The skin is part of the integumentary system, an organ system which helps regulate body temperature and protects the body from—among other things—abrasion, water loss, and outside invaders, which may otherwise cause infection. The skin is made up of many different layers, and each is composed of different cell types. Skin cancer is the most common of all human cancers in the United States and occurs when cells in the skin multiply uncontrollably. The different types of skin cancer arise from these different cell types found in the skin, and some of these types are as follows:

Melanoma

• Usually appears flat with either a blotchy or smudgy appearance.
• Has the potential to grow and become life-threatening quickly if not treated.
• Could spread to other parts of the body in what’s known as metastasis.

Basal Cell Carcinoma (abbreviated as “BCC”)

• Is also known as “Basal cell cancer”
• It is the most common type of skin cancer but is also the least dangerous.
• Often appears as a shiny, raised area of the skin.
• Grows slowly, usually on the skin of the head, neck, or upper torso.

Lymphoma of The Skin

• Are rare as lymphomas usually originate within the lymph nodes.
• Are referred to as “cutaneous lymphomas” whereby “cutaneous” means skin.
• More information on lymphoma causes, detection, signs and symptoms, and treatment may be found here (link to lymphoma entry).

Kaposi Sarcoma (abbreviated as “KS”)

• It is a type of sarcoma (soft tissue cancer) that can occur in the skin, lymphatic system, or body membranes and organs.
• Develops from cells lining either the lymph or blood vessels.
• It can appear as purple, red, or brown blotches.

Merkel Cell Carcinoma (abbreviated as “MCC”)

• It is a cancer of a sensory cell that normally helps us sense touch information.
• It is considered neuroendocrine cancer because Merkel cells share features in common with nervous (electrical signaling) cells as well as with endocrine (chemical signaling) cells.
• Tends to originate on areas of the skin most commonly exposed to the sun.

Squamous Cell Carcinoma (abbreviated as “SCC”)

• It tends to be slower to grow than melanoma but can also spread to other parts of the body if left untreated.
• Tends to originate on areas of the skin most commonly exposed to the sun.
• Develops from cells that make up the skin’s uppermost layers (the epidermis).

Sebaceous Gland Carcinoma

• Originates in a gland the secretes oil to lubricate and waterproof the skin.
• It is uncommon yet aggressive in its growth and infiltration.
• It can be indicated by the hardening of the skin and/or formation of a painless nodule.

Skin cancers develop as a result of changes to the genetic material within skin cells. These changes result in the pattern of cell growth and division characteristic of skin cancer. Although the increased likelihood of developing skin cancer is associated with the following risk factors, in most cases, physicians and scientists are still trying to determine what causes skin cancer to develop:

• Exposure to high levels of radiation.
• Exposure to UV radiation in sunlight.
• Use of indoor tanning booths.
• Genetic abnormalities.
• Having a lighter skin color.
• Immune system impairment.
• Family history of skin cancer.
• Personal history of skin cancer.
• Personal history of sunburns during early development.
• Skin that burns, freckles, reddens easily, or is painful in the sun.
• Having either blue- or green-colored eyes.
• Having blonde- or red-colored hair.
• Having many and certain types of moles.

Skin cancer detection begins at home. Regularly checking your skin, preferably once a month, is important in order to detect any irregularities which may be indicative of skin cancer. When checking yourself, you should be mindful of the marks on your skin, so you can readily notice any changes to your normal skin pattern, such as new moles or changes in existing moles.

If you notice anything concerning or otherwise unusual during a self-check, it is best to consult with a physician to determine if treatment is necessary.

Some doctors perform skin exams as part of their routine physical examinations. When performing a physical examination, your doctor will record the details of any areas of skin suspicious for skin cancer and other abnormalities, if applicable. Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing, and review radiological studies to approach patient care in the most comprehensive and personalized manner. Your doctor will determine if a biopsy is necessary. A biopsy is a collection of a small amount of body tissue suspected, in this case, to be involved by cancer to be sent for laboratory analysis. Your physician might also check to see if your lymph nodes are enlarged.

The following may be indicative of skin cancer but may also be indicative of other illnesses:

• New and/or unusual bumps or growths of the skin
• Changes in the size, shape, or color of an existing mark or marks on the skin
• Bleeding of either a new or existing mark or marks on the skin

It is important you tell your doctor if you have any of these signs and symptoms, so he or she may determine their cause and plan treatment, if necessary.

“Staging” occurs when a physician uses to test and scan results to determine which parts of the body are involved by cancer, in this case, skin cancer. Staging is important because different stages of skin cancer are better addressed with treatments that may differ in amount, combination, or type. Although the staging system for melanomatous skin cancer (melanoma) is slightly different from that used for non-melanomatous skin cancers, such as basal or squamous cell carcinoma, the stages are described generally as follows based on the staging system agreed upon by the American Joint Committee on Cancer (AJCC):

Stage 0

Skin cancer with a stage of 0 (zero) means the cancer cells are confined to the upper-most layer of skin, have not spread, and may be cured by surgical removal.

Stage I

Stage I skin cancer has grown deeper into the skin than the top layer but does not involve surrounding lymph nodes or other areas of the body.

Stage II

At stage II, skin cancer has grown deeper still into the skin, and may have features, such as deeper penetration and size, indicative of being more developed, but still does not involve the lymphatic system or other parts of the body.

Stage III

Skin cancer with a stage of III indicates involvement of nearby lymph nodes but not of distant parts of the body.

Stage IV

Stage IV skin cancer has spread beyond the skin and surrounding lymph nodes.

Treatment of skin cancer, depending on the stage and type, may include chemotherapy, immunotherapy, radiation therapy, and/or surgery. These treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on a skin cancer treatment plan include

• Your age, health, and lifestyle.
• The stage of your cancer.
• Any other serious health conditions you have.
• Your feelings about the need to treat cancer right away.
• Your doctor’s opinion about if you need to treat cancer right away.
• The likelihood that treatment will help fight or cure your cancer.
• Possible side effects of each treatment method.

You may feel the need to make a quick decision, but it is very important to ask questions if there is anything about which you’re not entirely sure. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible adverse effects in order to ultimately determine which treatment option is best for you.