Learning Some Basics About Basal and Squamous Cell Skin Cancer

Skin cancer is the most prevalent of all types of cancers. It is estimated that more than 3 million Americans develop skin cancer every year.

Cancer is a condition where one type of cell grows without limit in a disorganized fashion, disrupting and replacing normal tissues and their functions, much like weeds overgrowing a garden. There are three main forms of skin cancer:

Basal Cell Carcinoma is not only the most common form of skin cancer, but it is also the most frequently occurring of all cancers of the body. The name is derived from the skin cell that is growing in an uncontrollable fashion-the basal cell. This is the cell type located at the base or bottom of the upper skin layer – the epidermis. Although basal cell carcinoma can damage the skin where it appears, it rarely spreads to other parts of the body unless its size becomes enormous. It does not spread through the bloodstream and almost never involves the lymph nodes (glands). One might think of basal cell carcinoma as a colony of termites. If left untreated, it will destroy any tissue or structure in its path or growth. This is of a particular concern when the basal cell carcinoma is located near the eye, ear or nose. One cannot predict how quickly basal cell carcinomas will grow. Although they are usually slow- growing tumors, basal cell carcinomas can grow rapidly and spread. Basal cell carcinoma initially may have the appearance of a small pimple, a non-healing or bleeding sore, a shiny papule, a cyst or a larger growth. Discomfort and itching can occur but are rare. These symptoms are not reliable indicators of whether or not the lesion is a skin cancer. The diagnosis of basal cell carcinoma cannot be confirmed without a biopsy or sample being sent to a pathology laboratory for microscopic examination.

 

Squamous Cell Carcinoma can be a more serious disease than basal cell carcinoma. The squamous cells are located above the basal layer in the epidermis. This tumor may spread to the nearby glands or lymph nodes or travel through the bloodstream to distant areas of the body. Squamous cell carcinoma usually appears as rough scaly plaque or large growth.

 

Malignant Melanoma, which often looks like a brown or black patch or an unusual mole, is potentially the most serious form of skin cancer. Microscopically controlled surgery is not often used as the treatment for melanoma.

Unfortunately, we do not know most of the factors that cause skin caner. However, skin cancer does occur more frequently in people with fair complexions (blonde hair, blue eyes), individuals of Celtic descent and those who tend to get more than average exposure to the sun. Accumulated exposure to the damaging ultra-violet radiation of the sun over many years may change normal cells of the skin to cancerous cells. This is why areas of the body exposed constantly to the sun (the face, hands) tend to be more prone to skin cancer than sun protected areas. However, this is not the entire answer. Dark-skinned individuals may also develop skin cancer, but this is rare. Other factors such as heredity and environmental agents may play some role.

If a skin biopsy reveals cancer, the dermatologist has an array of medical and surgical procedures as treatment, depending upon the type of cancer, its location, and the needs of the individual.

Dermatologic surgical treatments include, MOHS Surgery (highest cure rate of up to 99%), surgical excision, electrodessication and curettage (ED&C) which involves alternately scraping or burning the tumor in combination with low levels of electricity, cryosurgery (freezing using liquid nitrogen), and laser surgery. Mohs micrographic surgery is a special procedure used to remove the whole tumor while sparing as much normal skin as possible.

Other dermatologic treatments include radiation therapy and photodynamic therapy (a chemical is applied to the skin prior to exposure to a light source). Topical chemotherapy products may also be used.

For more information about The Skin Surgery Center of Houston or for treatment information please call (713) 984-0010.

* Some Information Provided by The American Academy of Dermatology

Develop a regular routine to inspect your body for any skin changes. If a growth, mole, sore, or skin discoloration appears suddenly, or begins to change, see a dermatologist. It is wise to have an annual skin examination by a dermatologist, especially for adults with significant past sun exposure or a family history of skin cancer.

Overexposure to ultraviolet light (sunlight or tanning lamps), especially if it results in sunburn and blistering, is the main cause of skin cancer. Prevention means guarding the skin against the known causes of skin cancer. Since the sun’s ultraviolet rays are the main culprit, the most effective preventive method is sun avoidance.

  • Seek shade when appropriate, remembering that the ultraviolet rays are the most intense between 10:00 A.M. to 4:00 P.M.
  • Wear light-colored, tightly-woven, protective clothing like long sleeves and pants, a wide- brimmed hat, and sunglasses.
  • Apply a broad-spectrum sunscreen that protects against both UVA and UVB rays, with a SPF (Sun Protection Factor) of at least 15.
  • Reapply sunscreen every two hours when in the sun and even on cloudy days.
  • Begin early use of sun protection in childhood. Children under 6 months of age should not have prolonged sun exposure, but if it is impossible to avoid the sun, use a sunscreen.
  • The use of sunscreen should always be part of a program for sun avoidance and never as an excuse for increasing sun exposure.

Early detection and removal offer the best chance for a cure. Periodic self-examinations aid in recognition of any new or developing lesion. Get familiar with your skin and your own pattern of moles, freckles, and “beauty marks.” Make sure to look at the entire body every month or two. Watch for changes in the number, size, shape, and color of pigmented areas. Consult a dermatologist promptly if any changes are noticed. Individuals at high risk should be examined by a dermatologist on a regular basis.