If You Have been diagnosed or may have Skin Cancer

Skin cancer is the abnormal growth of skin cells which most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight. Skin cancer develops primarily on areas of sun-exposed skin, including the scalp, face, lips, ears, neck, chest, arms and hands, and on the legs in women. But it can also form on areas that rarely see the light of day — your palms, beneath your fingernails or toenails, and your genital area.

Types:

There are three major types of skin cancer

Basal cell carcinoma

Basal cell carcinoma usually occurs in sun-exposed areas of your body, such as your neck or face.

• A pearly or waxy bump
• A flat, flesh-colored or brown scar-like lesion
• A bleeding or scabbing sore that heals and returns

Melanoma

Melanoma can develop anywhere on your body, in otherwise normal skin or in an existing mole that becomes cancerous. Melanoma most often appears on the face or the trunk of affected men. In women, this type of cancer most often develops on the lower legs. In both men and women, melanoma can occur on skin that hasn't been exposed to the sun. Melanoma can affect people of any skin tone. In people with darker skin tones, melanoma tends to occur on the palms or soles, or under the fingernails or toenails. Melanoma signs include:

• A large brownish spot with darker speckles
• A mole that changes in color, size or feel or that bleeds
• A small lesion with an irregular border and portions that appear red, pink, white, blue or blue-black
• A painful lesion that itches or burns
• Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining your mouth, nose, vagina or anus

Squamous cell carcinoma of the skin

Most often, squamous cell carcinoma occurs on sun-exposed areas of your body, such as your face, ears and hands. People with darker skin are more likely to develop squamous cell carcinoma on areas that aren't often exposed to the sun.

Squamous cell carcinoma may appear as:

• A firm, red nodule
• A flat lesion with a scaly, crusted surface

Tests:

Your doctor may look at your skin to determine whether your skin changes are likely to be skin cancer. Further testing may be needed to confirm that diagnosis. Your doctor may remove a sample of the suspicious-looking skin for lab testing. (skin biopsy)

Understanding your stage:

Staging usually isn’t needed for basal cell skin cancer. That’s because these cancers are often treated before they spread to other areas.

Squamous cell skin cancers have a higher probability of spreading, although the risk is still fairly low.

Squamous cell and basal cell skin cancers are staged as follows:

Stage 0: The cancerous cells are only present in the upper layer of the skin (epidermis) and haven’t spread deeper into the skin.

Stage 1: The tumor is 2 cm (centimeters) or less, hasn’t spread to nearby lymph nodes, and has one or fewer high-risk features.

Stage 2: The tumor is 2 to 4 cm, hasn’t spread to nearby lymph nodes, or the tumor is any size and has two or more high risk features.

Stage 3: The tumor is more than 4 centimeters, or it has spread to one of the following:

• subcutaneous tissue, which is the deepest, innermost layer of skin that includes blood vessels, nerve endings, and hair follicles
• bone, where it has caused minor damage
• a nearby lymph node

Stage 4: The tumor can be any size and has spread to:

• one or more lymph nodes, which are larger than 3 cm
• bone or bone marrow
• other organs in the body

Treatment:

What kind of treatment will I need?

You might have different types of doctors on your treatment team. Most basal and squamous cell cancers (as well as pre-cancers) are treated by dermatologists – doctors who specialize in treating skin diseases. If the cancer is more advanced, you may be treated by another type of doctor, such as:

A surgical oncologist: a doctor who treats cancer with surgery

A medical oncologist: a doctor who treats cancer with chemotherapy or other medicines

A radiation oncologist: a doctor who treats cancer with radiation therapy. Discuss with your doctor if HIFU is the best treatment for you.