Exposure to the harmful radiation of the sun or tanning beds causes damage to the genetic material of the skin cells. These altered skin cells divide uncontrollably to form a tumour mass. These appear as new growth or sore that does not heal. The cancer of the basal cells is called basal cell cancer and that of keratinocytes is called squamous cell cancer. The cancer of the melanocytes is called melanoma, discussed here. The basal cell cancer and squamous cell cancer together are categorized as non-melanoma skin cancers.
Basal cell carcinoma is the most common form of skin cancer.. It can look like a small pearly nodule or pinkish patch on the skin. It can also appear as a sore that seems to heal but returns repeatedly or as yellowish waxy scar. These cancers grow slowly and rarely spread to other parts of the body.
About 20% of skin cancers are squamous cell carcinoma. Squamous cell carcinoma develops most commonly in middle-aged and elderly people with fair complexion and long-term exposure to sun rays. It appears as a crusted or scaly area over your skin. It is most commonly seen on sun-exposed areas of the body.
There are other rare type of skin cancers such as Merkel Cell carcinoma, Kaposi’s sarcoma and T cell lymphoma of the skin that account for 1% of the total skin cancers.
The primary mode of treatment for any skin cancer is removal of the cancerous lesion.. The type of surgery used to remove the skin cancer depends on the type of skin cancer, its size and its location. Treatment options include:
Mohs micrographic surgery – Mohs surgery is indicated for skin lesions where it is important to preserve as much of the surrounding healthy tissue for functional and cosmetic purposes, such as on the face or the backs of hands. The surgeon removes the visible tumor along with a thin margin, and processes the tissue to ensure clearance before closing the wound.
Excision – The skin cancer is removed along with a margin of normal skin. Sutures are placed and then removed 1-2 weeks later. The procedure is performed in-office under local anesthesia.
Electrodessication & Curettage- A small sharp tool (curette) is used to scrape out the cancer cells followed by cauterization. No sutures are placed so a follow-up visit is not immediately necessary. The procedure is quick and is performed in-office under local anesthesia.
Topical chemotherapy or immunotherapy: Certain topical prescription medications are available including 5-Fluorouracil(Efudex) and imiquimod (Aldara). These often have a lower clearance rate than surgical removal, however they may be recommended by your dermatologist depending on severity and location of lesion and patient preference.
Common preventive techniques include: