appear after age 50, but skin damage from the sun begins at an early age. Therefore, protection should start in childhood to prevent skin cancer later in life.

Did You Know?

• The skin is the largest organ of the body.
• Skin cancer is the most common of all cancers.
• More than 1 million cases of non-melanoma skin cancer are diagnosed each year in the United States.
• Most are considered to be sun related, developing on the face, ear, neck, lips and the backs of the hands.
• Non-melanoma skin cancers can be fast or slow growing, but they rarely spread to other parts of the body.
• Approximately 60,000 cases of melanoma are diagnosed each year.
• About 10,850 deaths a year are attributed to skin cancer – most (8,110) are from melanoma.
• About 80% of melanomas are diagnosed at a localized stage. Survival rate is 99%.
• All melanomas are curable if caught early. If caught late, survival rate for regional stage melanoma is 65%; distant stage melanoma is 15%.

Source: American Cancer Society , 2007 data