Skin Cancer

Skin cancer is a condition in which malignant (cancerous) cells develop in the skin’s tissues.

The epidermis (the apparent outer layer of the skin) is where most skin malignancies occur, especially in sun-exposed locations (face, head, hands, arms and legs). They are usually easy to detect by inspecting the skin, which increases the odds of early diagnosis and treatment and survival.

Types of Skin Cancer

There are various varieties of skin cancer, each of which is named after the type of skin cell from which it arises. The majority of skin malignancies are classified as one of the following:

  • Basal cell carcinoma (also known as BCC) arises from the basal cells in the epidermis’s lowest layer. Basal cell carcinomas account for 80-85% of all skin malignancies.
  • Squamous cell carcinoma — The skin cells (keratinocytes) that make up the top layers of the skin give rise to squamous cell carcinoma (also known as SCC). SCC accounts for about 10% of all skin malignancies.
  • Melanoma is caused by melanocytes, which produce the pigment melanin, which gives skin its color. Melanoma accounts for 5% of all skin cancers. Melanoma is a particularly severe type of skin cancer that is the primary cause of death from skin illness, despite its rarity.

To distinguish them from melanoma, basal cell and squamous cell carcinoma are frequently referred to as “non-melanoma skin cancer.”

When the afflicted cells remain concentrated in a single group, skin cancer is considered low risk. When cells have invaded adjacent tissues, it is considered a high-risk situation. Cancers with a high probability of recurrence require more vigorous treatment.

Almost all skin malignancies begin as tiny, low-risk lesions that, if left untreated, can develop and become high-risk lesions. Melanoma is the most alarming type because it has a higher risk of invading surrounding tissues or spreading to other parts of the body (metastasis) before being detected. Skin cancers such as squamous cell carcinoma and basal cell carcinoma are more likely to be diagnosed and treated well before they progress to malignancy.

If skin cancer is detected before it has spread to surrounding tissues, chances of a complete cure are excellent.

Precancers: Precancerous Skin Lesions

Precancers are lesions that commonly precede skin cancer. Actinic keratoses are the most well-known of these lesions (AKs).

An actinic keratosis lesion is considered an early form of squamous cell carcinoma. An actinic keratosis, a new or changing mole (nevi) and other unusual lesions on your skin should be carefully monitored and brought to the attention of your doctor.

Skin Cancer Causes

Sunlight is composed of visible light (all the colors we see in daylight), infrared radiation (which provides warmth) and ultraviolet (UV) radiation, which is carcinogenic (cancer-causing). More than 90% of all skin cancer is caused by long-term exposure to UV radiation.

UV radiation damages the skin’s DNA, causing a cell to behave abnormally. The body normally has mechanisms to repair damaged DNA but these repair mechanisms do not function normally after exposure to UV radiation. This allows the abnormal skin cell to replicate itself, making more cells with the same damaged DNA. This growing collection of abnormal cells is the beginning of a cancer.

The immune system can often detect and destroy cancer cells, just as it defends against infections by bacteria or viruses. However, UV radiation disrupts the immune system so that our natural defenses may not detect the cancer, allowing it to grow unchecked.

Melanin in the skin, which gives skin its tan to brown color, can block the damaging effects of UV radiation. The more melanin, the darker the skin. And the darker the skin, the better protected it is from UV radiation. This is why a body darkens when exposed to sunlight (tanning). It is trying to build a better barrier to UV light. However, the melanin provides only partial protection, even for those with very dark skin. And those with fair skin have almost no melanin to protect them.

It is important to remember that a tan develops only AFTER the skin has been damaged by UV radiation and that this tan provides only minor protection from additional damage.

In addition to sun exposure, family history may also play a role in a small percentage of skin cancers, especially melanomas.

Skin Cancer Treatment

Skin cancer can be treated in a number of different ways. The type, location and severity of the lesion will determine the method that your doctor chooses.

  • Cryosurgery involves using liquid nitrogen to freeze off the tumor.
  • Curettage and Desiccation involve using a small metal tool to scrape out the tumor in combination with the application of an electric current into the tissue to kill any remaining cancerous cells.
  • Radiation Therapy may be used for tumors that are either difficult to access or persistent.
  • Surgical Excision involves the surgical removal of the tumor, which is sutured afterward.
  • Mohs Micrographic Surgery is ideal for large tumors. It is particularly effective because it removes less non-cancerous skin than other methods, leaving less damage on the body.

Recovery from any of these methods will largely depend on the type of treatment used and the severity of the lesion.

Mohs Surgery

Skin cancer may be removed via Mohs Micrographic Surgery, which is a surgical process. Basal cell carcinoma and squamous cell carcinoma are the most prevalent cancers treated by Mohs surgery.

What is Mohs Micrographic Surgery?

Mohs surgery is a highly accurate and successful way to remove a skin cancer lesion as well as any “roots” that may have extended beneath the surface.

During Mohs surgery, small layers of tissue are removed one at a time and microscopic inspection of the tissue is performed. Tissue is removed from the surgical location until all evidence of skin cancer can no longer be seen under a microscope.

Mohs surgery is distinguished from other skin cancer removal treatments by the use of a microscope to analyze thin slices of tissue throughout the procedure.

Skin cancer that is removed with Mohs surgery preserves as much surrounding healthy skin as possible, thus in many cases, reducing the size of the wound after surgery. Mohs surgery cure rates are reported to be 99 percent for initial therapy and 95 percent for recurring cases after five years.

Your doctor will determine whether Mohs surgery is the appropriate method for treating your skin cancer, based on a number of factors including your skin cancer history and the location of the lesion.

The Benefits of Mohs Surgery

Mohs surgery has various advantages for persons with skin cancer, in addition to its excellent cure rate:

  • The precision of Mohs surgery, when compared to standard surgery, usually results in less scarring.
  • It does not require general anesthesia.
  • Mohs surgery is performed in-office.

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