Spring is around the corner and for most people, this means spending more time outdoors but at the same time, exposing your skin to the sun. For more than a million Americans this year, that sun exposure could lead to skin cancer.
“The incidence and mortality rates of basal cell carcinoma and squamous cell carcinoma – the two most common forms of skin cancer – have increased exponentially during the past several decades, and every year the figure continues to rise,” said Alicia Miller, M.D., dermatologist at Scott & White Healthcare – Round Rock. “Prevention is actually best, but for people who are already at risk, early identification and treatment could save their life.”
Basal cell carcinoma
According to Dr. Miller, basal cell carcinoma (BCC) is the most common form of skin cancer, affecting one million Americans each year – in fact, it is the most common of all cancers. The average age of onset of the disease has steadily decreased and more women are getting it than in the past. Those with fair skin, light hair, and blue, green, or gray eyes are at highest risk, in addition to those who have jobs that may require longer hours outdoors.
“Almost all basal cell carcinomas are caused by chronic exposure to sunlight,” said Dr. Miller. “They occur most frequently on exposed parts of the body – the face, ears, neck, scalp, shoulders, legs and back.”
Warning signs of basal cell carcinoma typically include:
- An open sore that bleeds, oozes, or crusts and remains open for three or more weeks.
- A reddish patch or irritated area, frequently occurring on the chest, shoulders, arms, or legs.
- A shiny bump or nodule, that is pearly or translucent and is often pink, red, or white. The bump can also be tan, black, or brown, especially in dark-haired people, and can be confused with a mole.
- A pink growth with a slightly elevated rolled border and a crusted indentation in the center.
- A scar-like area which is white, yellow or waxy, and often has poorly defined borders.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC), the second most common skin cancer, afflicts more than 200,000 Americans each year. SCC is similar to basal cell carcinoma in that chronic exposure to sunlight causes most of its cases and many tumors appear on sun-exposed parts of the body.
However, SCC may also occur where skin has suffered certain kinds of injury such as burns, scars, long-standing sores, and sites previously exposed to X-rays or certain chemicals. “In addition, chronic skin inflammation or medical conditions that suppress the immune system over an extended period of time may encourage development of squamous cell carcinoma,” said Dr. Miller.
Warning signs of squamous cell carcinoma include:
- A wart-like growth that crusts and occasionally bleeds.
- A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds.
- An open sore that bleeds and crusts and persists for weeks.
- An elevated growth with a central depression that occasionally bleeds. A growth of this type may rapidly increase in size.
Once a patient has been diagnosed with skin cancer, they should be well informed about the treatment options. There are five standard methods for the treatment of skin cancers. The two nonsurgical treatments are cryotherapy (deep freezing) and radiation therapy. The three surgical methods include simple excision, currettage and desiccation, and Mohs Micrographic Surgery.
Of all treatments for skin cancer, the cure rate for Mohs Micrographic Surgery is the highest —up to 99 percent. This procedure, the most exact and precise method of tumor removal, minimizes the chance of re-growth and lessens the potential for scarring or disfigurement. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots.
Mohs is typically indicated for more aggressive skin cancers, large skin cancers, and those where tissue sparing is important (i.e. nose, eyelids, or ears).
Scott & White’s Dermatology Clinic in Temple performs Mohs surgery. Dr. Howard Steinman, who completed a fellowship in Mohs surgery in Chicago and has written two books on the surgery, joined the clinic in September.