Melanoma and Non-Melanoma Skin Cancer

Skin cancer is the most common type of cancer in the United States. More than one million cases are diagnosed each year and according to current estimates, 40 to 50 percent of Americans who live to age 65 will have skin cancer at least once. Learning the characteristics of the most common types of skin cancer is essential to staying healthy. Early detection and diagnosis are key.

Four skin cancer types, ranging from keratosis to melanoma.What Are the Types of Skin Cancer?

There are four types of skin cancer: actinic keratosis, basal cell carcinoma, squamous cell carcinoma and malignant melanoma.

Actinic keratosis or solar keratosis is a precancerous condition that has the potential for developing into squamous cell carcinoma. It appears as rough red or brown scaly patches on the skin. They are often more easily felt than seen. Like skin cancer, it is usually found on sun-exposed areas of the body, but it can be found on other parts as well.

Basal cell carcinoma accounts for more than 90 percent of all skin cancer cases. It appears as a small pink bump or patch on the head or neck, although it may be found on any part of the body. If left untreated, it will ulcerate, bleed or crust over. Basal cell cancer is slow growing and does not usually spread to other parts of the body. However, it can spread to nearby areas and invade bone and other tissues under the skin if not treated. A person who develops basal cell cancer is at risk of developing the cancer again either in the same place or elsewhere on the body.

Squamous cell carcinoma can look like basal cell cancers, but it is usually more scaly and rough. This type of cancer is often found on the head and neck, but it has a tendency to grow on the ears, lips and the backs of arms and hands. It can also develop in other skin areas like scars or ulcers. Squamous cell carcinoma may be more aggressive than basal cell carcinoma and is also more likely to grow deep below the skin and spread to distant parts of the body. If treated early, however, this type of cancer is potentially curable. Squamous cell carcinoma is the most common skin cancer in organ transplant recipients.

Malignant melanoma is less common than basal or squamous cell carcinoma, but it is more dangerous. It usually appears as an irregular brown, black and/or red spot or changing mole. Among white men, melanoma appears most frequently on the trunk. Among white women, it appears mostly on the lower leg. Although rare in African Americans, melanoma appears most frequently on the palms, the soles of the feet and under the nails. If caught early, melanoma is potentially curable.

What Are MD Anderson Cancer Center at Cooper’s Skin Cancer Screening Guidelines?

MD Anderson at Cooper’s skin cancer screening guidelines are based on your personal risk of skin cancer.

If you are at low risk of skin cancer, pay close attention to your skin. Promptly show your health care provider any:

  • Suspicious skin area.
  • Sore that does not heal.
  • Change in a mole or freckle.

If you are at a high risk of skin cancer, get a complete skin evaluation by your health care provider every year and pay close attention to your skin. Promptly show your health care provider any:

  • Suspicious skin area.
  • Sore that does not heal.
  • Change in a mole or freckle.

You are considered high risk for skin cancer if you have one or more of the following:

  • Red hair and freckling.
  • Albinism (little or no pigment in your eyes, skin or hair).
  • Greater than 50 moles.
  • Family history of melanoma.
  • Genetic syndromes associated with increased sun sensitivity.
  • Exposure to a large amount of natural sunlight (e.g. construction workers, farmers and sunbathers).
  • History of using tanning beds or sun lamps.
  • History of blistering sunburn(s).
  • Personal history of pre-cancers, such as dysplastic nevi (abnormal moles) or actinic keratosis.
  • Personal history of basal cell and squamous cell skin cancer.
  • Prior radiation therapy.
  • Immunosuppressive therapy, especially after an organ transplant.

How Do I Check My Skin?

To check your skin, find a well lit, private area with a mirror and fully undress. Typically, before or after a bath may be most convenient.

Start with your head, scalp and face. Continue in an orderly fashion down the entire length of your body, both front and back. It is important to look for any new growths or changes. A friend can help you examine your back and scalp.

Bend your elbows and look carefully at your palms, forearms, including the undersides, and the upper arms.

Examine the back and front of your legs. Also look between your buttocks and around your genital area.

Sit and closely examine your feet, including the soles and the spaces between the toes.

When checking your skin, remember the ABCDEF’s of moles:

  • Asymmetry: Does half of the mole (or other pigmented skin spot) look different from the other half?
  • Border: Is the border of the mole irregular or ill defined?
  • Color: Is the color uneven (shades of one or more colors) or has it changed over time?
  • Diameter: Is the mole larger than a pencil eraser?
  • Elevation: Has the surface of the mole changed? If it was smooth and flat before, is it now elevated (raised)?
  • Feeling: Has the sensation (feeling) around the mole changed? Does it itch? Is it painful?

If you notice any changes or unusual moles, make an appointment with your doctor or dermatologist.

How Can Skin Cancer Be Prevented?

There are several ways to prevent skin cancer. These include:

  • Stay indoors or avoid unnecessary sun exposure, especially between the hours of 10 a.m. and 4 p.m., when the sun’s rays are the strongest.
  • Use sunscreen with a sun protection factor (SPF) of 30 or higher that protects against UVA and UVB rays.
  • Apply a sunscreen as part of your daily routine. Do so generously for maximum protection, especially on body parts easily overlooked (e.g. lips, tops of ears, head, back of neck and hands, and feet).
  • Apply sunscreen 30 minutes before going into the sun.
  • Wear protective clothing, such as wide-brimmed hats, long-sleeved shirt and pants, and sunglasses with UV protection.
  • Avoid reflective surfaces such as water, sand, snow and concrete.
  • Stay in the shade.
  • Beware of cloudy days. You can still get burned.
  • Don’t use sunlamps or tanning beds.

For an appointment with a skin cancer specialist at MD Anderson Cancer Center at Cooper, please call 855.MDA.COOPER (855.632.2667).