Published: Sept. 20, 2010
Updated: Aug. 22, 2011
Skin cancer is not one problem but a collection of separate diseases. There are three common forms of skin cancer:
Basal cell carcinoma is not only the most common form of skin cancer, but also the most frequently occurring of all human cancers. The name is derived from the skin cell that is growing in an uncontrolled fashion -- the basal cell. This is the cell type located at the base or bottom of the upper skin layer -- the epidermis.
Although basal cell carcinoma can extensively damage the skin and underlying tissues where it appears, this cancer very rarely spreads to other, more distant parts of the body unless its size becomes enormous. It does not spread through the bloodstream and almost never involves the lymph nodes (glands).
If a basal cell carcinoma is left untreated, however, it can destroy any tissue or structure in its path of growth. This is of particular concern when the basal cell carcinoma is located near the eye, ear, or nose. One cannot predict how quickly basal cell carcinomas will grow. Although they are usually slow-growing tumors, basal cell carcinomas can also grow rapidly and invade deeply.
Basal cell carcinomas initially may have the appearance of a small pimple, a non-healing or bleeding sore, a shiny bump, a cyst, or a larger, deeper growth. Discomfort and itching can occur, but these symptoms are uncommon. Unfortunately, any symptoms are not reliable indicators of whether or not any lesion is a skin cancer.
The diagnosis of a basal cell carcinoma must be confirmed with a biopsy (a surgically removed skin sample that is sent to a pathology laboratory for microscopic examination).
Squamous cell carcinoma can be a more serious skin cancer than basal cell carcinoma. The squamous cells are located above the basal cell layer in the epidermis, the outer layer of skin.
Although squamous cell carcinoma can also cause extensive tissue destruction, this tumor may also spread to the nearby glands or lymph nodes. Uncommonly, the cancer can also travel through the bloodstream to distant areas of the body.
When treated early and appropriately, squamous cell carcinoma is typically curable before it reaches the point where it can become a threat to a patient’s health.
Squamous cell carcinoma usually appears as a rough, scaly area of skin or a larger growth or bump.
Malignant melanoma, which often looks like a brown or black patch or an unusual mole, is potentially one of the most serious forms of skin cancer because melanoma has a higher likelihood of spreading inside the body (metastasizing).
Microscopically controlled (Mohs) surgery has emerged as a potential form of treatment for invasive melanoma, particularly when the cancer is located on critical areas of the face. Please discuss any questions concerning the treatment of malignant melanoma with your Mohs surgeon.
Other, less common skin cancers (such as dermatofibrosarcoma protuberans, merkel cell carcinoma, atypical fibroxanthoma, sebaceous carcinoma, etc.) can also be particularly well suited for treatment using the Mohs surgical technique. Your physician can certainly provide additional information regarding the surgical management of these unusual tumors.
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