There are differences in the types of cancer that can form in the skin, and such malignancies can form anywhere on the body, although they are most commonly found in the areas that sunlight frequently touches, such as the face, ears, arms, neck and hands. But skin cancer also can occur in those areas that are hard to see and rarely are exposed to the sun, including in the backs of the knees, palms, beneath the fingernails or toenails, and in the genital area.
Beyond a visual examination of your skin, there are specific tests that can be performed to diagnose which type you may have formed.
Basal cell carcinoma is the most common form of skin cancer, and squamous cell carcinoma is the second most common. Both are termed nonmelanoma skin cancers, and they typically don’t spread elsewhere beyond the initial area of affliction. Melanoma skin cancer can spread, but it is the rarest form of skin cancer.
Skin cancer is one of the most prevalent forms of cancer. There are more than 5 million people treated annually for the disease, which is more than the combined amount of people who have lung, prostate, breast and colon cancer. In the past 30 years, there have been more cases of skin cancer than all other cancers combined, with about 20 percent of all Americans expected to develop it at some point in their lives, according to American Cancer Society statistics.
Risky Business
There are several types of people who are more susceptible to skin cancer than others. Having one or more of these risk factors doesn’t necessarily mean you will contract the disease, and conversely, not having them does not mean you are immune.
There are several risk factors for basal cell and squamous cell carcinoma. These include having a fair complexion that easily sunburns, does not tan well and exhibits freckles; having light-colored eyes, with blue and green particularly susceptible, along with those who have red or blond hair; having the skin condition known as actinic keratosis, which can develop into skin cancer; a weak immune system or past radiation treatments; exposure to arsenic; possessing certain genes that are linked to skin cancer; and being exposed to sunlight or a tanning bed for long periods of time.
Only your doctor can determine whether changes in your skin are a sign of skin cancer or actinic keratosis. Here are six signs that you may need to see a doctor to determine your condition:
1) Areas of the skin that are shiny, smooth, raised or take on a pearl-like glint
2) Having a sore that doesn't heal
3) Having skin that resembles a scar and may be yellow, white or waxy
4) Having a raised, reddish-brown or red scar
5) A crusty, scaly or bleeding area of skin
6) The signs for actinic keratosis are similar, including a rough patch of red or brown skin and cracking in the lower lip that is not healed by lip balm or other protective coverings. Because these can develop into skin cancer, it’s wise to seek a formal diagnosis.
In the case of melanoma skin cancer, the signs are similar but are somewhat more severe. Most melanoma cancers appear on the face or trunk of a man, while women are usually affected on the lower legs. In people with darker skin tones, it can appear on the soles of their feet or palms or even under the toenails or fingernails.
Melanoma may be indicated when you have a large brown spot with dark speckles, particularly if it changes size, color, feel or begins bleeding; if you have a dark spot with an irregular border and one that has different colors in it; and if you develop dark lesions on the soles of your feet, palms, fingertips or toes. You also may develop lesions in the mucous membranes of your nose, mouth, anus or vagina.
Some less common skin cancers that can develop include Kaposi's sarcoma, which manifests in red or purple patches and is common in people with HIV/AIDS; Merkel cell carcinoma, which can appear in hair follicles or just beneath the skin as shiny nodules found on the neck, head or trunk; and sebaceous gland carcinoma, which typically begins in the oil glands in the skin and appears as hard, painless nodules that can develop anywhere but usually appear on the eyelid.
Testing for Skin Cancer
Your doctor will have several methods of testing and certain procedures that will be used to diagnose your condition and determine whether a problem is skin cancer or actinic keratosis. The first is a visual exam, wherein the doctor or a nurse will examine you for spots or bumps that appear abnormal. They are looking for areas that may be different in size, shape, texture or color from your normal skin.
If there’s a questionable area, a skin biopsy may be performed, which calls for removing all or part of the area in question. It is then examined by a trained pathologist in a lab. There are several types of skin biopsy techniques, including the shave biopsy, which uses a sterile razor blade to remove the abnormal growth; a punch biopsy, which uses a special instrument that removes a circle of the growth from the afflicted area; an incisional biopsy, which uses a scalpel to remove part of the growth; or an excisional biopsy, which uses a scalpel to take all of the growth.
Skin Cancer Prognosis
If you are determined to have skin cancer, your outlook will be determined by several factors. These include whether it has spread to other parts of the body or has embedded itself deeper into the skin; the type of cancer; how big the tumor has grown; and your general health. The key, as with any cancer, is early detection.